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Rethinking performance crises in professional soccer: German coaches’ insights into systemic vulnerabilities and escalating dynamics
Professional soccer, as a global phenomenon, is characterized not only by outstanding performances but also by frequent and sometimes prolonged periods of underperformance, which represent performance crises. Despite the growing body of research on performance crisis, the specific perspectives of coaches remain underexplored. Previous studies have largely focused on players’ viewpoints, resulting in a lack of understanding of the systemic and escalating dynamics of crises from the perspective of those in leadership positions. This study addresses this gap by investigating how professional soccer coaches perceive the development and persistence of performance crises in professional soccer. Employing a qualitative research design, twelve professional coaches with diverse roles (head coaches, assistant coaches, and goalkeeper coaches), a mean age of 43 years (range: 32–51), and extensive coaching experience in professional soccer (7–23 years, M = 15.5) were interviewed. The interviews were analyzed using data-driven and concept-driven content analysis based on thematic qualitative text analysis. The analysis reveals that performance crises are not attributable to isolated incidents but rather arise from the interplay between pre-crisis vulnerabilities, their transition to crisis dynamics, acute triggers, and escalating dynamics at team, organizational, and external levels. Pre-crisis vulnerabilities include latent factors such as organizational incongruence, and fragile team cohesion, that increase susceptibility to crises. Notably, coaches emphasized that success temporarily masks these underlying tensions, which surface and intensify when performance declines. Acute triggers refer to specific disruptive events or negative results that catalyze instability and initiate the crisis process. Escalating dynamics describe the self-reinforcing processes whereby psychological, social, and structural problems perpetuate and deepen the crisis. The study advances the field by highlighting systemic, self-reinforcing cycles of crisis and organizational incongruence that undermine coaching authority. These insights have practical implications for improving leadership coherence and resilience strategies in professional sports environments.
Prospective multicenter study of ctDNA versus tumor tissue guiding FGFR-targeted therapy in metastatic urothelial cancer
Stem cell therapy for female stress urinary incontinence: Results, limitations and lessons learned from a pilot clinical study
Objective This pilot clinical study aimed to develop and validate standardized manufacturing and quality control procedures for autologous skeletal muscle-derived (SkM-MSCs) and bone marrow-derived mesenchymal stem cells (BM-MSCs), and to explore the feasibility, safety and preliminary efficacy of periurethral injection of these products in women with stress urinary incontinence (SUI). Methods Twenty-six diagnosed with SUI were enrolled and allocated to receive either SkM-MSCs or BM-MSCs. Autologous MSCs were isolated from skeletal muscle or bone marrow biopsies, expanded under Good Manufacturing Practices (GMP), and subjected to rigorous quality control assessments, including identity, genetic stability, viability, potency, and sterility. In this pilot study, ten million MSCs were injected periurethrally under local anesthesia, and participants were followed for 12 months post-treatment. Results Eleven SkM-MSCs and nine BM-MSCs final products met all quality criteria and were administered. One participant from the SkM-MSCs lost the follow-up. MSC therapies were well tolerated, with no long-term adverse effects or tumor formation observed. In the SkM-MSCs group, the proportion of women with a positive cough test decreased significantly from 100% to 40% (p = 0.010). In the BM-MSCs group, modest improvements were seen but did not reach statistical significance. Overall, improvements in both pad test outcomes and quality of life measures among participants were observed, though not uniformly significant. The study was discontinued before reaching its intended sample size due to limited efficacy, logistical challenges, and financial constraints. Conclusion Autologous MSC‑based therapy for SUI was feasible and showed an acceptable short‑term safety profile in this pilot research setting; however, clinical efficacy remained modest. The manufacturing and quality control methodology is reproducible in specialized cell processing centers, but its application should remain confined to clinical research conducted in compliance with current regulations governing human cell therapy. Future studies with optimized cell products, refined delivery strategies and adequately powered, randomized designs are required before any potential translation to routine clinical practice can be considered.
