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Aims: Valgus subsidence of uncemented tibial components following medial unicompartmental knee arthroplasty (UKA) poses a challenge in the early postoperative phase, necessitating a comprehensive understanding of its prevalence, risk factors, and impact on patient outcomes., Methods: This prospective multicentre study analyzed 97 knees from 90 patients undergoing UKA across four participating hospitals. A standardized surgical technique was employed uniformly by all participating surgeons. Postoperative evaluations were conducted preoperatively, and one day, four weeks, three months, and one year postoperative, encompassing weightbearing radiographs, bone mineral density assessments, and clinical outcome reports using the Forgotten Joint Score and Oxford Knee Score. Statistical analyses, including non-parametric correlation analysis using the Kendall correlation coefficient and Mann-Whitney U test, were performed to explore associations between subsidence and various patient-related or radiological parameters., Results: A total of eight patients showed more than 2° valgus subsidence (8.2%), higher than previously reported rates. There were significant correlations between subsidence and higher preoperative varus alignment of the tibia, larger adaptation of the preoperative varus to a postoperative neutral or valgus alignment, mediolateral undersizing of the tibial component, excessive lateral load of tibial component by more lateral position of femoral component relative to tibial component, a lower T-score, and female sex. Our study found no significant difference in pain scores between subsidence and non-subsidence groups at various postoperative milestones., Conclusion: These findings corroborate earlier suggested risk factors based on biomechanical models. Further research might provide the opportunity to identify high-risk groups preoperatively and adapt treatment strategies for these patients., Competing Interests: C. Depuydt reports course faculty payments from ConMed Europe and support for attending meetings from Zimmer Biomet, unrelated to this study. F. Hardeman reports consulting payments from Zimmer Biomet, unrelated to this study. J. Victor reports royalties or licenses from Smith & Nephew, payments or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Medacta, and a leadership or fiduciary role in BVOT, the European Knee Society, and the Belgian Knee Society, all of which are unrelated to this study., (© 2025 Gallant et al.)

The Brain Tumor Group (BTG) of the European Organization for Research and Treatment of Cancer (EORTC) conducts academic clinical trials and translational research to improve clinical management of patients with primary and secondary brain tumors. The EORTC BTG has traditionally played an important role in providing evidence and thus advancing the field, albeit with a main focus on radiotherapy and pharmacotherapy in gliomas. Although examples of well-designed neuro-oncological surgical trials can be found, evidence in surgical neuro-oncology predominantly includes data from uncontrolled prospective series or retrospective cohorts. By means of a thorough literature and EORTC database review, we demonstrate, firstly, that while the pathway of the neuro-oncology patient most often starts with neurosurgery, its several aspects have traditionally been poorly acknowledged in clinical trials in neuro-oncology. We also show that the definitions and methods of assessment vary greatly between studies, limiting generalizability. The newly established Neurosurgery Committee of the EORTC BTG aims to address this gap by increasing the number of prospective surgical trials, but also the involvement of neurosurgeons in clinical trial design, promoting standardized terminology for description of the surgical aspects, including extent of resection. We will also explore alternative trial designs when randomization is deemed difficult, as well as focus on defining surgical quality indicators that influence outcome. By addressing these challenges, the committee aims to enhance the quality of neurosurgical evidence in neuro-oncology and define optimal surgical methods and standards of care. This should ultimately improve outcomes and quality of life for patients with brain tumors through evidence-based surgical interventions., Competing Interests: Declaration of Competing Interest PK, MB, JG, GP, AJ, RG, RG, MJ, GW, MN, TP, CQ, TG, GM report no COI JD is editorial board member of Neuro-Oncology practice and was not involved in the editorial review or the decision to publish this article. TP is member of the editorial board of Neurosurgical Review (advisory board) and was not involved in the editorial review or the decision to publish this article. MB is in the editorial board of Acta Neurochirurgica and Brain and Spine and was not involved in the editorial review or the decision to publish this article. MJ is editorial board member of Neuro-Oncology and was not involved in the editorial review or the decision to publish this article. GM is an Editorial Board Member of Neuro-Oncology, Radiotherapy and Oncology, Journal of Neuro-Oncology; Associate Editor of Neuro-Oncology Practice, Neuro-oncology Advance and was not involved in the editorial review or the decision to publish this article. MP is executive editor of Neuro-Oncology and was not involved in the editorial review or the decision to publish this article. JD has received honoraria for advisory board participation from Miltenyi, Servier E.L.R. has received research grants from Bristol Meyers Squibb (BMS), and honoraria for lectures or advisory board participation or consulting from Bayer, Biodexa / Sitoxi, Janssen, Leo Pharma, Pierre Fabre, Roche, Seattle Genetics, and Servier. MP has received honoraria for lectures, consultation or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, BMJ Journals, MedMedia, Astra Zeneca, AbbVie, Lilly, Medahead, Daiichi Sankyo, Sanofi, Merck Sharp & Dome, Tocagen, Adastra, Gan & Lee Pharmaceuticals, Janssen, Servier, Miltenyi, Böhringer-Ingelheim, Telix, Medscape, OncLive. MW has received research grants from Novartis, Quercis and Versameb, and honoraria for lectures or advisory board participation or consulting from Anheart, Bayer, Curevac, Medac, Neurosense, Novartis, Novocure, Orbus, Pfizer, Philogen, Roche and Servier., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The lake riparian zone (LRZ) is a key area of material circulation between terrestrial and aquatic ecosystems. However, the exchange of endocrine disrupting compounds (EDCs) in this area is still unknown. Thus, in this study, the distribution, convection and microbial response of two typical EDCs, bisphenol A (BPA) and nonylphenol (NP), in submerged (SS) and temporarily flooded sediment (FS) of LRZ were investigated by in-situ diffusive gradients in thin films technology. Concentrations of BPA (11.07 ± 2.49 μg/kg) and NP (20.42 ± 8.23 μg/kg) in FS significantly fluctuated with depth, conversely, their concentrations in SS increased steadily with depth (BPA: 14.01 ∼ 74.76 μg/kg; NP: 14.14 ∼ 137.01 μg/kg). BPA and NP dynamics analysis based on the DIFS (DGT-induced fluxes in sediments) model and fugacity fraction showed the water-sediment exchange capacity of BPA and NP in SS was on average 2-3 times higher than in FS. Some bacterial genera involved in nitrogen metabolism can effectively transform BPA and NP, such as Pseudomonas, Novosphingobium, and Sphingomonas, which are more active in oxygenic FS than in hypoxic SS. Considering this evidence as well as an increasing EDCs pollution, the behavior and quantification of EDCs at the water-sediment interface of the LRZ merits a further investigation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Early maladaptive schemas are well-established mechanisms between childhood maltreatment (i.e., abuse and neglect) and psychopathology in adulthood. However, research has not yet examined the unique contribution of childhood maltreatment, while controlling for the family dysfunction-related experiences, in shaping specific EMS domains and their associations with distinct psychopathological outcomes., Objective: Our aim was to examine the unique role of childhood maltreatment, while controlling for the effects of family dysfunction on early maladaptive schemas and subsequently on personality disorders and psychological distress using structural equation modelling and network analysis., Methods: A total of 2,011 unique inpatients aged 18 to 80 years (M = 39.7, SD = 14.18; 53.4% women) admitted to the Alexianen Zorggroep Tienen Psychiatric Hospital between 2011 and 2021 were included in this study. Self-report questionnaires were completed as part of the hospital admission process. Data were analyzed using structural equation modeling and network analysis., Results: The results showed positive associations between childhood maltreatment, family dysfunction, early maladaptive schema domains, symptoms of personality disorders, and psychological distress. Accounting for the effects of family dysfunction-related experiences, early maladaptive schema played a significant mediating role in the association between childhood maltreatment and psychopathological outcomes. The results highlighted the central role of the domains disconnection/rejection and impaired autonomy/performance for personality disorders and psychological distress. There were no significant gender-specific differences in the network of relationships between the variables., Conclusions: These results demonstrate the key role of EMS in the domains of disconnection/rejection and impaired autonomy/performance in the association between childhood maltreatment and personality pathology and psychological distress in psychiatric inpatients. Clinical implications, study limitations, and recommendations for future research are discussed., Competing Interests: Declaration of competing interest On behalf of all authors, the corresponding author declares that there are no conflicts of interest related to this manuscript., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Background: The German cockroach Blattella germanica is a notorious urban health pest that has developed resistance to multiple pesticides. Thus, novel non-lethal pest control agents are urgently needed. Olfaction interference via disruption of sex pheromone recognition-related genes offers a promising approach. The German cockroach has a unique courtship behavior in which female adults emit contact sex pheromones (CSPs) in response to antennal touching, which subsequently triggers distinctive male sex behavioral responses. Due to the limited volatility of CSPs, the molecular mechanisms underlying their recognition and the specific olfactory pathways activated remain poorly defined. Although the odorant receptor coreceptor (Orco) is critical for most insect olfaction, sensory neuron membrane proteins (SNMPs), in particular SNMP1, also play crucial roles in sex pheromone recognition in moths and flies. While multiple SNMP1 homologs have been identified in multiple insect species, they have yet to be fully functionally characterized in cockroaches., Results: In this study, RNA-interference (RNAi)-mediated knockdown of BgerOrco reduced both the electrophysiology responses and courtship behaviors of males, indicating CSP perception proceeds via an olfaction pathway. Similar RNAi knockdown of BgerSNMP1e and BgerSNMP1d, which are predominantly expressed in male antennae, revealed critical roles in perceiving the major component of the Blattella germanica CSP blend. Unlike BgerSNMP1e, BgerSNMP1d was also found to function in the perception of the minor CSP component. Molecular docking analyses revealed no differences in the binding affinities of BgerSNMP1d for the major and minor CSP components, whereas the binding affinities of BgerSNMP1e displayed clear selectivity for the major component., Conclusion: Our results show that the olfactory pathway is critical for CSP recognition and that two male-enriched SNMP genes, BgerSNMP1e and BgerSNMP1d, are crucial factors mediating the male response to CSP stimulation in German cockroaches. This study lays a foundation for studying the mechanisms of CSP recognition and provides novel molecular targets with potential to be exploited as disruptors of courtship behavior. © 2024 Society of Chemical Industry., (© 2024 Society of Chemical Industry.)

