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In Situ Insights into Enhanced Cooperative Ligand Exchange Kinetics via Solvent-Induced Restacking in a 2D Metal–Organic Framework

Cumulative excess weight exposure over time and cardiovascular risk: A prospective cohort study

Background Obesity at a given point in time is a known cardiovascular risk factor. However, the contribution of long-term excess weight exposure to cardiovascular risk has not been well established. We therefore conducted a study to evaluate the relationship between long-term excess weight exposure and incidence of cardiovascular events. Methods This secondary analysis of a prospective cohort study analyzed data from adult participants in Nurses’ Health Study and Health Professionals Follow-Up Study with a BMI > 25 kg/m 2 between 01/01/1990 and 12/31/1999. We investigated the relationship between cumulative exposure to body mass index (BMI) > 25 kg/m 2 between 1990 and 1999 and time to the composite primary outcome of fatal and non-fatal myocardial infarction (MI) and stroke beginning in 2000. Results The mean baseline BMI of 136,498 study participants was 27.2 kg/m 2 and the mean annualized cumulative excess BMI exposure was 3.9 kg/m 2 . In multivariable analysis having annualized cumulative excess BMI in the 4 th vs. 1 st quartiles was associated with an increased cardiovascular risk for women aged < 35 (HR 1.60; 95% CI 1.05–2.44) and 35−50 years (HR 1.27; 95% CI 1.01–1.58); and for men aged 35−50 (HR 1.57; 95% CI 1.22–2.03) and 50−65 (HR 1.23; 95% CI 1.02–1.48). There was no increase in cardiovascular risk with greater excess BMI exposure for women older than 50 and for men older than 65. Baseline BMI (in 1990) was not associated with cardiovascular risk in models adjusted for cumulative excess BMI exposure. Conclusion Long-term excess weight exposure plays a greater role in cardiovascular risk than weight at a single point in time. This risk is strongest in younger individuals.

Validation of the safety, empathy and utility of a large language model conversation agent for parents of autistic and neurodivergent children

Abstract This paper presents three descriptive validation studies of a large language model (LLM) conversation agent designed to support families and carers with autistic children. In the first study, a LLM’s responses to 400 parent/carer questions were assessed against 10 criteria across 3 domains—safety, empathy and utility by experienced human evaluators. In the second study, the LLM’s capacity to identify safeguarding issues was evaluated. In the third study, the responses to 50 parent/carer questions from the LLM and health clinicians were blind rated by an experienced evaluator and compared. The LLM’s responses were rated as safe, empathetic and useful. The LLM identified and correctly flagged the safeguarding issue in 100% of the presented questions. The ratings for LLM and clinician’s responses were highly correlated and the evaluator was able to distinguish which the provenance of the responses (74%). This is the first deployment of a comprehensive evaluation model that uses human ratings to scrutinize the output of LLM designed to support families with autistic children. It provides a demonstration of how LLMs have the potential to be safe, empathetic and clinically useful tools for responding to the unmet support needs of parents and carers of autistic children.

Copper-Catalyzed Enantioconvergent Nucleophilic Fluorination of Alkyl Electrophiles to Generate α-Fluoroamides

Retraction: TGEL-transformer: Fusing educational theories with deep learning for interpretable student performance prediction

Enhanced anaerobic degradation and modeling of raw and treated municipal solid waste

Mechanistic Origins of Polydicyclopentadiene Oxidation

Prevalence, predictors, and clinical relevance of drug–drug interactions in outpatient prescribing: A national cross-sectional study

Background Drug–drug interactions (DDIs) represent a major preventable cause of medication-related harm globally. Their prevalence varies across health systems, but common drivers include polypharmacy, aging populations, and specialty-specific prescribing patterns. Large-scale pharmacoepidemiologic analyses of real-world prescription data can clarify the magnitude of the problem and inform strategies to reduce risks. Methods This retrospective study included 2,365,811 outpatient prescriptions (982,102 patients) from Tehran, Iran. The top 100 most prescribed medications were screened for potential DDIs via Micromedex®. Interactions were classified as contraindicated, major, or moderate. Logistic regression identified demographic, specialty, and prescription-level predictors. Results Potential DDIs occurred in 46.1% of prescriptions, with 57.8% of patients affected. Major DDIs (62.6%) dominated, followed by moderate (32.8%) and contraindicated (4.6%). ASA was a frequent contributor to high-risk pairs. Contraindicated interactions were largely NSAID duplications, most common in orthopedics and emergency medicine. Psychiatry and cardiology prescriptions showed the highest prevalence, while polypharmacy strongly predicted DDIs, with incremental risks amplified in older adults. Conclusions Outpatient DDIs represent a substantial burden in routine care, comparable to international reports. Prevention requires comprehensive strategies, including e-prescribing with CDSS, pharmacist-led reviews, patient education on OTC use, and policy interventions to limit reimbursement of unsafe combinations.