Systematic review and meta-analysis of the evidence for an illusory truth effect and its determinants
Abstract Over the last four decades, studies provided evidence that individuals tend to rate statements as being more truthful when they are re-exposed to them, the so-called ‘illusory truth effect’. In light of a growing number of studies published since the previous meta-analysis in 2006 and concern of publishing biases, we conduct a meta-analysis on 182 studies and 366 effect sizes (N = 31,184 participants) published from 1977 to 2025. After correcting for small-study effects, we observe a small illusory truth effect (g = 0.37, 95% confidence interval [0.30, 0.44]), with a substantial within and between-study heterogeneity. Here, we show that multiple variables accounted for such heterogeneity, including the type of item, the instructions during the first exposure, the presence of veracity cues, and the duration of presentation on first exposure to the statement. We highlight the importance of the initial exposure and discuss practical implications regarding the current misinformation crisis.
Hand grip strength and cognitive dysfunction amongst older Africans in Nigeria
Background The relationship between physical and cognitive health among Africans, known for a rising incidence of frailty, cardiometabolic, and cognitive disorders, is unclear. We investigated the relationship between hand grip strength (HGS), and cognitive impairment among older adults in an urban settlement in Ibadan, South West Nigeria. Methods In this study, we assessed 608 participants from the Vascular heAlth, fraiLty, and cognItion in Ageing Nigerians sTudy [VALIANT] – a population-based cohort of 1021 older persons in Ibadan, a city in Southwestern Nigeria. They were recruited through a multi-stage, stratified cluster random sampling method. Data on HGS were obtained using a digital hand dynamometer while cognitive function was assessed via a consensus diagnosis. The relationship between cognitive impairment and HGS was investigated using a multivariable-adjusted logistic regression analysis. Results The mean (SD) age of the study participants was 64.6 ± 11.5 years and 67.6% were females. The proportion of participants with cognitive dysfunction was 22.9%, while the mean (SD) HGS (in kg) was 18.16 (8.06). The mean (SD) HGS was lower among participants with cognitive dysfunction (13.44 ± 5.45) compared to those without cognitive impairment (19.58 ± 8.38; p-value <0.001). After adjustment for age, sex, clinical frailty, level of education, and other metabolic risk markers, high HGS showed a protective association with cognitive impairment, aORs (95%CI) 0.91 (0.87–0.95). This protective association [aORs (95% CI)] was consistent for individuals aged <65 years [0.87 (0.80–0.94] and ≥65 years [0.90 (0.85–0.96)], as well as males 0.88 (0.78–0.99) and females 0.91 (0.84–0.99). Conclusions HGS was independently associated with cognitive impairment, buttressing the intricate link between physical and cognitive health in this unique West African population. Future work will explore the predictive ability of grip strength as an early indirect non-invasive biomarker of incident cognitive decline and the utility of targeted resistance training exercises in the primary prevention of neurocognitive disorders.
Drift-free ferroelectric photodetection with fast temporal response via thermal diffusion engineering
Evaluation of the mechanism underlying melatonin action in cholestatic liver disease treatment via network pharmacology, molecular docking, and in vivo experiments
The aim of this study was to investigate the mechanism underlying the action of melatonin (MT) in treating cholestatic liver disease. Melatonin and therapeutic targets for cholestatic liver disease were screened. A protein–protein interaction network was constructed using intersecting targets. Core targets were subjected to GO and KEGG enrichment analyses. We evaluated core target affinity through molecular docking. Biochemical indicators were measured in a mouse model of cholestasis to determine the pathological changes in liver tissue. The expression of core targets (MMP9, EGFR, and AKT) was detected through western blotting. The core targets for treating cholestatic liver disease included ALB, AKT1, ESR1, CASP3, PPARG, MMP9, PTGS2, SRC, EGFR, and IGF1. The biological processes included lipopolysaccharide stress response, bacterial molecular response, nutrient level response, and regulation of inflammatory response. Additionally, the estrogen, tumor necrosis factor-alpha, and VEGF signaling pathways were enriched in cholestatic liver disease. Molecular docking showed that MT had a strong binding affinity for MMP9, EGFR, and AKT1. Animal experiments demonstrated that melatonin alleviated inflammation and fibrosis in cholestatic liver disease, downregulated MMP9 expression, and upregulated the expression of EGFR, AKT, and phosphorylated AKT. Network pharmacology predictions suggested that these targets are closely associated with the estrogen signaling pathway. In conclusion, the protective effect of melatonin against cholestatic liver injury is likely mediated through the downregulation of MMP9 and upregulation of EGFR/AKT.
