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A qualitative analysis of Chinese novice general dentists’ perspectives on using ergonomic loupes in clinical practice

Background Ergonomic loupes are the next-generation loupes with built-in refractive prisms that enable the user to sit up straight, look straight ahead, and reduce neck tilt while viewing the operating field from down below. They differ greatly from traditional loupes in optic design and viewer perspective. They appeared on the market in 2022 and are quickly gaining popularity in China. In this study, we sought to use semi-structured interviews and thematic analysis to assess the perspectives of novice Chinese general dentists on using ergonomic loupes in clinical practice. Methods The study population consisted of nineteen general dentistry residents undergoing training at Peking University Third Hospital in Beijing, China. Semi-structured interviews were conducted individually with participants. The interview data were analyzed thematically using NVivo 11 software. Results The findings revealed that the benefits of using ergonomic loupes included enhanced visual acuity, more precision, improved posture, and improved treatment quality. Main disadvantages included discomfort from use, splash protection issue, fixed viewpoint, and limited field of view. There was typically a brief adaptation process for the new user. Participants were weighing cost and benefit in deciding whether and where to use ergonomic loupes. Comparative experience showed that ergonomic loupes had ergonomic advantages, while traditional loupes had hand-eye coordination advantages. Conclusion The participants had overall positive perspectives on using ergonomic loupes in clinical practice. Comparative experience showed that ergonomic loupes had ergonomic advantages, while traditional loupes had hand-eye coordination advantages.

Molecular design beyond training data with novel extended objective functionals of generative AI models driven by quantum annealing computer

Abstract Deep generative modeling to stochastically design small molecules is an emerging technology for accelerating drug discovery and development. However, one major issue in molecular generative models is their lower frequency of drug-like compounds. To solve this problem, we develop a novel, quantum annealing, generative-model approach for optimizing deep generative models, an approach that includes integrating with a D-Wave annealing quantum computer. Of particular note, our neural hash function (NHF) is used simultaneously as a regularization scheme and binarization scheme, of which the latter is for transformation between continuous and discrete signals of the classical and quantum neural networks, respectively, in the error evaluation (i.e., objective) function. The compounds generated via the quantum-annealing generative models exhibit higher quality in both validity and drug-likeness than those generated via the fully-classical models, and even exceed the training data in terms of drug-likeness features, without any restraints and conditions to deliberately induce such an optimization. These results suggest that quantum annealing could be used as a stochastic generator integrated with our novel neural network architectures for extending the performance of feature space sampling and the extraction of characteristic features in drug design.

Direct correspondence between liquid and glass polymorphism in densely packed metallic alloys

Complete genomes of two Ikeda-genotype Orientia tsutsugamushi isolates from South Korea reveal within-lineage divergence and contrast with the Boryong reference strain

Orientia tsutsugamushi strain Ikeda is a scrub typhus reference strain originally described in Japan, and Ikeda 56-kDa type-specific antigen sequence types have also been reported in South Korea. However, complete genome resources for South Korean Ikeda-genotype isolates remain limited. Here, we generated complete genomes for two archived clinical O. tsutsugamushi isolates from northern South Korea, CH219 and K4-135, using a PacBio HiFi and Illumina hybrid assembly approach and compared them with the Japanese reference strain Ikeda and the South Korean reference strain Boryong. Both genomes were assembled as single circular chromosomes and contained a substantial fraction of duplicated identical coding sequences, consistent with the highly repetitive nature of O. tsutsugamushi genomes. Strains CH219 and K4-135 had identical 56-kDa TSA sequences and MLST profiles to those of the Ikeda reference strain and clustered within the Ikeda-associated clade in recombination-filtered core-genome phylogeny and ANI analyses. Within this comparison, the two South Korean isolates showed more closely related to each other than to the Japanese Ikeda reference genome. Whole-genome dot plots further indicated structural variation among the Ikeda-associated genomes. Insertion sequence (IS) profiling showed differences in IS-related CDS copy number patterns between the Boryong reference genome and the Ikeda-associated genomes, with strain Boryong showing a higher observed number of ISOt6-related CDS hits and fewer high-identity ISOt3-related hits under the applied thresholds. Together, these genomes provide new resources for Ikeda-like O. tsutsugamushi strains detected in South Korea and support the need for expanded complete and well-supported whole-genome data to better understand genome diversity in scrub typhus agents.