Advances in affinity chromatography now make it possible to analyze immunoglobulin G from plasma and its fractions with a simple chromatographic method. Ligands derived from camelid antibodies have been developed which have affinity to all 4 subclasses of human IgG without a cross reactivity to other immunoglobulins. The commercially available Capture Select FcXL is the basis for a simple method for direct quantification of immunoglobulin G from plasma or from fractions from cold ethanol precipitation. After direct injection of the sample into the column the unbound proteins are washed out with equilibration buffer and eluted with a pH-step. The elution the peak is integrated, and quantity is derived form a standard curve. The limit of detection with 40 µg/mL, and a linearity up to 250 µg/mL allows an analysis of samples ranging from 0.04 to 50 mg/mL using varying injection volume without further dilution and the two-wavelength detection. A full cycle is completed within five minutes. This method can serve as orthogonal method for in-process control but also for process development.

Background: Advanced education of midwives acting during the first 1000 days in life is key in optimum care provision for intergenerational health and wellbeing., Aim: This paper provides a comprehensive analysis of the current context of midwifery care and (inter)national trends in midwifery education. Gaps for optimizing midwifery education in Belgium are defined., Results: Societal, medical, and technological changes including medicalization of birth impact the midwife's profession and competency requirements. The World Health Organization demands adapted midwifery competency frameworks to meet these changes and achieve universal health coverage by 2030. While the European Union's directives address the recognition of professional qualifications of midwives, basic midwifery programs in Europe range from vocational to master's programs. In Belgium, basic midwifery programs are direct-entry bachelor programs; however, the program length varies according to the region. A horizon scanning by the Belgian Health Care Knowledge Center concluded that an extension and advancement of the current midwifery program are urgently needed to enable midwives to fulfil an autonomous role in accordance with national laws and international directives., Discussion: Basic midwifery education anno 2023 does not fit (1) the changes in women's health towards 2030; (2) the future demands regarding midwifery competence, and (3) the current and future demands for autonomy according to the legal frameworks., Conclusion: An extension and advancement of the basic midwifery programs are needed to sufficiently arm midwives to meet changes they are confronted with. Therefore, a debate involving all stakeholders concerned with the future of midwifery care and education is recommended., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: In individuals with chronic musculoskeletal pain, a reciprocal relationship between sleep and pain across short and long-term evaluations exists. Sleep influences pain levels, while the level of pain also impairs sleep. However, given the day-to-day variability of both sleep and pain intensity, assessing this relationship within a daily time frame should be considered., Objectives: To systematically review the literature concerning the bidirectional day-to-day relationship between night-time sleep variables and day-time pain intensity in individuals with chronic musculoskeletal pain., Methods: A systematic search (final search on October 12, 2023) in four databases (PubMed, Web of Science, Embase, PsycInfo) identified eligible articles based on pre-defined criteria. Three independent reviewers executed data extraction and risk of bias assessment using the "Quality In Prognosis Studies" tool. The study findings were synthesized narratively., Results: Eleven articles (1014 study participants; 83 associations) were included. A bidirectional relationship between pain intensity and sleep was found. Nine articles indicated night-time sleep quality to be a more consistent predictor for next day pain intensity than vice versa., Conclusion: Nonetheless the bidirectional day-to-day sleep-pain relationship in individuals with chronic musculoskeletal pain, results suggest that self-reported sleep quality has a stronger predictive value on pain intensity then vice versa., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Physicians have significant influence on end-of-life decisions. Therefore, it is important to understand the connection between physicians' personal end-of-life care preferences and clinical practice, and whether there is congruence between what they prefer for themselves and for patients., Aim: Study to what extent physicians believe their personal end-of-life preferences impact their clinical practice and to what extent physicians' personal treatment option preferences differ from what they prefer for their patients., Design: A cross-sectional survey was conducted from May 2022 to February 2023., Setting/participants: Eight jurisdictions: Belgium, Italy, Canada, USA (Oregon, Wisconsin, and Georgia), and Australia (Victoria and Queensland). Three physician types were included: general practitioners, palliative care physicians, and other medical specialists., Results: We analyzed 1157 survey responses. Sixty-two percent of physicians acknowledge considering their own preferences when caring for patients at the end of life and 29.7% believe their personal preferences impact the recommendations they make. Palliative care physicians are less likely to consider their own preferences when caring for and making recommendations to patients. Congruence was found between what physicians prefer for patients and themselves with cardiopulmonary resuscitation considered "not a good option for both" by 99.1% of physicians. Incongruence was found with physicians considering some options "not good for the patient, but good for themselves"-palliative sedation (8.3%), physician-assisted suicide (7.0%), and euthanasia (11.6%)., Conclusion: Physicians consider their own preferences when providing care and their preferences impact the recommendations they make to patients. Incongruence exists between what physicians prefer for themselves and what they prefer for patients., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Competing Interests: Competing interests: The author declares no competing interest.