Single-cell structural biology with intracellular electron crystallography
Abstract Intracellular crystallization is an emerging approach in structural biology that bypasses the need for protein purification. In 2024, the InCellCryst pipeline was introduced for structural studies of intracellular crystals by serial X-ray crystallography. Serial crystallography requires the exposure of tens of thousands of cells containing intracellular crystals, precluding high-resolution studies on proteins that crystallize only in a few cells. Here we introduce IncelluloED , a method that combines intracellular crystallization with in situ 3D electron diffraction in cells and achieves high-resolution structures from just one crystal inside one cell. Experiments on a microcrystal of the HEX-1 protein from Magnaporthe grisea , grown inside an insect cell, give a structure at 1.9 Å resolution from a volume of ~1.6 µm 3 as compared to 1.8 Å resolution achieved by serial X-ray crystallography from a combined volume exceeding eleven million µm 3 . IncelluloED uses widely available cryo-EM tools and brings high-resolution structural biology into home laboratories while also advancing a vision for a “single-cell structural laboratory”.
The problem is escalating: Barriers faced by medical students in conducting research; A scoping literature review
Background Research is a cornerstone of medical education, equipping future healthcare professionals with critical thinking skills and the ability to apply evidence-based practices. Despite its importance, medical students often encounter numerous obstacles that hinder their active participation in research. These challenges not only affect students’ academic growth but also limit the advancement of medical knowledge and innovation within the healthcare system. Aim This study aimed to review, map, and synthesize the barriers that hinder medical students from engaging in research, and to provide insights that can inform educational reforms and policy interventions to strengthen research capacity among medical students. Methods The authors followed the Joanna Briggs Institute (JBI) Scoping review guidelines. The initial search was conducted in January 2025 and concluded in August 2025. A comprehensive literature search was performed across three major electronic databases: PubMed, Web of Science, and Scopus. The following key terms were used: “medical students”, “research barriers”, “research participation”, “challenges”, and “medical education”. Only peer-reviewed studies published in English between 2010 and 2025 that examined barriers faced by medical students in conducting research were included. Studies focusing on non-medical or postgraduate students, non-English articles, editorials, and abstracts without full texts were excluded. Results Fifty-seven studies met the inclusion criteria. The review identified key barriers hindering medical students’ engagement in research, including limited mentorship, heavy academic workload, and insufficient research training. Institutional challenges such as inadequate funding and poorly structured curricula further restricted participation. Conclusion Improving mentorship, research training, and institutional support is crucial to empower medical students and foster greater engagement in research.
Activation of IRF3 in cardiomyocytes impairs mitochondrial oxidative function through PGC-1α inhibition and drives heart failure
Abstract Heightened sterile inflammation and mitochondrial metabolic dysfunction drives the pathophysiology of heart failure in ischemic cardiomyopathy. Yet, the transcriptional regulators within cardiomyocytes driving crosstalk between inflammation and energy metabolism remain ill-defined. Here we identify elevated Ser396/Ser398 phosphorylation of the type I interferon (IFN) response regulating transcription factor IRF3 in the myocardium of patients and male mice with ischemic cardiomyopathy. Cardiomyocyte-specific IRF3 deficiency attenuates ischemia induced contractile dysfunction. Conversely, IRF3 activation in cardiomyocytes through a phosphomimetic IRF3 mutant represses Ppargc1α expression leading to dysfunctional mitochondrial oxidative phosphorylation, altered metabolic flux in the pentose phosphate pathway/TCA cycle, impaired NAD metabolism and an excessive type I IFN activation, collectively detrimental for cardiac function. Restoring cardiomyocyte-specific Ppargc1α expression in IRF3-overexpressor male mice attenuates contractile dysfunction by augmenting a metabolic shift towards fatty acid oxidation and decreasing inflammatory fibrotic responses. These findings identify IRF3 activation in cardiomyocytes as a transcriptional nexus between cardiac inflammation and metabolic fuel switch contributing to heart failure progression.