Integrated eco-hydrological and vegetation productivity analysis of wetland landscapes in Madhubani, Bihar (2002–2024)

Abstract Wetlands are highly productive ecosystems that regulate hydrological processes, store carbon, and support rich biodiversity, yet they remain highly vulnerable to hydro-climatic variability and anthropogenic pressures. This study examines long-term eco-hydrological dynamics influencing wetland systems in the Madhubani district of North Bihar during 2002–2024 using an integrated framework of climatic, hydrological, and ecological indicators. Rainfall trends were analyzed alongside Actual and Potential Evapotranspiration (ET, PET), Standardised Water Deficit (SWD), Wetness Index (WI), Gross and Net Primary Productivity (GPP, NPP), and remote sensing indices, including the Modified Normalized Difference Water Index (MNDWI) and Soil-Adjusted Vegetation Index (SAVI) derived from Terra MODIS and Landsat datasets. Trend analysis indicates a non-significant but persistent decline in annual rainfall (Z = − 1.33; Sen’s slope = − 7.53 mm year −1 ), with stronger decreases during the monsoon season (− 8.65 mm year −1 ). ET (320–720 mm yr −1 ) remained substantially lower than PET (2030–2520 mm yr −1 ), indicating persistent atmospheric water demand and increasing moisture stress, as reflected in Standardised Water Deficit variability and relatively low Wetness Index values. Vegetation productivity exhibited considerable interannual variability, with GPP ranging from ~ 770 to 1530 g C m −2  yr −1 and NPP from ~ 100 to 430 g C m −2  yr −1 . Both productivity metrics declined sharply during 2012–2015, suggesting sensitivity to monsoon rainfall variability. Spatial analysis reveals significant hydrological and ecological changes. Post-monsoon moderately wet areas declined from 75.10% (2002) to 55.27% (2024), while dry zones expanded from 17.24 to 39.55%, indicating progressive wetland contraction. Vegetation dynamics derived from SAVI show spatial redistribution of vegetation cover, with dense vegetation increasing from 21.32 to 26.18%, particularly in northern areas associated with irrigation supported agriculture. Correlation analysis further demonstrates strong eco-hydrological coupling, with rainfall positively correlated with the wetness index and negatively associated with water deficit. Overall, the findings indicate a shifting eco-hydrological regime in Madhubani characterized by declining rainfall reliability, increasing moisture stress, wetland shrinkage, and changing vegetation patterns. These trends highlight the need for integrated wetland management and climate-resilient water resource strategies to sustain ecological stability in the floodplain landscapes of North Bihar.

Author Correction: The mitochondrial β-oxidation enzyme HADHA restrains hepatic glucagon response by promoting β-hydroxybutyrate production

In silico antimicrobial resistance profiling of 1,240 Stenotrophomonas maltophilia genomes: AMR gene prevalence, temporal evolution, and ST-specific associations

