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Men who have sex with men (MSM) living with HIV tend to experience a range of mental health issues, in particular generalised anxiety disorder (GAD), often caused and maintained by psychosocial variables including HIV stigma, discrimination, self-esteem issues, substance abuse and loneliness. This is particularly problematic in countries like Nigeria where same sex activity is illegal and can result in up to 14 years imprisonment. An important psychological variable that may contribute to the experience of GAD are metacognitive beliefs. Participants ( N  = 311) completed measures to examine the relationship between these variables. Results indicated that metacognition was associated with, and significantly predicted, GAD in this population. Moderation analysis showed that the effect of HIV stigma on GAD was explained by the proposed interaction with metacognition. Findings suggest that metacognition may be an important variable in explaining GAD symptoms in MSM living with HIV in Nigeria., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Syncope is a frequent reason for hospitalization from the emergency department (ED), but the benefit of hospitalization is unclear. This systematic review and meta-analysis (SRMA) aims to cohere and synthesize the best current evidence regarding the potential benefit of hospitalization for ED syncope patients for developing an evidence-based ED syncope management guideline., Methods: We conducted a SRMA according to the patient-intervention-control-outcome (PICO) framework: In patients 16 years of age or older who present to the ED with syncope (population), does hospitalization (intervention) or direct ED discharge (comparison) improve short-term outcomes (outcome)? The primary outcome was a composite of all adverse events as defined by individual studies, up to 30 days. Two reviewers independently assessed articles for inclusion and methodological quality. We measured heterogeneity among included studies with I-squared statistic and used GRADE criteria to assess the quality of evidence., Results: Our search strategy identified 2140 publications and included 18 publications (510,545 participants) in the analysis. All studies reported higher rates of adverse events in hospitalized patients (0.7%-43.8%) compared to discharged patients (0%-3.7%). Our meta-analysis detected considerable statistical heterogeneity. The GRADE assessment for all adverse events and all-cause mortality revealed risk ratios of >5 favoring ED discharge for both outcomes at a median follow-up of 30 days. However, point estimates are limited by serious risk of bias, inconsistency, imprecision, indirectness, and publication bias., Conclusions: Due to the uncertainty of the available evidence, this SRMA's findings do not support a recommendation for or against hospitalizing patients presenting to ED with syncope. However, discharging low-risk patients with syncope from the ED is associated with a low risk of short-term adverse events., (© 2025 Society for Academic Emergency Medicine.)

In drug development, quantitative systems pharmacology (QSP) models are becoming an increasingly important mathematical tool for understanding response variability and for generating predictions to inform development decisions. Virtual populations are essential for sampling uncertainty and potential variability in QSP model predictions, but many clinical efficacy endpoints can be difficult to capture with QSP models that typically rely on mechanistic biomarkers. In oncology, challenges are particularly significant when connecting tumor size with time-to-event endpoints like progression-free survival while also accounting for censoring due to consent withdrawal, loss in follow-up, or safety criteria. Here, we expand on our prior work and propose an extended virtual population selection algorithm that can jointly match tumor burden dynamics and progression-free survival times in the presence of censoring. We illustrate the core components of our algorithm through simulation and calibration of a signaling pathway model that was fitted to clinical data for a small molecule targeted inhibitor. This methodology provides an approach that can be tailored to other virtual population simulations aiming to match survival endpoints for solid-tumor clinical datasets., (© 2024 Pfizer, Inc. and Vantage Research Inc. CPT: Pharmacometrics & Systems Pharmacology published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)