Prevalence and factors associated with comorbidities in Iranian patients with type 2 diabetes: A national study
Introduction Type 2 diabetes (T2DM) is often accompanied by comorbidities such as hypertension (HTN), cardiovascular disease (CVD), and chronic kidney disease (CKD), which increase the disease burden and complicate its management. In Iran, where diabetes prevalence is growing, understanding the extent and determinants of these comorbidities is crucial for improving clinical care and informing national public health strategies. Materials and methods We used data from the WHO STEPwise approach to non-communicable diseases risk factor surveillance (STEPS) 2021 to assess the prevalence of comorbidities among Iranian patients with T2DM. Comorbidity was defined as ≥ 2 of: HTN, CKD, history of CVD, or cancer. Multivariable logistic regression was done to identify the potential socio-demographic factors associated with comorbidities. Results Of a total of 2,900 participants aged 25-70 years with T2DM (56.24% women), 27.00% (95% confidence interval (CI): 24.74–29.40) had no comorbidity, 39.82% (95% CI: 37.26–42.43) had one comorbidity (HTN: 79.62%, CKD: 10.66%, CVD: 8.64%, cancer: 1.09%), and 33.18% (95% CI: 30.58–35.89) had ≥ 2 comorbidities. The prevalence of comorbidity was significantly associated with male gender, age ≥ 60 years, living in a rural area, body mass index >30 kg/m2 (all p-values < 0.05). However, higher years of schooling, being employed, and physical activity ≥ 150 min/week were associated with lower odds of comorbidities. Discussion Over 70% of Iranian adults have additional health conditions alongside diabetes, which significantly impact public health and underscore the need for personalized and multi-faceted preventive approaches.
Crystallization-driven template autocatalysis induces mirror symmetry breaking and amplification
Critical node identification and resilience analysis against cascading failures
Ensuring the robustness and resilience of critical infrastructure networks such as transportation and energy systems is a core security challenge for modern societies. Vulnerabilities in these networks often concentrate on a small number of critical nodes, whose failure can trigger catastrophic cascading failures. Therefore, accurately identifying critical nodes and formulating effective reinforcement strategies are crucial for enhancing the overall defense capability of the system. Existing graph neural network (GNN)-based methods often rely on topological centrality metrics, neglecting the distribution of node information and the impacts of cascading failures. To bridge this gap, this study constructs a comprehensive analytical framework (TEC-GNN, Topology-Entropy-Cascading Graph Neural Network) integrating graph neural networks, feature engineering, and resilience assessment. It aims to address two core questions: which graph neural network model is most suitable for critical node identification, and how to enhance network resilience by regulating redundant resource allocation. Systematic evaluation indicates that the GraphSAGE model delivers the best overall performance in critical node identification. Its results exhibit high consistency with supervised signals (Spearman’s correlation coefficient of 0.822), achieving a Normalized Discounted Cumulative Gain at Top-K (NDCG@K) of 0.918, an F1 Score at Top-K (F1@K) of 0.879, and a Top-K accuracy of 0.879. Its inference efficiency (0.002 s) is comparable to GCN and significantly outperforms GAT, meeting the demands of real-time analysis for large-scale networks. After feature dimension reduction via principal component analysis (PCA), the model’s discriminative power further improved, with effect size (Cohen’s d) increasing by approximately 4% without efficiency loss, validating the effectiveness of scientific dimension reduction. The model’s accuracy was robustly validated through attack experiments: selectively removing the top 10% critical nodes identified by GraphSAGE reduced the network’s largest connected component ratio (LCC_Ratio) to approximately 0.4, severely impairing network functionality. When the removal rate reached 20% (equivalent to 60% removal in random attacks), the network became nearly paralyzed. Another core finding reveals the complex nonlinear regulatory mechanism of redundancy coefficient β on network resilience. The resilience metric R exhibits clear diminishing marginal