Stenotrophomonas maltophilia is an opportunistic pathogen with clinically important multidrug resistance, yet large-scale genome-based analyses integrating population structure, resistance determinants, and epidemiological metadata remain limited. We analyzed 2,419 publicly available genomes retrieved from NCBI GenBank. After quality control with CheckM, 2,389 assemblies passed filtering criteria, and species identity was further evaluated by average nucleotide identity using FastANI. A final curated dataset of 1,240 confirmed S. maltophilia genomes was retained for downstream analyses. Antimicrobial resistance determinants were identified using AMRFinderPlus, sequence types were assigned by multilocus sequence typing, and temporal, geographic, host-associated, and gene co-occurrence analyses were performed. The 1,240 genomes represented isolates collected between 1900 and 2025 from 40 countries. Geographic metadata were available for 1,239 isolates, host source for 1,239 isolates, and collection year for 1,105 isolates. Human-derived isolates predominated, whereas animal-derived isolates were rare and environmental isolates were absent. MLST assigned 876 isolates to 97 sequence types, with ST5, ST4, ST1, ST31, and ST162 as the most prevalent lineages. The resistome comprised 69 unique resistance-associated genes across 12 functional classes and showed a bimodal structure, with a highly conserved intrinsic core and a sparse accessory component. Core genes included emrA , emrB , emrC , smeF , blaL1 , aac (6′)- Iz , aph (6), aph (3′)- IIc , ermB , and ermC , most of which occurred at very high prevalence. In contrast, acquired determinants such as sul2 , tet (G), aadA2 , blaNDM-1 , blaGES-1 , and blaOXA-74 were infrequent. Plasmid replicons were also uncommon, supporting a predominantly chromosomal resistance architecture. Temporal analyses showed that intrinsic genes were present in the earliest available isolates, whereas acquired genes appeared only in recent decades and generally remained rare. Several acquired genes, including floR , aph (3′′)- Ib , aph (6)- Id , and aac (6′)- Ib4 , declined over time, while no acquired resistance determinant showed a significant increasing trend. Gene presence pattern and co-occurrence analyses identified dominant conserved resistome configurations and a smaller set of variable accessory modules associated with putative mobile genetic elements. Comparative analysis further showed enrichment of intrinsic efflux-associated determinants in clinical isolates, whereas non-clinical isolates carried a broader diversity of acquired aminoglycoside resistance genes. These findings indicate that the global resistome of S. maltophilia is dominated by conserved intrinsic, chromosomally encoded resistance determinants, whereas acquired resistance genes remain rare, sporadic, and lineage-associated. This curated genome-scale framework provides a resource for surveillance and for future studies linking resistome evolution, mobile genetic elements, and genotype-phenotype relationships.

Lower socioeconomic status strengthens the risk of otitis media with effusion after COVID-19 infection: a case-crossover study in Northeast China

Abstract To investigate the associations of otitis media with effusion (OME) with different socioeconomic status (SES) before during and after the coronavirus disease 2019 (COVID-19) outbreak in Northeast China. Three cross-sectional data on daily emergency and outpatient were included pre, during and post COVID-19 epidemic. We recorded the number of OME and symptoms and confirmed SARS-Cov-2 infection in patients with OME. We used logistic regression to evaluate the odds ratio (OR) for OME with COVID-19 infection, and employed an interrupted time series analysis to quantify the effect of COVID-19 outbreak on OME, and a time-stratified case-crossover analysis to evaluate the association of OME with SES before, during and after the COVID-19 outbreak, especially in the two months following the COVID-19 outbreak. During COVID-19 outbreak, the OME significantly increased by 50% (RR: 1.563, 95% CI 1.256–1.942) compared to the same period in other years, low SES was associated with an increased risk of OME, but this low SES-related risk elevation significantly increased during the outbreak of COVID-19, especially in the first month after COVID-19 infection. Individuals under 50 years old were still vulnerable to SES after COVID-19 infection in Liaoning. Lower SES might aggravate OME and greater efforts are needed to improve SES in post-COVID-19.

Aligning climate and air quality goals demands early VOC control for China’s ozone pollution

Abstract Global surface ozone (O 3 ), intensified by climate change, poses increasing health and ecosystem threats. Despite stringent air policies, China’s persistent O 3 pollution exemplifies a global challenge intertwined with climate actions reshaping emission pathways. Optimal mitigation remains contentious, primarily due to inconsistent conclusions regarding the sensitivity of summer regional O 3 formation. Here we show the path dependency in O 3 mitigation strategies for synergistic clean air and climate action goal achievement over multidecade scales. This path dependence is validated by observed concurrent plateaus (2020-2023) in deweathered O 3 concentrations and sensitivity trends across Chinese megacity clusters. Leveraging this understanding of path dependency, we quantitatively reveal that the optimal future strategy involves prioritizing early volatile organic compound reductions, as their high effectiveness for regional O 3 mitigation gradually diminishes towards 2050. This challenges prevailing nitrogen oxides priority paradigms. Our work reframes O 3 control, providing a paradigm for resilient air quality-climate governance.