Introduction: Fibromyalgia syndrome (FMS) causes significant pain, disability, and costs among patients. It is paramount that healthcare professionals have an updated knowledge of its characteristics and Clinical Practice Guidelines (CPGs)., Objectives: To determine the knowledge, adherence to CPGs, and confidence of Italian physiotherapists in managing patients with FMS, explore barriers to the implementation of CPG' recommendations, compare groups' adherence to CPGs, and determine which variables explained most of the participants' knowledge., Methods: The survey was administered via social media and newsletter (i.e., Italian Association of Physiotherapists, AIFI) to Italian practicing physiotherapists. The protocol of this work was prospectively registered in the Open Science Framework., Results: Total replies were 398. Italian physiotherapists showed a good knowledge of FMS and adherence to CPGs. Ninety-one percent reported a medium or lower confidence in managing patients with FMS. Sixty-seven percent judged their knowledge of CPGs as poor or very poor. The remaining 33% mentioned patients' psychosocial aspects, multidisciplinary relationships, and lack of training on communication strategies as the main barriers to the implementation of CPGs. Being an Orthopaedic Manipulative Physical Therapist (OMPT) resulted in a better adherence to CPGs on 11/14 items. Knowledge scores were correlated (r = 0.244) with being an OMPT (Stand β = 0.123) and years of professional activity (Stand β = -0.126)., Conclusions: Although Italian physiotherapists demonstrated a good knowledge of FMS and reported a good adherence to CPGs' recommendations, they may still experience barriers to the implementation of evidence-based management strategies., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Persistent inflammation leading to neuronal sensitization in pain pathways, are key features of chronic inflammatory pain. Alike macrophages in the periphery, glial cells exacerbate hypersensitivity by releasing proalgesic mediators in the central nervous system. Expressed by peripheral and central immune cells, the cystine-glutamate antiporter system x c - plays a significant role in inflammatory responses, but its involvement in chronic inflammatory pain remains underexplored. We herein investigated the contribution of this exchanger in nociceptive hypersensitivity triggered by a peripheral inflammatory insult., Methods: Complete Freund's adjuvant (CFA) was injected into the left hind paw of wild-type C57Bl/6 female mice, of xCT-deficient mice (specific subunit of system x c - ) and of mice receiving the system x c - inhibitor sulfasalazine. Paw edema was measured over three weeks and pain-associated behaviors were evaluated. Additionally, pro-inflammatory cytokine levels were assessed in blood samples., Results: CFA injection led to a persistent increase in paw edema and hypersensitivity to mechanical and thermal stimuli, which were less pronounced in xCT-deficient mice. This reduced sensitivity was accompanied by lower systemic pro-inflammatory cytokine levels in xCT-deficient mice. Accordingly, pharmacological inhibition of system x c - with sulfasalazine, either before or after pain induction, efficiently reduced the algesic and inflammatory responses to CFA in wild-type mice., Conclusion: Our findings reveal a critical role for system x c - in the pathophysiology of inflammatory pain. xCT deficiency reduces pain behaviors and peripheral inflammation, positioning system x c - as a promising therapeutic target for alleviating chronic inflammatory pain., Competing Interests: Declaration of Competing Interest None, (Copyright © 2025. Published by Elsevier Ltd.)

The older population is diversifying. Extensive research has shown the preference of older adults to age in place. Recent research shows that older migrants also prefer to age in place. However, not much is known about their reasons for doing so. Therefore, this paper focuses on older migrants who are ageing in placee and explores their home experiences both in the material and immaterial setting of home. In-depth interviews using photo-elicitation with older migrants (n = 23) from Limburg, Belgium were conducted. The results depart from older migrants' strong wish to age in place, which can be explained by the sense of familiarity the long-inhabited dwelling and neighbourhood provide, which concerns both a material and immaterial setting. However, the material setting of home can become a threat to ageing in place, as the interviews reveal, through physical obstacles and housing maintenance. Furthermore, the immaterial setting of home also comes into play as participants referred to their ethnic identity in discussing home experiences. The results further discuss the interrelatedness of material and immaterial settings of home. Interestingly, migration background did not always appear as relevant variable in older migrants home experiences. Instead, participants' interviews were more often imbued with age-related narratives. This shows the shifting influence of diverse variables (e.g. age, migration, gender), highlighting the importance of adopting an intersectional lens. Moreover, the results point to the dynamic nature of participants' sense of home, both in terms of 'age' (e.g. changing needs) and 'migration' (e.g. changing ethnic identity)., Competing Interests: Declarations. Competing Interests: The authors have no competing interests to declare that are relevant to the content of this article., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Primary ovarian insufficiency (POI) is an important cause of female infertility, stemming from follicle dysfunction or premature oocyte depletion. Pathogenic variants in genes such as NOBOX, GDF9, BMP15, and FSHR have been linked to POI. NOBOX, a transcription factor expressed in oocytes and granulosa cells, plays a pivotal role in folliculogenesis. Loss-of-function variants in NOBOX are reported in 1-2% of POI women. This study aims to describe the association of novel NOBOX variants with a distinct oocyte, zygote, and embryo maturation arrest (OZEMA) phenotype in infertile women., Methods: Three unrelated women experiencing OZEMA and undergoing multiple in vitro fertilization (IVF) cycles present with a germline NOBOX variant. The detected variants were cross-referenced with a large genetic database to explore their association with IVF outcomes., Results: A heterozygous NM_001080413.3 (NOBOX): c.1797_1798del, p.(Cys600Phefs*27) variant was detected in a woman with oocyte maturation arrest. Another heterozygous variant, NM_001080413.3 (NOBOX): c.1849C > T, p.(His617Tyr), was detected in two women experiencing embryonic developmental arrest. Segregation analysis in one of the two latter families revealed the presence of the p.(His617Tyr) variant in an affected sister, while the two fertile sisters did not carry this variant. Furthermore, the p.(His617Tyr) variant was found in three women in a large database of whom two presented with an embryonic developmental arrest., Conclusion: Two heterozygous NOBOX variants were identified in women with an OZEMA phenotype. Where pathogenic NOBOX variants are typically linked to POI, our clinical findings suggest that NOBOX plays a role in subsequent oocyte maturation and early embryo development., Competing Interests: Declarations. Ethics approval: Ethical approval was obtained from the Institutional Review Board of the Universitair Ziekenhuis Brussel (B.U.N. 143201836854). Written informed consent was obtained from all the participants prior to their inclusion in the study. Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

In schema therapy early adaptive schemas (EASs) and early maladaptive schemas (EMSs) have been found to be independent but related constructs. The Young Positive Schema Questionnaire (YPSQ) was developed and validated in English to measure EASs. The present study investigated psychometric properties of the Dutch translation in a representative sample of 650 non-clinical Dutch individuals. Internal consistencies for all scales were assessed to be acceptable to good. The 14-factor model showed an adequate to good fit to the data. Considering the construct validity, the YPSQ-NL scales showed significant positive correlations with the Big 5 personality traits, life-satisfaction, self-esteem and positive affect, and significant negative correlations with negative affect. Incremental validity of EASs over and above EMSs was shown for these same measures, except positive affect. Construct validity with the Young Schema Questionnaire-S3 (YSQ-S3) showed significant negative correlations between the YPSQ-NL scales and YSQ-S3 negative related constructs, except for Healthy Self-interest/Self-care and Self-sacrifice. Directions for future studies, e.g. in clinical samples, are discussed.

Deep eutectic solvents (DES) have an emerging scientific role, assisting modern pharmaceutics. They are uniquely supporting the resolution of crucial issues, such as the effective extraction and isolation of bio-actives. They act as media and catalysts for pharmaceutical drug synthesis, and as green solvents and modifiers in pharmaceutical analysis. Their role in pharmaceutical formulation and drug delivery is also up-and-coming, for instance, as alternative drug-solubilizing agents, drug stabilizers and functional additives, as therapeutic deep eutectic solvents, deep eutectic API, and monomers and reaction media for the synthesis of biomaterials for advanced drug delivery. The DES also help transforming medicinal/pharmaceutical chemistry. Although DES were described in 1918, their first pharmaceutical use is only reported in 1960. In view of their broad applicability in pharmaceutics, it may be interesting to review their history, origin, evolution, potential advantages, limitations, and specific applications as green solvents. A chronological and comparative study of the literature showed the important role of DES in green approaches for modern pharmaceuticals. The concepts, applications, and outcomes of DES in pharmaceutical analysis, formulation/drug delivery, and pharmaceutical/medicinal chemistry are presented. A comprehensive outline of the atypical applications of DES as effective green solvents in pharmaceutical bioactive extraction was assessed. Efforts to present classifications of DES explored in pharmaceuticals were also made. The present manuscript also covers computational trend, adds on commercial aspects with potential future applications of DES in pharmaceutical sciences., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier B.V.)