Objectives: To determine whether daily provision of a high protein, high energy meal for 12-weeks to under-nourished older adults living independently in the community can improve physical, physiological, and psychological outcomes., Design: A randomised crossover trial., Setting: Participant homes within a 15-mile radius to meal supplier; Dartmoor Community Kitchen Hub., Participants: Fifty-six community dwelling older adults (82 ± 7 years, 70% female) were randomised (stratified for baseline mini nutritional assessment (MNA) score and cohabiting or living alone) to receive 12-weeks of meal provision followed by 12-weeks no intervention (meals first group, n = 28), or, 12-weeks without intervention followed by 12-weeks of meal provision intervention (meals second group, n = 28)., Intervention: A daily high protein and high energy home-delivered meal for 12-weeks. Each meal contained >50% daily protein requirements (0.6 g kg -1 of the recommended 1.2 g kg -1 .day -1 , ∼42 g protein per meal) and >40% daily energy requirements (∼715 kcal)., Measurements: Physical, physiological and psychological health (including MNA score, body composition, hand grip strength, self-esteem, and depression) were evaluated in participants' homes before and after each 12-week period (baseline, 12-weeks, and 24-weeks). The effect of meal provision was assessed by t-test then effects were combined using meta-analysis. Retention of any meal provision effect after cessation of meal delivery was quantified as change from the end of the meal intervention versus 12-weeks follow-up via paired t-test., Results: The meal intervention significantly increased MNA score with a medium effect size (MNA: pooled Cohen's D = 0.74, p < 0.001). Energy and protein intake increased significantly during the control period where participants were asked to maintain their habitual diet in the meals second group (energy intake: increase = 252 kcal [95% CI 36-487 kcal], t(22) = 2.408, p = 0.025, protein intake: increase = 0.20 g kg -1 [95% CI 0.04-0.357 g kg -1 ], t(22) = 2.629, p = 0.015), which confounded the principle of a randomised crossover design analysis. When the control effect in those in the meals second group was removed from the analysis, the effect of the meal provision was much greater (meal provision significantly improved energy and protein intakes (311 kcal D = 0.52 (95% CI 0.22 to 0.82), p < 0.001; 0.24 g kg -1 D = 0.52 (0.19-0.81), p < 0.001, respectively), MNA score (2.6 points D = 1.14 (0.78-1.50), p < 0.001), and handgrip strength (1.5 kg D = 0.36 (0.06-0.66), p = 0.02), but did not change levels of depression or self-esteem). Twelve weeks after meal removal, the following % of the meal effect was retained: 68% for MNA score, 27% for negative mood score, 15% for daily energy intake, 6% for daily protein intake and 0% for handgrip strength., Conclusion: Provision of high protein, high energy meals to community dwelling older adults for 12-weeks improved nutritional status and handgrip strength, indicative of reduced frailty risk. Benefits were not retained upon withdrawal of the intervention, suggesting a need for sustained interventions in this cohort to meet nutritional needs. Home-delivered meals offer a popular, and scalable intervention for community dwelling older adults to prevent malnutrition, promote health and sustain high quality independent living thus reducing the burden of ageing and frailty on health and social care systems., (Crown Copyright © 2024. Published by Elsevier Masson SAS. All rights reserved.)

Bacterial social interactions play crucial roles in various ecological, medical, and biotechnological contexts. However, predicting these interactions from genome sequences is notoriously difficult. Here, we developed bioinformatic tools to predict whether secreted iron-scavenging siderophores stimulate or inhibit the growth of community members. Siderophores are chemically diverse and can be stimulatory or inhibitory depending on whether bacteria have or lack corresponding uptake receptors. We focused on 1928 representative Pseudomonas genomes and developed an experimentally validated coevolution algorithm to match encoded siderophore synthetases to corresponding receptor groups. We derived community-level iron interaction networks to show that siderophore-mediated interactions differ across habitats and lifestyles. Specifically, dense networks of siderophore sharing and competition were observed among environmental and nonpathogenic species, while small, fragmented networks occurred among human-associated and pathogenic species. Together, our sequence-to-ecology approach empowers the analyses of social interactions among thousands of bacterial strains and offers opportunities for targeted intervention to microbial communities.