Caerin 1.1 and 1.9 inhibit glioblastoma growth associated with modulation of the ARHGAP26-β-catenin axis and enhancing intratumoral CD8+ T cell infiltration

Glioblastoma (GBM) is an aggressive brain tumor with limited effective treatment options and poor patient outcomes. This study investigates the antitumor activity and underlying mechanisms of of host defense peptides caerin 1.1 (F1) and caerin 1.9 (F3) in glioblastoma models. F1/F3 treatment inhibited the proliferation of U87 cells and was associated with increased expression of ARHGAP26, suppression of β-catenin signaling pathway, and reduced the expression of downstream targets including MMP2, MMP7, and VEGFA. Cell death is primarily induced through apoptosis-related pathways, while pyroptosis-related and PI3K-related signaling showed more limited alterations. Notably, in immunodeficient NSG mice, F1/F3 altered the tumor immune microenvironment by promoting macrophage infiltration and M1-like polarization but did not significantly inhibit tumor growth. In contrast, in PBMC-humanized NSG mice, F1/F3 significantly suppressed U87 tumor growth and was associated with increased infiltration of macrophages and CD8 + T cells, together with reduced PD-L1 expression. These findings demonstrate that F1/F3 exerts both direct anti-tumor effects and immune-modulatory activities in glioblastoma models. The results support further investigation of caerin peptides as potential immunomodulatory therapeutics for glioblastoma.

High-dimensional immune profiling reveals NK cell dysregulation and neutrophil polarization after aneurysmal subarachnoid hemorrhage in delayed cerebral ischemia

Asymmetric temperature responses to soil moisture drought legacies under anthropogenic forcing

Household income and academic performance in Korean adolescents: A longitudinal test of dual investment pathways

Building on the Family Investment Model (FIM), the present study examined how household income shapes adolescents’ academic performance through material and relational investments within the Korean educational context. Drawing on three waves of data from the nationally representative Korean Children and Youth Panel Survey 2018 (N = 2,387), we estimated a longitudinal parallel mediation model that accounted for baseline levels of each construct and demographic covariates. Results indicated that household income predicted higher private educational expenditure but was not associated with parent–child communication. Indirect effects revealed that household income influenced academic performance through material investment in private education, whereas the relational pathway was not significant. However, the difference between the two indirect pathways did not reach statistical significance. These findings suggest that private educational expenditure may represent one important pathway linking family economic resources to adolescents’ perceived academic performance in the Korean educational context. These findings underscore how household economic resources are differentially converted into educational advantages through family investment processes, highlighting implications for understanding income-based educational stratification in highly competitive educational contexts.

Tunable Tamm plasmon polaritons in the terahertz range using highly doped InSb as the plasmonic layer

Realization of the Bienenstock-Cooper-Munro rule in a single memristor

Beyond the freedom to refuse patient: A retrospective comparative study of emergency transportation during the COVID-19 pandemic in Japan

Emergency department overcrowding and ambulance diversion are significant problems worldwide and have become more apparent during the COVID-19 pandemic. In Japan, the Dedicated Emergency Physician (DEP) model has been associated with reduced transport time. However, whether this benefit persists during the pandemic remains unclear. This study analyzed the changes in transport outcomes during the COVID-19 pandemic in Japanese regions with and without DEP hospitals to evaluate the effectiveness of the DEP model and identify factors that could improve transport outcomes. Using nationwide data from January 2015 to December 2021, three target areas were analyzed: Urayasu-Ichikawa (DEP Group 1), Shonan-Fujisawa (DEP Group 2), and Ichinomiya-Toyota (Non-DEP Group 3). DEP Groups 1 and 2 contained DEP hospitals, while Non-DEP Group 3 was selected for its comparable population size and strong pre-pandemic transport performance. To minimize the impact of regional variations in COVID-19 prevalence, this study compared the changes in transportation outcomes before and after the pandemic between the target areas and nearby comparison areas. In total, there were 150,856 transports in Group 1; 186,965 in Group 2; and 516,655 in Group 3. In the target areas of Groups 2 and 3, transport time changes were significantly shorter by 2.016 and 0.606 min, respectively, compared to the comparison areas. Moreover, these areas had significantly lower odds of transportation difficulty (Group 2: odds ratio 0.131, 95% confidence interval 0.110–0.157; Group 3: OR 0.086, 95% CI 0.066–0.112). It was found that the common characteristics of these areas were densely located large-scale hospitals and makeshift buildings for patients with COVID-19, adjacent to large-scale hospitals. These findings suggest that DEP hospitals alone did not guarantee favorable transport outcomes during the pandemic. A sufficient number of large-scale hospitals and nearby temporary facilities may be crucial for maintaining effective emergency transportation during a pandemic.