Biphasic in vitro oocyte maturation (IVM) can be offered as a patient-friendly alternative to conventional ovarian stimulation in in vitro fertilization (IVF) patients predicted to be hyper-responsive to ovarian stimulation. However, cumulative live birth rates after IVM per cycle are lower than after conventional ovarian stimulation for IVF. In different animal species, supplementation of IVM media with oocyte-secreted factors (OSFs) improves oocyte developmental competence through the expression of pro-ovulatory genes in cumulus cells. Whether the addition of OSFs in human biphasic IVM culture impacts the transcriptome of oocytes and cumulus cells retrieved from small antral follicles in minimally stimulated non-hCG-triggered IVM cycles remains to be elucidated. To answer this, human cumulus oocyte complexes (COCs) that were fully surrounded by cumulus cells or partially denuded at the time of retrieval were cultured in a biphasic IVM system either without or with the addition of pro-cumulin, a GDF9: BMP15 heterodimer. Oocytes and their accompanying cumulus cells were collected separately, and single-cell RNA-seq libraries were generated. The transcriptomic profile of cumulus cells revealed that pro-cumulin upregulated the expression of genes involved in cumulus cell expansion and proliferation while downregulating steroidogenesis, luteinization and apoptosis pathways. Moreover, pro-cumulin modulated the immature oocyte transcriptome during the prematuration step, including regulating translation, apoptosis and mitochondria remodeling pathways in the growing germinal vesicle (GV) oocytes. The addition of pro-cumulin also restored the transcriptomic profile of matured metaphase II (MII) oocytes that were partially denuded at collection. These results suggest that cumulus cell and oocyte transcriptome regulation by pro-cumulin may increase the number of developmentally competent oocytes after biphasic IVM treatment. Future studies should assess the effects of pro-cumulin addition in human biphasic IVM at the proteomic level and the embryological outcomes, particularly its potential to enhance outcomes of oocytes that are partially denuded at COC collection., (© The Author(s) 2025. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

The convoluted relationships between plants, viruses, and arthropod vectors housing bacterial endosymbionts are pivotal in the spread of harmful plant viral diseases. Endosymbionts play key roles in: manipulating host responses, influencing insect resistance to pesticides, shaping insect evolution, and bolstering virus acquisition, retention, and transmission. This interplay presents an innovative approach for developing sustainable strategies to manage plant diseases. Recent progress in targeting specific endosymbionts through genetic modifications, biotechnological advancements, and RNA interference shows potential for curbing viral spread and disease progression. Additionally, employing synthetic biology techniques like CRISPR/Cas9 to engineer endosymbionts and disrupt crucial interactions necessary for viral transmission in arthropod vectors holds promise for effective control measures. In this review, these obligate and facultative bacterial cruxes have been discussed to elaborate on their mechanistic involvement in the regulation and/or inhibition of tripartite pathways of interactions. Furthermore, we provide an in-depth understanding of endosymbionts' synergistic and antagonistic effects on: insect biology, plant immunity, and virus acquisition and transmission. Finally, we point out open questions for future research and provide research directions concerning the deployment of genetically engineered symbionts to affect plant-virus-vector interactions for sustainable disease management. By addressing existing knowledge gaps and charting future research paths, a deeper comprehension of the role of endosymbionts in plant-virus-vector interactions can pave the way for innovative and successful disease management strategies. The exploration of antiviral therapies, paratransgenesis, and pathogen-blocking tactics using engineered endosymbionts introduces pioneering solutions for lessening the impact of plant viral diseases and green pest management.

Arginase-1 (ARG-1) is a promising target for cancer immunotherapy, but the small size and the highly polar nature of its catalytic site present significant challenges for inhibitor development. An alternative strategy to induce enzyme inhibition by targeting protein oligomerization has been developed recently, offering several advantages such as increased selectivity, promotion of protein degradation, and potential substoichiometric inhibition. In this study, we demonstrated that only trimeric ARG-1 is active, which was confirmed by producing monomeric arginase-1. Through in silico -driven site-directed mutagenesis, we identified an allosteric site involving five key amino acids responsible for ARG-1 trimerization. We further demonstrated the covalent modification of a key arginine residue within this pocket using phenylglyoxal disrupted ARG-1 oligomerization. Although phenylglyoxal has limited potency, it effectively supports the concept of ARG-1 inhibition via homomeric disruption, validating this allosteric targeting approach.

Biological organisms engineer peptide sequences to fold into membrane pore proteins capable of performing a wide variety of transport functions. Synthetic de novo-designed membrane pores can mimic this approach to achieve a potentially even larger set of functions. Here we explore water, solute, and ion transport in three de novo designed β-barrel membrane channels in the 5-10 Å pore size range. We show that these proteins form passive membrane pores with high water transport efficiencies and size rejection characteristics consistent with the pore size encoded in the protein structure. Ion conductance and ion selectivity measurements also show trends consistent with the pore size, with the two larger pores showing weak cation selectivity. MD simulations of water and ion transport and solute size exclusion are consistent with the experimental trends and provide further insights into structure-function correlations in these membrane pores.

Introduction: The incidence of Legionnaires' disease (LD) steadily increases worldwide. Although Legionella pneumophila is known as pathogenic, systematic investigations into antibiotic resistance are scarce, and reports of resistance in isolates are recently emerging., Methods: Clinical cases and metadata reported to the Belgian National Reference Centre between 2011 and 2022 were retrospectively analysed. 283 clinical isolates were typed by cgMLST. Acquired genes or mutations triggering resistance were extracted from all of them., Results: The number of LD cases has increased in Belgium. Urinary antigen testing remains the main used test, but PCR and serology allow the diagnostic in 14.8% and 2.4% of cases. cgMLST showed a good discrimination between STs and minimal variation for ST47 isolates, while ST1's were more diverse. Genotypic screening identified a 23S rRNA mutation linked to a high-level macrolide resistance in one isolate of ST188, which is genetically closed to resistant isolates from France., Conclusion: The raise in incidence is of concern and is likely an under-estimate due to the reliance on urine antigen testing. Routine typing by cgMLST allows good discrimination and the first clinical isolate reported as resistant for macrolides was cultured, underscoring the need to define resistance breakpoints and incorporate AST as routine clinical investigation practice., Competing Interests: Declaration of Competing Interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier Ltd.)

Focal facial dermal dysplasia (FFDD) type IV is a rare inherited facial defect caused by biallelic variants in CYP26C1. This study reports two novel Belgian FFDD type IV cases, both homozygous for a recurrent CYP26C1 frameshift variant, with a common 700 kb haplotype, indicating a founder effect., (© 2025 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/Objectives : Inadequate dosing and respiratory motion contribute to local recurrence for oligometastatic disease (OMD). While short-term LC rates are well-documented, data on long-term LC remain limited. This study investigated long-term LC after stereotactic body radiotherapy (SBRT), using respiratory motion management techniques. Methods: This retrospective study took place at UZ Brussel with follow-up until Oct 2024. It analyzed oligometastatic patients treated with SBRT between Jul 2012 and Feb 2017. Treatment involved delivering 50 Gy in 10 fractions on the 80% isodose line, building on data from a prior prospective study. Lesion movement was managed using internal target volume (ITV) or dynamic tumor tracking (DTT) with marker. The primary endpoint of the study was long-term LC and identifying variables associated with it using a Cox proportional hazards model. Results : A total of 100 patients were treated for a total of 211 metastatic lesions. Lesions were predominantly in the lungs (74%) and treated using ITV (88%). LC rates at 1, 3, 5, and 10 years were 76.5%, 53.8%, 38.1%, and 36.3%, respectively. Improved LC was observed in locations other than lung and liver (HR: 0.309; p = 0.024) and with increasing age (HR: 0.975; p < 0.010). Worse LC was seen in liver lesions (HR: 1.808; p = 0.103) and systemic therapy post-radiotherapy (HR: 3.726; p < 0.001). No significant associations were found with tumor size or tumor motion, nor between the two motion management strategies used (DTT and ITV). Conclusions : Appropriate motion management is key in LC for OMD. No significant difference in LC was found between both techniques. Lesion location, patient age, and systemic therapy post-radiotherapy were prognostic factors for LC.