Background: Nipple-sparing mastectomy (NSM) has become increasingly popular in recent years. However, the impact of prepectoral versus subpectoral implant reconstruction on nipple position, clinical outcomes, and patient-reported outcomes (PROs) after NSM remains unknown., Objective: We hypothesized that prepectoral reconstruction would lead to a more anatomic nipple position and improved clinical outcomes and PROs as compared to subpectoral reconstruction following NSM., Methods: Surgical characteristics, complications, and PROs in NSM patients with implant-based reconstruction from 2018 to 2021 were prospectively collected. Nipple displacement from baseline was analyzed using three-dimensional (3D) surface imaging., Results: 216 patients underwent 391 NSMs, separated into subpectoral (n = 96) and prepectoral (n = 120) cohorts. There were no differences in demographic and comorbidities between cohorts. Prepectoral showed a greater incidence of short-term return to OR (21% vs 10%, p=0.026). 3D analysis for 96 patients and 175 nipple positions were conducted. Compared to preoperative baseline, 3D imaging at 12 months postoperatively showed that the subpectoral cohort had greater straight-line distance between the nipples (23.1 mm vs 17.3 mm, p<0.001) and more lateral nipple displacement (9.2 mm vs 6.1 mm, p<0.001) as compared to the prepectoral cohort. Regression analysis found no relationship between incision pattern and nipple displacement. No postoperative differences were seen in PROs., Conclusions: Subpectoral NSM reconstruction was found to have more lateralized nipple displacement as compared to prepectoral patients, regardless of incision pattern used. Nipple displacement after NSM can play a significant role in postoperative aesthetic appearance and should be considered when deciding implant plane., (© The Author(s) 2025. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objectives: Approximately 10% of patients with syncope have serious or life-threatening causes that may not be apparent during the initial emergency department (ED) assessment. Consequently, researchers have developed clinical decision rules (CDRs) to predict adverse outcomes and risk stratify ED syncope patients. This systematic review and meta-analysis (SRMA) aims to cohere and synthesize the best current evidence regarding the methodological quality and predictive accuracy of CDRs for developing an evidence-based ED syncope management guideline., Methods: We conducted a systematic literature search according to the patient-intervention-control-outcome question: In patients 16 years of age or older who present to the ED with syncope for whom no underlying serious/life-threatening condition was found during the index ED visit (population), are risk stratification tools (intervention), better than unstructured clinical judgment (i.e., usual care; comparison), for providing accurate prognosis and aiding disposition decision for outcomes within 30 days (outcome)? Two reviewers independently assessed articles for inclusion and methodological quality. We performed statistical analysis using Meta-DiSc. We used GRADEPro GDT software to determine the certainty of the evidence and create a summary of the findings (SoF) tables., Results: Of 2047 publications obtained through the search strategy, 31 comprising 13 CDRs met the inclusion criteria. There were 13 derivation studies (17,578 participants) and 24 validation studies (14,845 participants). Only three CDRs were validated in more than two studies. The San Francisco Syncope Rule (SFSR) was validated in 12 studies: positive likelihood ratio (LR+) 1.15-4.70 and negative likelihood ratio (LR-) 0.03-0.64. The Canadian Syncope Risk Score (CSRS) was validated in five studies: LR+ 1.15-2.58 and LR- 0.05-0.50. The Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk score was validated in five studies: LR+ 1.16-3.32 and LR- 0.14-0.46., Conclusions: Most CDRs for ED adult syncope management have low-quality evidence for routine clinical practice use. Only three CDRs (SFSR, CSRS, OESIL) are validated by more than two studies, with significant overlap in operating characteristics., (© 2024 The Author(s). Academic Emergency Medicine published by Wiley Periodicals LLC on behalf of Society for Academic Emergency Medicine.)

We provide a broad overview of our original investigation of working memory; how the multicomponent model followed from our use of a dissociative methodology; and our intention that it should be simple, robust, and applicable. We describe how subsequent development of the model has increased its scope, depth, and applications while at the same time retaining its core features. Comparisons with the growing number of alternative models suggest agreement on the basic phenomena to be explained and more similarities than differences. While differences between models attract interest, we caution that they do not necessarily reflect the most important issues for future research, which we suggest relate principally to the nature of executive control. The longevity of the multicomponent model reflects not only the importance of working memory in cognition but also the usefulness of a simple, robust framework for further theoretical development and applications. [ABSTRACT FROM AUTHOR]

Working memory is an active system responsible for the temporary maintenance and processing of information in the support of cognition and action. In keeping with this, a growing body of research has explored the close links between working memory and attention, and how these might be harnessed to impact performance and possibly improve working memory efficiency. This is theoretically and practically important, given that working memory is a central hub in complex cognition yet is extremely capacity- and resource-limited. We review work carried out over the last 10 years or so looking at how high "value" items in working memory can be strategically prioritised through selective attention, drawing principally from visual working memory paradigms with young adult participants, while also discussing how the core effects extend to different task domains and populations. A consistent set of core findings emerges, with improved memory for items that are allocated higher value but no change in overall task performance, and a recency advantage regardless of point allocation when items are encountered sequentially. Value-directed prioritisation is effortful, under top-down strategic control, and appears to vary with perceptual distraction and executive load. It is driven by processes operating during encoding, maintenance, and retrieval, though the extent to which these are influenced by different features of the task context remains to be mapped out. We discuss implications for working memory, attention, and strategic control, and note some possible future directions of travel for this promising line of research. [ABSTRACT FROM AUTHOR]

In this study, we examine whether overconfident CEOs strive to smooth dividends. Our findings show overconfident CEOs increase dividends more as earnings increase and decrease dividends less as earnings decline, resulting in downward dividend stickiness. This asymmetric dividend payout is consistent with the selective self-attribution bias. Furthermore, the effect of managerial overconfidence on dividend stickiness is more pronounced for firms without catering incentives. In addition, overconfident CEOs do not manage share repurchases as they do for dividends. Therefore, we do not find a positive effect of managerial overconfidence on total payout stickiness. [ABSTRACT FROM AUTHOR]