Postpartum perspectives on navigating hypertensive diseases of pregnancy: a qualitative study

Author Correction: mRNA vaccine developed for sequential selective organ-to-cell targeting of glioma

Leveraging social media to mitigate HPV vaccine service disruptions in Abuja, Nigeria

Introduction Market priming strategies use communication to prepare target audiences for service uptake when services become available. In 2025, a health worker strike in Abuja, Nigeria resulted in the suspension of HPV vaccination services for approximately four months. Services were temporarily restored for five days (July 16–20, 2025) during a Maternal, Newborn, and Child Health (MNCH) week. This study assessed whether caregiver recall of a digital market priming campaign was associated with HPV vaccine uptake during this brief service resumption. Methods We conducted a cross-sectional exit survey of 271 caregivers of adolescent girls aged 9–17 years attending vaccination sites during MNCH week. The survey collected data on socio-demographic characteristics, Facebook use, recall of HPV vaccine advertising on Facebook or Instagram, and caregiver-reported adolescent vaccination status. Survey findings were triangulated with administrative data on the number of HPV vaccinations delivered during the MNCH week. Analyses included descriptive statistics and multivariable logistic regression. A two-stage residual inclusion (2SRI) model was used as a sensitivity analysis to assess potential bias from unobserved confounding related to social media use. Ward-level regression analyses using administrative data compared vaccinations delivered in wards targeted by the digital campaign with those in non-targeted wards. Results Overall, 33.6% of caregivers recalled HPV vaccine advertising on Facebook or Instagram, and 64.2% reported that their adolescent had received the HPV vaccine. Message recall was associated with higher odds of caregiver-reported vaccination (adjusted odds ratio = 3.36; 95% CI: 2.75–4.11). Model-predicted marginal effects indicated a 23.3 percentage-point difference in reported vaccination probability between caregivers who did and did not recall messages, corresponding to an estimated 7.9 percentage-point difference in vaccination prevalence when applied to the caregiver population attending vaccination services. The 2SRI analysis found no evidence of endogeneity (p = 0.736). Administrative data were consistent with survey findings, suggesting an approximately 3 percentage-point higher vaccination coverage in wards targeted by the digital campaign compared with control wards during MNCH week. Conclusions Caregiver recall of a digital market priming campaign was associated with higher HPV vaccination uptake during a short-term resumption of services following a prolonged disruption. These findings suggest that insights-informed, subnational digital priming strategies—when combined with complementary offline approaches to ensure equitable reach—may help maintain caregiver readiness and support HPV vaccine delivery during periods of service instability.

Decoding biological aging in Sparus aurata through a gene toolbox to infer welfare assessment and precision aquaculture interventions

Abstract Biological age (BA) has emerged as a promising integrative indicator of physiological state and welfare, but its use within aquaculture remains underdeveloped. Previous genome-wide analysis in gilthead sea bream revealed skeletal muscle markers with inverse age-related expression and methylation patterns. Specifically, psmd2 , ramp1 , sirt1 and smad1 were up-regulated and hypomethylated with age, while atp1a2 , bmp1 , calcrl , col5a1 , spred2 and thrb exhibited down-regulation coupled with hypermethylation. Here we assessed the responsiveness of this gene set across multiple aquaculture-relevant challenges using a real-time PCR array. Environmental stressors (e.g. increased temperature and high stocking density with low O 2 concentration) induced transcriptional profiles resembling muscle gene-expression patterns of older individuals. Conversely, cold exposure and nutritional interventions, including restricted feeding and feed supplementation with bioactive protein hydrolysates, microalgae meal with a PUFA-rich lipid source, or fat emulsifiers promoted signatures aligned with those observed in younger animals. Although the direct reversal of stress-induced aging signatures was not tested, results indicate that dietary interventions elicit opposing transcriptional patterns, highlighting potential strategies to mitigate environmentally mediated aquaculture stress through targeted nutrition. These findings provide preliminary evidence of a potential relationship between BA and aquaculture stressors in farmed fish, underpinning a genomics-based framework for welfare assessment and adaptive management.