3D pose estimation and gesture command recognition are crucial for ensuring safety and improving human-robot interaction. While RGB-D cameras are commonly used for these tasks, they often raise privacy concerns due to their ability to capture detailed visual data of human operators. In contrast, using RaDAR sensors offers a privacy-preserving alternative, as they can output point-cloud data rather than images. We introduce mmPrivPose3D, a dataset of 3D RaDAR point-cloud data that captures human movements and gestures using a single IWR6843AOPEVM RaDAR sensor with a frequency of 10 Hz synchronized with 19 corresponding 3D skeleton keypoints as the ground truth. These keypoints were extracted from RGB-D images captured by an Intel RealSense camera recorded at 30 frames per second using the Nuitrack SDK, and labeled with gestures. The dataset was collected from n = 15 participants. Our dataset serves as a fundamental resource for developing machine learning algorithms to improve the accuracy of pose estimation and gesture recognition using RaDAR data., (© 2025 The Author(s).)

Structural, architectural, contractile or electrophysiological alterations may occur in the left atrium (LA). The concept of LA cardiopathy is supported by accumulating scientific evidence demonstrating that LA remodeling has become a cornerstone diagnostic and prognostic marker. The structure and the function of LA and left atrial appendage (LAA) which is an integral part of the LA, are key elements for a better understanding of multiple clinical conditions, most notably atrial fibrillation (AF), cardioembolism, heart failure and mitral valve diseases. Rational use of various imaging modalities is key to obtain the relevant clinical information. Accordingly, this clinical consensus document from the European Association of Cardiovascular Imaging, in collaboration with the European Heart Rhythm Association, provides comprehensive, up-to-date, and evidence-based guidance to cardiologists and cardiac imagers for the best practice of imaging LA and LAA for the diagnosis, management and prognostication of the patients., (© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. 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.)

Background: Booklice, belonging to the genus Liposcelis (Psocodea: Liposcelididae), commonly known as psocids, infest a wide range of stored products and are implicated in the transmission of harmful microorganisms such as fungi and bacteria. The olfactory system is critical for insect feeding and reproduction. Elucidating the molecular mechanisms of the olfactory system in booklice is crucial for developing effective control strategies. In this study, we aim to bridge this knowledge gap by leveraging the transcriptome and genome data from five Liposcelis species., Result: Using HMMER method and manual annotation, we have identified common gene families associated with olfactory processes, including odorant binding proteins (OBPs), chemosensory proteins (CSPs), odorant receptors (ORs), ionotropic receptors (IRs), and sensory neuron membrane proteins (SNMPs). Specifically, we identified 94, 118, 26, 47, and 34 olfactory-related genes in L. bostrychophila, L. tricolor, L. entomophila, L. decolor, and L. yangi, respectively. Comparison of quantities revealed that the number of ORs and IRs in the genome is significantly higher than those identified in the transcriptome. This discrepancy may be due to the specific expression of these genes in certain tissues or their lack of expression during the experimental stage. Simultaneously, analysis of gene expression profiles across different developmental stages revealed varying periods of peak expression for olfactory-related genes. These results suggest that the identification of olfactory-related genes in booklice on a genome-wide scale is more feasible and reliable than using a transcriptome-based approach. Additionally, compared to parasitic lice, booklice possess significantly more olfactory-related genes. This increase may be due to the inability of parasitic lice to survive without a host, whereas booklice have a wide range of feeding habits and live in complex and variable environments. Furthermore, we observed that the IR gene family in L. tricolor has undergone a certain degree of amplification, which may facilitate its adaptation to diverse environmental conditions., Conclusions: We identified olfactory-related genes of five Liposcelis species for the first time, providing valuable insights for future functional investigations into olfactory genes associated with pheromone and odorant recognition. These discoveries present promising targets for effectively managing psocid pests., Competing Interests: Declarations. Ethics approval and consent to participate: No special permits were required to collect booklice. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Introduction: Clinical staging aims to refine psychiatric diagnosis by describing mental disorders on a continuum of disorder progression, with the pragmatic goal of improved treatment planning and outcome prediction. The first systematic review on this topic, published a decade ago, included 78 papers, and identified separate staging models for schizophrenia, unipolar depression, bipolar disorder, panic disorder, substance use disorder, anorexia, and bulimia nervosa. The current review updates this review by including new proposals for staging models and by systematically reviewing research based upon full or partial staging models since 2012., Methods: PsycINFO, MEDLINE, EMBASE, and the Cochrane databases were systematically searched from 2012 to June 2023. The original review's eligibility criteria were used and extended with newly introduced categories of DSM-5 mental disorders, along with mental disorders for which a progressive course might be expected. Included papers: a) contained a complete or partial staging model, or b) focused upon clinical features that might be associated with stages, or c) focused upon treatment research associated with specific stages., Results: Seventy-one publications met the inclusion criteria. They described staging models for schizophrenia and related psychoses (21 papers), bipolar (20), depressive (4), anxiety (2), obsessive-compulsive (3), trauma related (4), eating (3), personality disorders (2), and 'transdiagnostic' staging models (13)., Discussion: There is a steady but slow increase in interest in clinical staging and evidence for the validity of staging remains scarce. Staging models might need to be better tailored to the complexities of mental disorders to improve their clinical utility., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42021291703., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Clarke, Soons, Videler, van Alphen, Van, Dil, Pappijn, Corbeij, Broekhof, Chanen and Hutsebaut.)

The fall armyworm, Spodoptera frugiperda , is one of the most notorious pest insects, causing damage to more than 350 plant species, and is feared worldwide as an invasive pest species since it exhibits high adaptivity against environmental stress. Here, we therefore investigated its transcriptome responses to four different types of stresses, namely cold, heat, no water and no food. We used brain samples as our interest was in the neuroendocrine responses, while previous studies used whole bodies of larvae or moths. In general, the responses were complex and encompassed a vast array of neuropeptides (NPs) and biogenic amines (BAs). The NPs were mainly involved in ion homeostasis regulation (ITP and ITPL) and metabolic pathways (AKH, ILP), and this was accompanied by changes in BA (DA, OA) biosynthesis. Cold and no-water stress changed the NP gene expression with the same patterns of expression but clearly separated from each other, and the most divergent pattern of expression was shown after no-food stress. In conclusion, our data provide a foundation in an important model and pest insect with candidate NPs and BAs and other marker candidate genes in response to environmental stress, and also potential new targets to manage pest insects.