returns with increasing β : R rises rapidly as β increases from 0 to 0.5, then slows significantly with fluctuations thereafter. Based on this, the study proposes a “precision reinforcement” strategy: enhancing redundancy allocation only for critical nodes identified by GraphSAGE enables low-cost resilience improvement (e.g., R increases from 0.874 to 0.883). This strategy provides an efficient path for system fortification under resource constraints. The research framework proposed in this paper provides interpretable and scalable theoretical and methodological support for vulnerability assessment and resilience enhancement in critical infrastructure. The validated GraphSAGE model and “targeted reinforcement” strategy are particularly suitable for risk prevention and resource optimization in major infrastructure systems requiring dynamic analysis and rapid response, such as transportation and power grids.
Validating the effectiveness of an AI algorithm for pulmonary tuberculosis screening using chest X-ray: Retrospective study and test accuracy with localizer images of the chest CT
Introduction China accounted for 6.8% of global TB cases, and most patients are first diagnosed in general hospitals where chest X-rays (CXR) are widely used for early TB detection. To facilitate diagnosis in resource-limited settings, our study evaluates a CNN-based AI model trained on Chinese CXR data (JF CXR-1 v2), including its experimental application to CT localizer images. Materials and methods This retrospective study was conducted at China-Japan Friendship Hospital, including 290 CXR images and 433 CT localizer images from TB patients diagnosed between 2017 and 2021. The AI algorithm’s diagnostic performance was assessed using sensitivity, specificity, accuracy, Kappa value, and AUC from ROC analysis. Results The AI algorithm demonstrated high diagnostic performance on CXR images, achieving an AUC of 0.960 with 91.7% sensitivity and 92.7% specificity in bacteriologically confirmed TB cases. On localizer images of the chest CT, while the performance was more modest (AUC 0.719), a significant correlation between CXR and CT predictions in 105 paired cases suggests potential for cross-modality application with further validation. Discussion & conclusions The algorithm shows decent diagnostic capability for the CXR samples in this study. This AI algorithm developed based on CXR can, to some extent, identify the imaging features of pulmonary TB when applied to localizer images of chest CT.
Determinants of dairy products purchase decisions among polish doctors: A gender-based analysis
The study aimed to address a research gap by identifying the factors that influence the purchasing decisions of individual Polish doctors in the dairy products market, with gender as a demographic variable. The primary data collection method was a survey, conducted using the CAPI (Computer-Assisted Personal Interviewing) technique. The sample was selected using a purposive approach with elements of proportional territorial allocation. The survey involved 201 interviews with doctors from across Poland representing various fields of medical specialisation. The group of respondents surveyed is characterised by one of the highest levels of social trust. Conducting research among a professional group of doctors who are perceived as experts, whose knowledge is based on scientific evidence and many years of education, is an important contribution to the discussion on the factors that shape purchasing behaviour. The research confirmed the hypothesis that purchasing decisions in the dairy market are shaped by diverse factors. The study showed that the surveyed group of doctors most often makes purchasing decisions guided not only by health and quality values, but also by pragmatic ones, such as a product’s shelf life or availability in shops. The conducted research showed that differences between women and men representing the medical community in the assessment of factors influencing purchasing decisions in the dairy products market occur for 6 of the 26 variables assessed, thus one of the research hypotheses was only partially confirmed. Further research using principal component factor analysis made it possible to determine what hidden factors influence purchasing decisions among all respondents and groups distinguished by the demographic characteristic of gender, which allowed for the definition of customer segments.