Rapid quantitative profiling of kynurenine metabolites in human plasma using LC-MS/MS

A Film of Hydrophobic Cations Reshapes the Electric Double Layer at the Metal/Water Interface

The Relationships between physical activity, sedentary behaviour, sleep, and dementia: A systematic review and meta-analysis of cohort studies

Objective This study aimed to summarize the observational evidence from prospective cohort studies examining the associations of regular physical activity, sedentary behaviour, and sleep duration with incident dementia among community-dwelling adults aged 35 years and older. Methods Systematic literature searches (1946 to August 2025) of CINAHL, EMBASE, MEDLINE, PSYCINFO, and SPORTDISCUS were performed. Eligible studies included community-dwelling adults aged 35 + years with at least one year of follow-up and valid measures of movement behaviours and dementia outcomes. Studies were excluded if they included participants with baseline dementia, lacked risk estimates for all-cause dementia. Grey literature was excluded. Random effects meta-analysis generated pooled risk ratio (RR) and 95% confidence intervals (CI). Primary exposures were defined using national thresholds for physical activity, sedentary time, and sleep duration. Subgroup analyses were performed by age and follow-up duration. Results Forty-nine studies with physical activity (n = 2,855,529), 17 studies on sleep duration (n = 1,344,170), and three studies on sedentary duration (n = 295,809) were included. Regular physical activity significantly reduced the risk of incident dementia (pooled RR = 0.75, 95% CI = 0.68 to 0.82), though heterogeneity was substantial and partially explained by subgroup analyses. Prolonged sedentary behaviour (8 + hours/day sitting) increased dementia risk (RR = 1.27, 95% CI = 1.17 to 1.39) with low heterogeneity. Moreover, both short (<7 hours; RR = 1.18, 95% CI = 1.09 to 1.28) and long (>8 hours; RR = 1.28, 95% CI = 1.15 to 1.43) sleep were linked to higher dementia risk compared with 7–8 hours. Heterogeneity was moderate to substantial. Conclusion Regular physical activity, less sedentary time and appropriate nightly sleep (7–8 h) may be associated with reduced risk of dementia and are potentially modifiable factors in the prevention or delay of dementia. Future studies with middle-aged adults and longer-term follow-up including changes in movement behaviours over time are needed to better understand the relationship between physical activity, sedentary behaviour, and sleep for dementia risk. PROSPERO Registration CRD42021272054.

From expectation to strain: how pregnancy time perspective shapes postpartum stress in Poland and Italy

Near-Unity Triplet Quantum Yield in a Molecular Cofacial H-Dimer

Return to work outcomes in solid organ transplant recipients: A protocol for a global scoping review

Solid organ transplantation treats end-stage organ failure, improving longevity and quality of life. Return to work post-transplant is a positive indicator of treatment success. However, labor is influenced by multiple biopsychosocial factors, leading to complex barriers that affect recipients’ opportunities. Mapping return-to-work literature may reveal gaps in conceptualization, instruments, analyses, and key determinants. Following Joanna Briggs Institute methodology, this protocol aims to identify knowledge gaps and map the processes and outcomes in the literature on return to work after liver, kidney, heart, and lung transplantation. Following the Population, Concept, and Context strategy, this review is guided by the research question: “What has the literature shown about return to work after solid organ transplantation?”. This protocol was created and recorded on the Open Science Framework under DOI 10.17605/OSF.IO/Q6HVT . Database selection and search strategy were determined by a librarian specializing in health sciences. The literature search will be conducted in PubMed, Scopus, EMBASE, LILACS, and Web of Science databases. Eligible studies include primary and secondary research on return to work after transplantation, published in English or Portuguese, with no time restrictions. Two reviewers will independently perform the selection and data extraction. The data will be extracted using a pre-designed form to collect key details about the studies’ origin, context, purpose, content, population, and variables related to the return-to-work process. These data will be synthesized following Synthesis Without Meta Analysis guidelines and summarized narratively using tables, graphs, alongside thematic analysis.