The advent of accurate methods to predict the fold of proteins initiated by AlphaFold2 is rapidly changing our understanding of proteins and helping their design. However, these methods are mainly trained on protein structures determined with X-ray diffraction, where the protein is packed in crystals at often cryogenic temperatures. They can therefore only reliably cover well-folded parts of proteins that experience few, if any, conformational changes. Experimentally, solution nuclear magnetic resonance (NMR) is the experimental method of choice to gain insight into protein dynamics at near physiological conditions. Computationally, methods such as molecular dynamics (MD) simulations and Normal Mode Analysis (NMA) allow the estimation of a protein's intrinsic flexibility based on a single protein structure. This work addresses, on a large scale, the relationships for proteins between the AlphaFold2 pLDDT metric, the observed dynamics in solution from NMR metrics, interpreted MD simulations, and the computed dynamics with NMA from single AlphaFold2 models and NMR ensembles. We observe that these metrics agree well for rigid residues that adopt a single well-defined conformation, which are clearly distinct from residues that exhibit dynamic behavior and adopt multiple conformations. This direct order/disorder categorisation is reflected in the correlations observed between the parameters, but becomes very limited when considering only the likely dynamic residues. The gradations of dynamics observed by NMR in flexible protein regions are therefore not represented by these computational approaches. Our results are interactively available for each protein from https://bio2byte.be/af&#95;nmr&#95;nma/., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Lung cancer is mostly a disease of aging with approximately half of newly diagnosed patients being 70 years or older. Treatment decisions in this population pose unique challenges because of their heterogeneity with regards to daily functioning, cognition, organ function, comorbidities and polypharmacy, their underrepresentation in clinical trials and the impact of treatment on patient-centered outcomes, particularly in frail patients. The advent of targeted therapies and immunotherapy has revolutionized the management of advanced non-small cell lung cancer (NSCLC). Molecular profiling has allowed for the identification of actionable genomic alterations and targeted therapies have become standard of care for oncogene-driven NSCLC, significantly improving prognosis and quality of life. However, the data on the efficacy and tolerability of these treatments in older patients remain sparse. This review, conducted by the International Society of Geriatric Oncology (SIOG) NSCLC task force, examines the available literature on the use of targeted therapies in patients aged 70 years or older with oncogene-driven NSCLC. The task force's expert recommendations aim to guide treatment decisions for older patients with oncogene driven NSCLC., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Background: Continuous veno-venous hemodiafiltration (CVVHDF) is used in critically ill patients, but its impact on O₂ and CO₂ removal, as well as the accuracy of resting energy expenditure (REE) measurement using indirect calorimetry (IC) remains unclear. This study aims to evaluate the effects of CVVHDF on O₂ and CO₂ removal and the accuracy of REE measurement using IC in patients undergoing continuous renal replacement therapy., Design: Prospective, observational, single-center study., Methodology: Patients with sepsis undergoing CVVHDF had CO₂ flow (QCO₂) and O₂ flow (QO₂) measured at multiple sampling points before and after the filter. REE was calculated using the Weir equation based on V̇CO₂ and V̇O₂ measured by IC, using true V̇CO₂ accounting for the CRRT balance, and estimated using the Harris-Benedict equation. The respiratory quotient (RQ), the ratio of V̇CO₂ to V̇O₂, was evaluated by comparing measured and true values., Results: The mean QCO₂ levels measured upstream of the filter were 76.26 ± 17.33 ml/min and significantly decreased to 62.12 ± 13.64 ml/min downstream of the filter (p < 0.0001). The mean QO₂ levels remained relatively unchanged. The mean true REE was 1774.28 ± 438.20 kcal/day, significantly different from both the measured REE of 1758.59 ± 434.06 kcal/day (p = 0.0029) and the estimated REE of 1619.36 ± 295.46 kcal/day (p = 0.0475). The mean measured RQ value was 0.693 ± 0.118, while the mean true RQ value was 0.731 ± 0.121, with a significant difference (p < 0.0001)., Conclusions: CVVHDF may significantly alter QCO₂ levels without affecting QO₂, influencing the REE and RQ results measured by IC. However, the impact on REE is not clinically significant, and the REE value obtained via IC is closer to the true REE than that estimated using the Harris-Benedict equation. Further studies are recommended to confirm these findings., Competing Interests: Declarations. Ethics approval and consent to participate: All research procedures complied with the Declaration of Helsinki and the Medical University of Lublin Bioethics Committee guidelines. Approval was obtained from the Medical University of Lublin Bioethics Committee, approval number KE-0254/74/2021. Informed consent was obtained from each patient to participate in the study. If the patient’s condition did not permit this, consent was obtained from the patient’s legally authorized representative or closest family member. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests., (© 2025. The Author(s).)

Purpose: This survey aimed to assess the public's knowledge and opinions on oocyte donation (OD) among a large, unselected cohort of young Belgian women, and to explore aspects that could be enhanced to promote future OD programs., Methods: We conducted a quantitative, epidemiological, cross-sectional web-based survey from February 2023 to April 2023. A private questionnaire was distributed to young women (21-30 years) living in Belgium via a digital link. The survey covered socio-demographic characteristics, knowledge about the OD procedure, compensation, personal attitudes, motivations and perceptions about anonymity assurance., Results: A total of 390 women responded to the online questionnaire, with a drop-out rate of 10%. The survey revealed a good level of knowledge about the procedural aspects of OD, which did not influence willingness to donate. Only 19% of respondents were willing to donate, while 39.1% hesitated, particularly regarding private OD. No significant association was found between personal values and willingness to donate. Altruism emerged as the main motivation for gamete donation. Attitudes towards anonymity varied, with childless and older individuals more reluctant to reveal their identity., Conclusions: Our study confirms that a small portion of the population is willing to donate oocytes, while a considerable proportion (39%) is hesitating. These findings highlight the urgent need for global education programs to raise awareness and address concerns that may prevent women from participating in OD programs., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Educational programs for health-care providers increasingly implement culturally sensitive care. Clear methods for educating students in cultural awareness are still lacking. Research indicates that simply increasing knowledge on ethnicity, culture, or migration does not improve culturally sensitive behavior and can foster stereotypes. To overcome barriers like othering, a form of micro-racism, enhanced critical self-awareness is essential for health-care providers. Aim: A 4h module on culturally sensitive care was designed, implemented, and evaluated, with the aim of increasing nursing students' self-awareness about othering, racism, and exclusion in health care. Methods: This article describes (1) the content of the module, led by the Johari Window model and the needs and insights from nursing students and health-care providers, (2) implementation of the module, and (3) subsequent evaluation among 34 participants. Results: The survey findings were categorized into six themes: Understanding Differences and Prejudices, Applying Knowledge in the Context of Nursing Practice, Acquiring Insights through Interpersonal Engagement, Strengths of the Sessions, Weaknesses and Areas for Improvement, and Overall Impressions. The participants evaluated the module positively, identifying success factors (e.g., enhanced self-reported awareness of their own positionality) and working points (e.g., imbalance in interaction among students and time constraints). Conclusion: The study describes the design, implementation, and evaluation of a module that successfully increases nursing students' self-reported cultural competence and self-awareness, enhancing understanding of health-care inequalities and fostering open communication for more inclusive care., 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.