Water scarcity remains a significant challenge to agricultural sustainability in semi-arid and Mediterranean regions, with Kermanshah Province, Iran, exemplifying this issue. This study evaluates water resource dependency and water stress in Kermanshah's agricultural sector from 2010 to 2019, using comprehensive water footprint indicators, including the Water Stress Index (WSI), Agricultural Water Stress Index (AWSI), Blue Water Scarcity Index (BWS), and Regional Agricultural Water Footprint Intensity (AWFI). Plant-related data, such as evapotranspiration, effective rainfall, crop water requirements, and irrigation needs, were estimated using NETWAT (Network for Water and Agriculture Technologies) software alongside the FAO-Penman-Monteith (Food and Agriculture Organization)-Penman-Monteith equation. The results reveal that producing 26.62 million tons of crops (field and orchard crops) required a total water footprint of 159.8 Gm 3 , with field crops contributing over 90% of the total. Blue water, representing surface and groundwater resources, was the largest component (71.99%), followed by green water (16.86%) and gray water (11.14%). Among orchard crops, walnuts exhibited the highest total water footprint (4,079.75 m 3 /ton) under irrigated conditions, while, grapes had a total water footprint of 626.63 m 3 /ton. For field crops, chickpeas demonstrated a high-water footprint due to irrigation demand and fertilizer use, with a total of 4,646 m 3 /ton. Water stress indices showed persistent resource pressure. The BWS index exceeded 0.8 in all years, peaking at 0.93 in 2016, while the AWSI peaked at 0.87 in 2013, highlighting severe agricultural water scarcity. Water deprivation reached a maximum of 8,380 MCM in 2014, driven by low rainfall and overextraction of water resources. Although precipitation improvements in 2018-2019 slightly alleviated pressure, increased agricultural demand prevented significant recovery. The findings underscore the urgent need for sustainable water management strategies, including advanced irrigation technologies, optimized fertilizer application, and cultivation of high-yield, water-efficient crops., Competing Interests: Declarations. Ethical approval: All the authors have read and understood and have complied as applicable with the statement on “Ethical responsibilities of Authors” as found in the Instructions for Authors. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

From attentional prioritization to enhanced memory, self-cues trigger a variety of effects within human cognition. Recent work suggests that self-reference may also enhance working memory, possibly via attentional prioritization. However, there is no direct evidence that self-cues enhance working memory capacity, or that such boosts covary with individuals' attentional function. Here, we provide the first direct evidence of enhanced working memory capacity for self-referential cues, independent of attentional processing. We adapted a verbal working memory complex span to create a 'Self' condition (featuring the participant's own name), 'Other' condition (featuring a non-self-name), and Control condition (with no name), in 7-9-year-old children (Exp.1, N = 71) and adults (Exp.2, N = 52). In both experiments, the Self condition elicited significantly higher spans than the other conditions (Exp 1: p < .001, η p 2  = .32; Exp 2: p < .001, η p 2  = .25), but this increase in capacity was unrelated to measures of attentional processing or backward digit span. Moreover, equivalent boosts were observed in children and adults, despite adults' significantly higher underlying capacity. We propose a chunking interpretation based on enhanced binding of self-associated items, directly benefiting individual's working memory capacity regardless of their current attentional competence or 'baseline' capacity., (© 2025 The Author(s). British Journal of Psychology published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

The regulation of Visual Working Memory (VWM) distraction resistance by internal attention remains debated with four hypotheses: the null hypothesis (attentional priorities don't affect distraction resistance), protection hypothesis (higher priority, greater distraction resistance), vulnerability hypothesis (higher priority, lower distraction resistance), and available resource threshold hypothesis (distraction resistance depends on attentional resource allocation exceed required thresholds). A recent study found that temporal attention can influence VWM priorities, yet this hasn't been explored from the perspective of temporal attention. This study used a continuous reporting task to examine these issues. Experiment 1 established stable attentional priority using an auditory cue, while Experiment 2 removed this cue to introduce dynamic priority changes. To explore neural mechanisms, Experiment 3 employed EEG to measure contingent negative variation (CNV) and decode priority representations during the delay period. Behavioral results confirmed that visual distractors increased memory deviation during maintenance, but deviations were smaller for anticipated high-priority items, suggesting better memory accuracy. High-priority items showed greater resistance to distraction at long intervals. Without the auditory cue, high-priority items resisted distraction better at short intervals. EEG results revealed enhanced CNV before long interval targets and better decoding of priority with distractors during long intervals. In summary, distraction affects different priority items equally when resources exceed requirements. High-priority items resist interference when adequately resourced but suffer if resources are insufficient, supporting the available resource threshold hypothesis. This study highlights the temporal dynamics of distraction resistance in VWM representations., Competing Interests: Declarations. Ethics approval: APA ethical standards were followed in the conduct of this study, and the study was approved by Shandong Normal University ethics committee (approval ID:SDNU2023056). Consent to participate: Before commencing with the experiment, all participants provided informed consent. Consent for publication: Not applicable. Conflicts of interest: The authors do not have any conficts of interests., (© 2025. The Psychonomic Society, Inc.)