Cost-effective and scalable urban air quality monitoring using image-based deep learning

Retraction: Fast fault diagnosis of smart grid equipment based on deep neural network model based on knowledge graph

Optimization of hospital resource scheduling efficiency based on dynamic weighted distance anomaly detection algorithm

Mg-Doped Nanosized BaTaO ₂ N with Long-Lived Charge Carriers toward Efficient Overall Water Splitting

The impact of physical adjunctive interventions on outcomes of clear aligner treatment: A systematic review of randomized controlled trials

Introduction Physical adjunctive interventions (PAIs), including vibration devices and low-level laser therapy, are promoted to accelerate tooth movement, improve aligner tracking, and reduce discomfort in clear aligner treatment (CAT), but randomized evidence remains inconsistent. This systematic review aimed to assess whether PAIs improve CAT outcomes in terms of objective tooth-movement metrics, aligner tracking, overall treatment efficiency, and patient-centered outcomes, and to appraise the risk of bias and the certainty of the evidence at the outcome level. Methods Comprehensive electronic searches of PubMed, Embase, Scopus, Web of Science, and CENTRAL were conducted from database inception (earliest available indexing date in each database) to 30 June 2025 (coverage cut-off). Grey literature searching and hand-searching were also performed, with no restrictions on language or publication status. Eligible studies were human randomized controlled trials (RCTs) comparing CAT combined with PAIs versus CAT alone or sham interventions. Two independent reviewers performed study selection and data extraction, with risk of bias assessed using the Cochrane RoB 2 tool and certainty of evidence appraised with GRADE. Random-effects meta-analyses were conducted when feasible; otherwise, results were narratively summarized. The protocol was prospectively registered (PROSPERO CRD420251132229). Results Seven RCTs involving 266 participants were included. No significant improvement in Little’s Irregularity Index (maxilla MD = 0.08, p = 0.869; mandible MD = 0.44, p = 0.487). Vibration improved aligner tracking under a 7-day change schedule (p = 0.003) but not case completion (p = 0.999). Overall compliance was approximately 77%, and no between-group difference was observed (p = 0.390). Pain was slightly lower on days 1–3 only (p < 0.05); no quality-of-life benefits were observed; periodontal indices remained unchanged; biomarkers showed inconsistent results. The certainty of evidence was low to very low, suggesting that further well-designed RCTs are likely to change the effect estimates and may alter the conclusions. Conclusions Across objective tooth-movement metrics, aligner tracking, treatment efficiency, and patient-centered outcomes, current randomized evidence does not demonstrate a consistent benefit of physical adjunctive interventions in clear aligner treatment. Interpretation is limited by outcome-level risk of bias concerns and low to very low certainty of evidence.

Development of a questionnaire to assess the medication literacy of patients receiving oral anticancer drugs

Abstract Medication literacy is particularly important for patients undergoing oral anticancer therapy, as this treatment involves additional challenges and responsibilities compared to intravenous chemotherapy. The aim of this study was to develop a questionnaire to measure the medication literacy of patients receiving oral anticancer therapy. Following semi-structured interviews and an expert focus group, a first draft of the questionnaire was developed. The draft consisted of two parts, each containing four dimensions. Part A of the questionnaire measured patients’ self-assessed medication literacy, whereas Part B measured their functional medication literacy. After this, both parts of the draft questionnaire were evaluated by conducting a patient survey in oncology practices and community pharmacies. Based on the results of factor analyses, the questionnaire was adapted and finalised. Lastly, the criterion-related validity of the final questionnaire was tested using linear regression analysis, with the aim of investigating its possible influence on quality of life and patient enablement. Factor analysis resulted in a questionnaire that contained 27 items across 7 dimensions. A total of 307 patients was included in the patient survey. Patients achieved an average of 36.7 out of 50 points in Part A and 11.7 out of 17 points in Part B of the final instrument, with higher scores indicating better results. Part A was found to be positively associated with quality of life and patient enablement. While Part A exhibited sound psychometric criteria, Part B still lacked sufficient internal consistency. In conclusion, we developed the first medication literacy questionnaire designed completely from scratch for cancer patients receiving oral anticancer therapy. The part on self-assessed medication literacy could be used as a patient-relevant endpoint or for identifying patients in need of further support with their medication. The part on functional medication literacy needs further refinement. This project is registered in the German Clinical Trials Register (no. DRKS00034341, registration date: 2024-06-03; https://drks.de/search/en/trial/DRKS00034341 ).