Rationale: Early detection, standardized therapy, adequate infrastructure and strategies for quality improvement should constitute essential components of every hospital's sepsis plan., Objectives: To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute hospitals., Methods: A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals. This included the use of sepsis definitions, the implementation of sepsis guideline recommendations, diagnostic and therapeutic infrastructure, antibiotic stewardship, and quality improvement initiatives in hospitals., Measurements and Main Results: 1023 hospitals in 69 countries were included. Most of them, 835 (81.6%) were from Europe. Sepsis screening was used in 54.2% of emergency departments(EDs), 47.9% of wards, and 61.7% of intensive care units(ICUs). Sepsis management was standardized in 57.3% of EDs, 45.2% of wards and in 70.7% of ICUs. The implementation of comprehensive quality improvement initiatives(QIIs) was associated with increased screening (EDs +33.3%; wards +44.4%; ICUs +23.8% absolute difference) and increased standardized sepsis management (EDs +33.6%; wards +40.0%; ICUs: +17.7% absolute difference) compared to hospitals without QIIs. 9.8% of hospitals had implemented ongoing QIIs, and 4.6% had invested in sepsis programs., Conclusions: The findings indicate that there is considerable room for improvement in a large number of mainly European hospitals, particularly with regards to early identification and standardized management of sepsis, the availability of guidelines, diagnostic and therapeutic infrastructure, and the implementation of QIIs. Further efforts are required to implement a more comprehensive and appropriate quality of care. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Background: Ethnic differences in coronary atherosclerosis remain to be fully elucidated. We aimed to assess quantitative plaque characteristics from coronary CT Angiography (CCTA) in relation to ethnicity and cardiovascular risk factors in a multi-ethnic asymptomatic US population., Methods: This cross-sectional study retrospectively evaluated 388 asymptomatic patients selected from a prospective CCTA registry. A total of 194 patients from ethnic minority groups (Asian, African American, and Hispanic) were matched by age, sex, and cardiovascular risk factors to 194 White patients. Quantitative plaque volumes-including total plaque, non-calcified plaque, low-attenuation non-calcified plaque (<30 Hounsfield Units [HU]), and calcified plaque-were measured using artificial intelligence-enabled software. Pericoronary adipose tissue attenuation (PCAT) was also assessed and reported in Hounsfield Units (HU)., Results: The total study population included 388 patients (age 59.9±11.7 years, 68% male), of which 63% had coronary atherosclerosis with total plaque volumes of 149[IQR 50-438] mm 3 , driven predominantly by non-calcified plaque (122, IQR 27-369) mm 3 . Men presented higher volumes of all plaque components compared to women (P<0.05). In multivariable analysis adjusted for cardiovascular risk factors, only African American patients were associated with lower total plaque (β=-89.2, P=0.036), calcified (β=-26.1, P=0.015), and non-calcified plaque volumes (β=-62.7, P=0.022). African American patients were also associated with higher PCAT (β=5.8, P<0.001), along with family history of coronary artery disease (β=2.1, P=0.04)., Conclusions: Our study showed a uniformly high prevalence of atherosclerosis in this asymptomatic cohort, with lower plaque volumes of all sub-components in women. African American patients were associated with lower quantitative plaque volumes (total, non-calcified and calcified) but with higher PCAT compared to White patients; with no significant differences observed among other ethnic minorities., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Outside the current work, Drs Berman, Slomka, and Dey received software royalties from Cedars-Sinai Medical Center and report equity in APQ Health. Drs Slomka, Berman, and Dey hold a patent (US8885905B2 in the United States and World Intellectual Property Organization patent WO2011069120A1, “Method and System for Plaque Characterization”). The other authors declare no known competing financial interests or personal relationships that could have influenced the work reported in this paper., (© 2025 The Authors. Published by Elsevier B.V.)

Background: Paternal perinatal depression affects 10% of fathers, implying a significant burden on families and public health. A better insight into the population's health literacy could guide professionals and policymakers in addressing these men and making better use of existing healthcare options. It is also crucial for caregivers, as they play a vital role in identifying symptoms, encouraging help-seeking, and reducing stigma. This study aimed to explore the awareness, knowledge, and attitudes of the general population in Belgium towards paternal perinatal depression, using the validated DDads (Depression in Dads) questionnaire., Methods: This descriptive, cross-sectional study was conducted between March and May 2020-2022 using convenience sampling. Participants aged over 18 years, with a good understanding of Dutch and residing in the Brussels-Capital Region or Flemish Brabant were invited to participate. Data were analysed using descriptive statistics, Chi² analysis, and independent sample t-test., Results: A total of 314 participants, including women (n=165) and men (n=149) completed the questionnaire. Anxiousness was the most frequently cited mental health problem for men during their partners' pregnancy (82.5%) and in the postnatal period (68.5%). Over one-third (37.3%) viewed paternal depression as a 'normal' part of the transition to fatherhood. The recommended treatment for paternal depression was mostly non-pharmacological, with family support ranking first (79.9%) and seeking support from informal networks being the most recommended approach (45.2%). New personality characteristics such as withdrawal, cynicism, raging attacks, and irritability, among others, were seen as common symptoms (64.6%). Although 70% of respondents believed that perinatal depression requires specialized treatment, only 39.2% agreed that all men should be screened for depression during pregnancy., Conclusions: Recognition of paternal depression symptoms was relatively low but higher among females, participants with higher education, and those aware of paternal depression. Professional support recommendations were limited, especially among young people and those without children. The terms 'paternal perinatal depression' and 'perinatal mental health' are poorly understood. The findings highlight critical gaps in awareness and attitudes, offering valuable insights. Future research should develop tailored interventions to support men's mental well-being during the perinatal period. Targeted awareness campaigns and healthcare improvements are crucial for addressing this issue., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Akalin, D’haenens, Tricas-Sauras, Vermeulen, Demedts, Buyl and Fobelets.)

Pediatric cerebellar tumor survivors may present with spontaneous language impairments following treatment, but the nature of these impairments is still largely unclear. A recent study by Svaldi et al. (Cerebellum. 23:523-44, 2023) found a broad spectrum of spontaneous language impairments irrespective of postoperative cerebellar mutism syndrome (pCMS) diagnosis in long-term pediatric cerebellar tumor survivors. Several patients presented with reduced grammatical or lexical accuracy, but a detailed error analysis was lacking. The present study builds on this study by 1) investigating the error types in spontaneous language across three language processing levels in the same participant group and 2) by evaluating the possible association between pCMS and the processing nature of the language impairments. Spontaneous language was evaluated in 12 long-term survivors of pediatric cerebellar tumors (M(SD) = 4;8(3;8) years), of whom five were diagnosed with pCMS. The proportion of occurrence of each error type was compared between each patient and five matched controls using individual case statistics, reflecting (lexico-)phonological (i.e., phonemic paraphasias), lexical-semantic (e.g., empty speech) and morphosyntactic processing (e.g., verb inflection errors). Each patient showed a significantly higher proportion of at least one of the included error types across all language processing levels. A higher proportion of general-all-purpose verbs and inaccurate verb inflection were the most common errors and respectively reflected lexical-semantic and morphosyntactic processing. Additional language impairments were identified using the error analysis that were not identified with standard language measures and psycholinguistic analysis, suggesting the added diagnostic value of error analyses., Competing Interests: Declarations. Ethics Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. According to Dutch law, no approval of a Medical Ethical Committee is needed when patient data are studied that are obtained as part of routine patient care. Ethical approval for the collection of data from participants without neurological or language impairments was obtained from the Research Ethics Committee (CETO) from the faculty of arts of the University of Groningen (review number 76303408). Informed Consent: As is required by Dutch law, parents and patients over 12 years old signed a consent form before neuropsychological assessment in which they allowed the data to be used for research. Conflict of Interest: The authors declare no competing interests., (© 2025. The Author(s).)

This review aims to comprehensively and systematically analyze the anodic oxidation process to form nanostructured oxide films on the surface of the most technologically relevant Fe-based alloys and steels. A special emphasis is put on detailed analysis of the mechanisms of the anodic formation of Fe-based nanostructured materials. The effect of anodizing parameters including the type of Fe-alloy, electrolyte composition, potential/current regimes, as well as various post-treatment procedures (including annealing treatment) on the growth, morphology, composition, and properties of the resulting oxide films is discussed in detail. Examples of possible applications of the anodic films grown on Fe-alloys in various fields including photocatalysis, energy storage, sensors, biomedicine, and others are also provided. Finally, current trends, challenges, and perspectives in the anodizing of Fe-alloys are addressed., (Creative Commons Attribution license.)

Background: Coronary computed tomography angiography (CCTA) and fractional flow reserve (FFR) derived from CCTA (FFR-CT) may provide a means of reducing unnecessary invasive coronary angiography (ICA) in patients with suspected non-ST-elevation acute coronary syndromes (NSTE-ACS)., Aims: The aim of this study was to evaluate the capacity of FFR-CT and CCTA to rule out significant lesions in high-risk NSTE-ACS patients, using ICA with invasive FFR as the gold standard., Methods: High-risk NSTE-ACS patients admitted to 4 European centres were enrolled in this single-arm, prospective core lab-adjudicated study. Patients underwent CCTA with FFR-CT analysis, followed by ICA with invasive FFR., Results: Out of the 250 initially planned NSTE-ACS patients, 168 were included, of whom 151 (92%) had sufficient CCTA image quality to undergo CCTA and FFR-CT analysis. The median high-sensitivity troponin T level at 1 hour post-hospitalisation was 5.3 (interquartile range: 1.8-18.6) times the upper reference limit. At the patient level, the diagnostic performance of FFR-CT was numerically higher as compared to CCTA though not statistically significant (sensitivity: 94% vs 93%, specificity: 63% vs 54%, positive predictive value: 83% vs 79%, negative predictive value: 85% vs 80% and accuracy: 83% vs 79%; p=0.58), suggesting an enhanced capability to avoid unnecessary ICA. At the lesion level, the ability of FFR-CT to detect significant lesions was significantly better than that of CCTA (receiver operating characteristic curves: 0.84 vs 0.65 respectively; p<0.01)., Conclusions: In patients with high-risk NSTE-ACS, FFR-CT offers better diagnostic accuracy - though not statistically significant - and a higher ability to rule out haemodynamically significant stenoses as compared to CCTA. This indicates that FFR-CT can reduce unnecessary invasive procedures by more accurately identifying patients requiring further intervention.