This work addresses the role of accurate input data in hydrological model simulations and explores the often-overlooked errors associated with evapotranspiration (ET). While existing literature primarily focuses on uncertainties in rainfall, this study underscores the necessity of considering errors in ET, as evidenced by some studies suggesting their substantial impact on hydrological model responses. A comprehensive exploration of uncertainty quantification resulting from errors in ET in hydrological model simulations is presented, highlighting the imperative to scrutinize this facet amidst diverse uncertainties. There are two approaches for addressing uncertainty in potential evapotranspiration (PET) inputs as discussed: directly considering uncertainty in PET data series or accounting for uncertainty in the parameters used for PET estimation. Furthermore, details are provided about the existing error models for PET measurements, revealing a limited number of studies that specifically account for ET-related uncertainties. Researchers commonly address ET errors by considering both systematic and random errors; some studies suggest that systematic errors in PET have a more substantial impact compared to random errors on hydrological model responses. In summary, the objective of this paper is to offer an in-depth exploration of uncertainty associated with PET inputs and their influence on hydrological modeling., Competing Interests: The authors declare there is no conflict., (© 2025 The Authors This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits copying, adaptation and redistribution, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/).)

Cognitive reserve (CR) and busyness can boost memory, whereas stress can impair memory. Nevertheless, extant research has not yet examined busyness in conjunction with CR and stress, nor whether CR or stress moderate the relationship between busyness and episodic memory. Middle-aged and older adult participants (N = 71; ages 50-74; 31% African-American) answered lifestyle questionnaires and completed a visual paired-associate memory fMRI task. Dimension reduction techniques identified two latent CR factors-personal CR (own education; occupation complexity; socioeconomic status) and parental education (mother's/father's education), and identified two latent stress factors-external stress (neighborhood stress/violence; financial strain) and personal stress (perceived stress; work/personal stress). We cast these latent factors into a series of regression models, revealing that (1) in isolation, higher busyness predicted better episodic memory, (2) higher external stress predicted worse memory, (3) both greater personal CR and greater parental education predicted better memory, (4) busyness did not interact with stress nor with CR, and (5) in a combined model, higher parental education and lower external stress were significant independent predictors. Neuroimaging data revealed that higher CR was associated with more efficient brain activity in the hippocampus and posterior cingulate during successful episodic memory retrieval, whereas higher personal stress was associated with heightened activity in the precuneus. No interactions or main effects of busyness were observed for the fMRI data. Thus, although busyness was associated with superior episodic memory, busyness did not modulate brain activity during episodic memory retrieval, nor did CR or stress moderate the relationship between busyness and associative memory., Competing Interests: Declarations. Ethics approval: This study was approved by the institutional review board (IRB) at the University of Alabama. Consent to participate: All participants provided written informed consent and were treated within the ethical guidelines of the American Psychological Association (APA) and the Declaration of Helsinki. Consent for publication: Not applicable. No identifying personal information is reported. Conflicts of interest/competing interests: The authors have no relevant financial or non-financial interests to disclose., (© 2024. The Psychonomic Society, Inc.)

The pathophysiology of restless legs syndrome (RLS) remains incompletely understood. Although several studies have investigated the alterations of brain connectivity as one of the pathophysiological mechanisms of RLS, there are only few reports on functional connectivity changes after RLS treatment. Forty-nine patients with newly diagnosed RLS and 50 healthy controls were prospectively enrolled. The patients underwent resting-state functional magnetic resonance imaging (rs-fMRI) at baseline, and 39 patients underwent follow-up rs-fMRI, 3 months after treatment with pramipexole or pregabalin. Patients were divided into good or poor medication response groups. Functional brain connectivity was analysed using rs-fMRI and graph theoretical analysis. Significant differences in functional connectivity were observed between the RLS patients and healthy controls. The average path length, clustering coefficient, transitivity, and local efficiency were lower (2.02 vs. 2.30, p < 0.001; 0.45 vs. 0.56, p < 0.001; 3.08 vs. 4.21, p < 0.001; and 0.71 vs. 0.76, p < 0.001, respectively) and the global efficiency was higher (0.53 vs. 0.50, p < 0.001) in patients with RLS than in healthy controls. Differences in functional connectivity at the global level were also observed between post- and pre-treatment RLS patients who showed a good medication response. Transitivity in the post-treatment group was higher than that in the pre-treatment group (3.22 vs. 3.04, p = 0.007). Global efficiency was positively correlated with RLS severity (r = 0.377, p = 0.007). This study demonstrates that RLS is associated with distinct alterations in brain connectivity, which can be partially normalised following symptom management. These findings suggest that therapeutic interventions for RLS modulate brain function, emphasising the importance of symptom-focussed treatment in managing RLS., (© 2024 European Sleep Research Society.)