Background: Three-dimensional (3D) imaging enhances surgical planning and documentation in plastic surgery, but high costs limit accessibility. Mobile Light Detection and Ranging (LiDAR) technology offers a potential cost-effective alternative., Objectives: To evaluate the accuracy and clinical utility of iPhone-based LiDAR scanning for breast measurements compared to traditional methods, and to establish standardized protocols for clinical implementation., Methods: In this prospective validation study, 25 consecutive patients (mean age: 44 years; range: 32-64 years; mean BMI: 23.2 kg/m²) undergoing breast procedures were evaluated using the "3D Scanner App" on iPhone 15 Pro (Apple Inc., Cupertino, CA). Three standardized measurements (sternal notch-to-nipple, nipple-to-midline, nipple-to-inframammary fold) were compared between LiDAR and manual techniques. Technical error of measurement (TEM) and relative TEM (rTEM) were calculated. Inter-rater reliability, learning curve assessment, and cost-effectiveness analysis were performed., Results: LiDAR measurements showed very good accuracy for sternal notch-to-nipple (rTEM 1.43%, 95% CI: 1.21-1.65) and nipple-to-midline distances (rTEM 3.45%, 95% CI: 3.12-3.78). Nipple-to-inframammary fold measurements showed moderate accuracy (rTEM 8.80%, 95% CI: 8.21-9.39). Inter-rater reliability was excellent (ICC=0.92). Learning curve analysis demonstrated measurement stability after 5 cases. Cost analysis revealed 97.8% reduction in initial investment compared to commercial 3D imaging systems., Conclusions: Mobile LiDAR technology provides accurate breast measurements for most anatomical landmarks at a fraction of the cost of traditional 3D imaging systems. The technology shows excellent reliability after a short learning curve, offering an accessible solution for surgical planning and documentation., (© 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.)

L-Amino acid transporters (LATs) play a key role in a wide range of physiological processes. Defects in LATs can lead to neurological disorders and aminoacidurias, while the overexpression of these transporters is related to cancer. BasC is a bacterial LAT transporter with an APC fold. In this study, to monitor the cytoplasmic motion of BasC, we developed a single-molecule Förster resonance energy transfer assay that can characterize the conformational states of the intracellular gate in solution at room temperature. Based on combined biochemical and biophysical data and molecular dynamics simulations, we propose a model in which the conserved lysine residue in TM5 supports TM1a to explore both open and closed states within the cytoplasmic gate under apo conditions. This equilibrium can be altered by substrates, mutation of conserved lysine 154 in TM5, or a transport-blocking nanobody interacting with TM1a. Overall, these findings provide insights into the transport mechanism of BasC and highlight the significance of the lysine residue in TM5 in the cytoplasmic gating of LATs., (© The Author(s) 2025. Published by Oxford University Press on behalf of National Academy of Sciences.)

Computed tomography coronary angiography provides a non-invasive evaluation of coronary artery disease that includes phenotyping of atherosclerotic plaques and the surrounding perivascular adipose tissue (PVAT). Image analysis techniques have been developed to quantify atherosclerotic plaque burden and morphology as well as the associated PVAT attenuation, and emerging radiomic approaches can add further contextual information. PVAT attenuation might provide a novel measure of vascular health that could be indicative of the pathogenetic processes implicated in atherosclerosis such as inflammation, fibrosis or increased vascularity. Bidirectional signalling between the coronary artery and adjacent PVAT has been hypothesized to contribute to coronary artery disease progression and provide a potential novel measure of the risk of future cardiovascular events. However, despite the development of more advanced radiomic and artificial intelligence-based algorithms, studies involving large datasets suggest that the measurement of PVAT attenuation contributes only modest additional predictive discrimination to standard cardiovascular risk scores. In this Review, we explore the pathobiology of coronary atherosclerotic plaques and PVAT, describe their phenotyping with computed tomography coronary angiography, and discuss potential future applications in clinical risk prediction and patient management., Competing Interests: Competing interests: P.J.S., D.B. and D.D. may receive royalties from Cedars-Sinai Medical Center and have equity in APQ Health. The other authors declare no competing interests., (© 2025. Springer Nature Limited.)

Objectives: To explore the need for a specialization in clinical pharmacy and the model to be adopted, as perceived by Portuguese stakeholders., Methods: A nominal group technique through two online meetings addressed four questions: pros and cons of specialization models used internationally; preferred model for Portugal; and success factors for implementation., Key Findings: All nine stakeholders recognized the need to train pharmacists in clinical pharmacy and agreed specialization is essential, through a model including strong clinical undergraduate education, supplemented with postgraduate training. The postgraduate component considered most suited comprised a balanced approach to theoretical and practical training, where the relative weigh of theory (20%-60%) could progressively decrease with the implementation of the European directive 2024/782 establishing the minimum training requirements for the professions of pharmacists, where the clinical pharmacy is to be strengthened at the undergraduate level. Success factors for implementing this model include, establishing a regulatory framework for the career and the desired characteristics of the graduates from the postgraduate programme., Conclusions: This study led to a consensus among key Portuguese stakeholders on the model to be adopted for a clinical pharmacy specialization in Portugal and, the information gathered will be used to guide future implementation., (© The Author(s) 2025. Published by Oxford University Press on behalf of the Royal Pharmaceutical 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.)

Background: Monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) or the CGRP-receptor have revolutionized the prevention of migraine. Despite their effectiveness, worries have surfaced regarding potential unwanted cardiovascular effects linked to the vasodilation function of CGRP, suggesting a potential influence on blood pressure (BP)., Methods: Studies were systematically retrieved from PubMed, Cochrane Database of Systematic Reviews, Web of Science, MEDLINE and EMBASE up to 1 May 2024. We focused on randomized controlled trials and observational cohort or case-control studies examining the impact of anti-CGRP(R)-monoclonal antibodies (mAbs) compared to control treatments on BP in patients with migraine. Two reviewers independently conducted study selection, data extraction and risk of bias assessment., Results: The literature search yielded 693 articles. After removing duplicates and conducting screening, 22 full-text articles were evaluated, with only four studies meeting the inclusion criteria. Among these, only one study had a low risk of bias and reported elevated BP following initiation of anti-CGRP(R)-mAb treatment., Conclusions: Although anti-CGRP(R)-mAbs offer substantial benefits for migraine prevention, the potential risk of increased BP requires attention. Despite the current limited evidence, clinicians are urged to monitor BP of migraine patients undergoing treatment with anti-CGRP(R)-mAbs and to remain aware of the increased risk of cardiovascular events in these patients., 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.

This study investigates the impact of the overall intensity and changes in grandparental caregiving on loneliness in grandparents in European countries. Data from waves 5 to 8 of the Survey on Health, Ageing, and Retirement in Europe (SHARE) were used (N individuals = 30,896 and N observations = 48,562). We included grandparents (aged 50 years and over) with at least one grandchild at the beginning of the study. The analyses reveal that any intensity of grandparental care decreases the risk of loneliness. When looking at changes in grandparental care the results show that stable caregiving roles appeared to reduce loneliness, while starting to provide grandparental care makes grandparents more vulnerable to loneliness. In conclusion, our findings underscore that consistent grandparental care is important for grandparents in mitigating loneliness, highlighting the importance of sustained caregiving roles over fluctuations in caregiving intensity., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)