The application of quantitative systems pharmacology (QSP) has enabled substantial progress and impact in many areas of therapeutic discovery and development. This new technology is increasingly accepted by industry, academia, and solution providers, and is enjoying greater interest from regulators. In this chapter, we summarize key aspects regarding how effective collaboration among institutions and disciplines can support the growth of QSP and expand its application domain. We exemplify these considerations through a selection of successful cross-institutional or cross-functional collaborations, which resulted in reuse, repurposing, or extension of QSP modeling results or infrastructure, with important and novel results., (© 2024. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

In this chapter, we envision the future of Quantitative Systems Pharmacology (QSP) which integrates closely with emerging data and technologies including advanced analytics, novel experimental technologies, and diverse and larger datasets. Machine learning (ML) and Artificial Intelligence (AI) will increasingly help QSP modelers to find, prepare, integrate, and exploit larger and diverse datasets, as well as build, parameterize, and simulate models. We picture QSP models being applied during all stages of drug discovery and development: During the discovery stages, QSP models predict the early human experience of in silico compounds created by generative AI. In preclinical development, QSP will integrate with non-animal "new approach methodologies" and reverse-translated datasets to improve understanding of and translation to the human patient. During clinical development, integration with complementary modeling approaches and multimodal patient data will create multidimensional digital twins and virtual populations for clinical trial simulations that guide clinical development and point to opportunities for precision medicine. QSP can evolve into this future by (1) pursuing high-impact applications enabled by novel experimental and quantitative technologies and data types; (2) integrating closely with analytical and computational advancements; and (3) increasing efficiencies through automation, standardization, and model reuse. In this vision, the QSP expert will play a critical role in designing strategies, evaluating data, staging and executing analyses, verifying, interpreting, and communicating findings, and ensuring the ethical, safe, and rational application of novel data types, technologies, and advanced analytics including AI/ML., (© 2024. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Background: The deep inferior epigastric perforator (DIEP) flap is currently the gold standard for autologous breast reconstruction. In cases where the DIEP is contraindicated, the profunda artery perforator (PAP) flap is now the preferred second-line option in our institution. The PAP flap poses unique challenges to the reconstructive surgeon, especially in Asian women with low body mass index (BMI). Herein, we share the unique technical pearls when performing breast reconstruction in this population., Methods: This is a retrospective cohort studies, where data were collected on all consecutive patients who underwent breast reconstruction by the senior author, from June 2015 to February 2023. Only patients who underwent the PAP free flap reconstructions were included in this study. The PAP flap design was based on the transverse pattern in the upper medial third of the thigh. The flap is inset in the transverse fashion in the mastectomy pocket, utilizing either the internal mammary pedicle, lateral thoracic pedicle, or the thoracodorsal pedicle., Results: A total of 32 free PAP flaps were performed for 31 Asian patients. The average age was 39.5 years old (range 25-60), and the average BMI was 21.3 (range 18.5-27.4). An average of 5.0 of myocutaneous perforators (range 1-7) can be identified in each donor site. The average flap was 7.8 cm wide (range 6-10), 21.3 cm long (range 15-30), weighing 259.6 g (range 145-555), with an average of 1.3 perforators (range 1-3) and a pedicle length 5.9 cm (range 4-10). The critical steps to a successful reconstruction with the PAP flap lie with the appropriate patient selection, pre-operative imaging, flap design, inset, and donor site management., Conclusions: East Asian women tend to have lower BMI and smaller breasts and are good candidates for the PAP flap., (© 2025 Wiley Periodicals LLC.)

Diverse drivers such as climate, soil fertility, neighborhood competition, and functional traits all contribute to variation in tree stem demographic rates. However, these demographic drivers operate at different scales, making it difficult to compare the relative importance of each driver on tree demography. Using c. 20,000 stem records from New Zealand's temperate rain forests, we analyzed the growth, recruitment, and mortality rates of 48 tree species and determined the relative importance of demographic drivers in a multilevel modeling approach. Tree species' maximum height emerged as the one most strongly associated with all demographic rates, with a positive association with growth rate and negative associations with recruitment and mortality rates. Climate, soil properties, neighborhood competition, stem size, and other functional traits also played significant roles in shaping demographic rates. Forest structure and functional composition were linked to climate and soil, with warm, dry climates and fertile soil associated with higher growth and recruitment rates. Neighborhood competition affected demographic rates depending on stem size, with smaller stems experiencing stronger negative effects, suggesting asymmetric competition where larger trees exert greater competitive effects on smaller trees. Our study emphasizes the importance of considering multiple drivers of demographic rates to better understand forest tree dynamics., (© 2024 The Ecological Society of America.)

Droughts are a natural hazard of growing concern as they are projected to increase in frequency and severity for many regions of the world. The identification of droughts and their future characteristics is essential to building an understanding of the geography and magnitude of potential drought change trajectories, which in turn is critical information to manage drought resilience across multiple sectors and disciplines. Adding to this effort, we developed a dataset of global historical and projected future drought indices over the 1980–2100 period based on downscaled CMIP6 models across multiple shared socioeconomic pathways (SSP). The dataset is composed of two indices: the Standardized Precipitation Index (SPI) and Standardized Precipitation Evapotranspiration Index (SPEI) for 23 downscaled global climate models (GCMs) (0.25-degree resolution), including historical (1980–2014) and future projections (2015–2100) under four climate scenarios: SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5. The drought indices were calculated for 3-, 6- and 12-month accumulation timescales and are available as gridded spatial datasets in a regular latitude-longitude format at monthly time resolution. [ABSTRACT FROM AUTHOR]

Mitigating environmental impacts is an urgent challenge supported by (scientific) intensive care societies worldwide. However, making green choices without compromising high-quality care for critically ill patients may be challenging. The current paper describes a three-step approach towards green intensive care units. Starting with the measurement of environmental sustainability, intensive care units can identify hotspots, quantify the environmental impacts of products and procedures, and monitor sustainable progress. Subsequently, a multidisciplinary approach is proposed to improve environmental sustainability, including a collaboration of procurement specialists and healthcare professionals, using co-creation and green teams as efficient grassroots change agents. A context-specific approach for enhancing sustainable healthcare practices is key in order to fit local regulatory requirements and create support of professionals. A final step is to share results and create momentum, including publishing initiatives and participating in online (inter)national networks. Based on the core sustainability principles, this three-step approach towards green ICUs provides a valuable tool to professionals worldwide to facilitate change towards environmentally responsible intensive care units. [ABSTRACT FROM AUTHOR]

Nickel catalysis has experienced a renaissance over the past two decades, driven by its ability to access diverse oxidation states (0 to +4) and unique reactivity. This review consolidates the advancements in nickel chemistry, providing an overview of ligands that stabilize specific nickel oxidation states. The stability, reactivity, and catalytic applications of Ni0 sources, including in situ generation from air- and moisture-stable NiII precursors, are discussed, along with the roles of NiI and NiIII intermediates in catalytic cycles. The progress in synthesizing and utilizing NiIV complexes highlights their emerging importance in catalysis. Advances in spectroscopic and theoretical tools have enhanced the understanding of nickel's complex catalytic behavior. [ABSTRACT FROM AUTHOR]

Protein N-glycosylation, as one of the most crucial post-translational modifications, plays a significant role in various biological processes. The structural alterations of N-glycans are closely associated with the onset and progression of numerous diseases. Therefore, the precise and specific identification of disease-related N-glycans in complex biological samples is invaluable for understanding their involvement in physiological and pathological processes, as well as for discovering clinical diagnostic biomarkers. However, protein N-glycosylation suffers from microscopic heterogeneity and low abundance in biological systems, leading to N-glycopeptide signals being overshadowed by those of their non-glycosylated counterparts during mass spectrometry (MS) analysis. Consequently, there is an urgent demand for the development of novel methods for highly efficient N-glycan enrichment. In this study, we introduced a novel hydrophilic nanomaterial, nitrogen-modified reduced graphene oxide (N-rGO), tailored for this purpose, which was formed by a condensation reaction between the amino groups of rGO and the carboxyl groups of Fmoc-Photo-Linker. Compared to other enrichment materials, N-rGO not only supports efficient N-glycans enrichment via hydrophilic interaction (HILIC), but also serves as an effective matrix for direct MALDI-TOF MS analysis combined with DHB, thereby avoiding sample loss during N-glycans release. 76 and 81 serum N-glycans were obtained from 3 healthy individuals and 3 hepatocellular carcinoma (HCC) patients. Notably, relative quantification of serum N-glycans between 20 patients and 20 healthy controls showed significant expression differences, such as H5N4F1S1, H6N5F1, H5N4S2, H5N4F2S1 and H5N5F1S1, indicating the potential of N-rGO for biomarker discovery. [ABSTRACT FROM AUTHOR]

A novel and efficient synthesis of 3- and 2-substituted indoles starting from 2-(2-nitro-1-phenylethyl or 2-nitro-1-alkyl)cyclohexanones and 1,4-diketones, respectively, using a catalytic amount of Pd/C and 1-octene system is reported. [ABSTRACT FROM AUTHOR]

Introduction: Digital health technologies have vastly improved monitoring, diagnosis, and care during pregnancy. As expectant mothers increasingly engage with social media, online platforms, and mobile applications, these innovations present valuable opportunities to enhance the quality of maternal healthcare services. Objective: This review aims to assess the applicability, outcomes, and recent advancement of digital health modalities in antenatal care. Method: We conducted a scoping review by searching four electronic databases (Scopus, Web of Science, PubMed, EBSCOhost), performing manual searches of Google Scholar, and examining the references of relevant studies. Eligible studies included original research published in English between 2010 and 2024 involving the use of digital health technologies for antenatal care, complying with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review guidelines. Results: One hundred twenty-six eligible articles were identified, with the majority (61.11%) conducted in high-income countries, including the United States, United Kingdom, and Australia. Digital health studies have increased over time, driven by telehealth adoption in affluent nations. Interventions predominantly focused on patient-provider consultations, remote monitoring, and health education, complementing in-person visits or as a substitute when necessary. High levels of acceptance and satisfaction were reported among users. These interventions primarily targeted general maternal care (28.57%), gestational diabetes mellitus (15.07%), and mental health (13.49%) while also addressing gestational weight management, hypertensive disorders, high-risk pregnancies and maternal education. The findings demonstrated positive outcomes in managing clinical conditions, enhancing knowledge, promoting birth preparedness, and improving antenatal care access and utilisation. Additionally, the findings revealed the cost-effectiveness of these approaches in alleviating financial burdens for patients and healthcare systems. Conclusion: Digital health is emerging as a pivotal tool in maternal and child care, fostering positive outcomes and high acceptance among patients and healthcare providers. Its integration into antenatal care ensures the maintenance of standard care quality, with no adverse effects reported despite limited discussions on safety and privacy concerns. As these technologies continue to evolve, they are set to redefine antenatal care by offering more accessible, efficient, and patient-centred solutions, ultimately shaping the future of maternal healthcare delivery. [ABSTRACT FROM AUTHOR]

Background: Developing countries’ public health systems struggle with digital health implementation, and reports of low digital health readiness exist within the workforce. This study investigates the perceived digital health readiness of healthcare leaders in operational management to implement digital health tools. Methods: A cross-sectional survey using the E-Ready 2.0 scale was used to measure digital health readiness (n = 329) in 11 hospitals in the Western Cape, South Africa (September 2023 – March 2024). Descriptive statistics summarised respondent characteristics and the E-Ready 2.0 subscales: conditions for change at the workplace and among individuals, support and engagement from management, colleagues’ readiness, consequences for the status quo and workplace attitudes. Statements scoring 60% or more were considered to have higher readiness. Chi-square and Mann–Whitney U tests were used to examine associations between demographic variables and subscale statements. Results: A total of 143 healthcare leaders responded (56.1% response rate) (n = 114 nurses [79.7%], n = 29 medical doctors [20.3%]). The average age was 46.4 ± 10.0 years. Overall, higher levels of readiness (above 70%) were observed with statements related to workplace attitudes, whereas conditions for change at the workplace and among individuals showed lower readiness (below 50%). Conclusion: Despite significant investment in digital health tools, there remains limited digital health readiness among those responsible for leading these implementations. [ABSTRACT FROM AUTHOR]

Variability of myoelectric activity during walking is the result of human capability to adapt to both intrinsic and extrinsic perturbations. The availability of sEMG signals lasting at least some minutes (instead of seconds) is needed to comprehensively analyze the variability of surface electromyographic (sEMG) signals. The current study introduces a dataset of long-lasting sEMG signals recorded during walking sessions of 31 healthy subjects, aged between 20 and 30 years, conducted at the Movement Analysis Lab of Università Politecnica delle Marche, Ancona, Italy. The sEMG signals were captured from ten distinct lower-limb muscles (five per leg), including gastrocnemius lateralis (GL), tibialis anterior (TA), rectus femoris (RF), hamstrings (Ham), and vastus lateralis (VL). Synchronized electrogoniometric and foot-floor-contact signals are also supplied to enable the spatial/temporal analysis of the sEMG signals. The experimental procedure involves subjects walking barefoot on level ground for approximately 5 minutes at their natural speed and pace, following an eight-shaped path featuring linear diagonal segments, curves, accelerations, and decelerations. An advanced analysis of the sEMG signals was performed to test the reliability and usability of the current dataset. The considerable duration of the signals makes this dataset particularly useful for studies where a significant volume of data is crucial, such as machine/deep learning approaches, investigations examining the variability of muscle recruitment during physiological walking, validations of the reliability of novel sEMG-based algorithms, and assembly of reference datasets for pathological condition characterization. [ABSTRACT FROM AUTHOR]