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461 papers

Conditional sparing in FLASH radiotherapy: Conformal dosimetry and ALARA remain essential.

Chang CC et al. · Jul 1, 2026

FLASH radiotherapy shows promise in reducing normal tissue toxicity while maintaining tumor control. However, preclinical and early clinical evidence reveal biological and technical uncertainties. We review preclinical and veterinary studies, highlight unexpected toxicities, and argue that the fundamental principles of precision and safety in radiotherapy-particularly conformal treatment and ALARA-remain crucial.

Physics and Astronomy

Systematic Review of Intravenous Ceftriaxone Administration in Animals.

de Vasconcelos PMF et al. · Jul 1, 2026

Background Ceftriaxone is an antibiotic frequently prescribed in veterinary medical practice due to its effectiveness against several pathogenic microorganisms responsible for diseases in different animal species. Objective To select scientific articles from the academic databases PubMed and Web of Science that analysed the pharmacokinetic aspects of intravenously administered ceftriaxone in animals. Methods In accordance with the principles of scientific transparency, the systematic review protocol and all research stages were previously registered on the Open Science Framework (OSF) platform. The scientific articles that met the inclusion criteria were subjected to a checklist comprising 24 minimum assessment items designed for reporting pharmacokinetic studies. Results A total of 52 pharmacokinetic profiles were identified from the 29 selected scientific articles, including records involving 13 different animal species used in ceftriaxone experimental studies. Conclusion The limitations and inconsistencies identified in this review highlight the importance of detailed reporting of pharmacokinetic data derived from experimental trials in animals.

Medicine

Uncertainty quantification of U-Net based segmentation tool using conformal prediction.

Borden BJ et al. · Jul 1, 2026

Background The radiation therapy treatment process is very labour intensive, and artificial intelligence (AI) based auto contouring tools are increasingly being adopted to improve efficiency. However, current acceptance testing of AI auto contouring algorithms relies primarily on area- and distance-based metrics, with limited assessment of model uncertainty. Purpose To demonstrate conformal prediction as a complementary error analysis technique for AI auto contouring algorithms, providing spatially localized uncertainty information that traditional metrics do not capture. Methods A U-Net architecture with a ResNet-34 encoder was trained on BC Cancer breast data to segment the left lung, right lung, and the heart. Initial testing was performed on a subset of 376 computed tomography (CT) scans using both area-based (IoU) and distance-based (HD95) metrics. Conformal prediction using adaptive prediction sets was then performed on 138 CT scans. The change in the derivative of the intersection over union (IoU) between the original predictions and the conformal predictions was observed with respect to the selected confidence level. Results U-Net achieved a mean IoU of 0.924 and a mean HD95 of 11.35. When conformal prediction was applied using a 90% confidence threshold, the percent differences between the conformal prediction IoUs and the U-Net prediction IoUs were 1.01%, 0.89%, and 1.46% for the left lung, right lung, and the heart, respectively. The IoU derivatives differed significantly between true positive and false positive structure predictions (P Conclusions Conformal prediction provides an additional tool for acceptance testing of AI auto contouring algorithms. Beyond traditional area- and distance-based metrics, it spatially localizes uncertain predictions and offers a mechanism for identifying false positives.

Physics and Astronomy

Clinical Features and Surgical Outcomes of Cats With Presumed Primary Lens Instability: A Retrospective Study of 34 Cases (2018-2022).

Sarfaty H et al. · Jul 1, 2026

Objective Describe the clinical features, disease progression, and outcomes of presumed primary lens instability (PLI) in cats, and to assess its association with glaucoma. Animals studied Thirty-four cats (68 eyes). Procedures Medical records were reviewed for signalment, clinical history, ophthalmic findings, and treatment. Eyes were classified as anterior lens luxation (ALL) or subluxated lens (SLL). Clinical monitoring included intraocular pressure (IOP), menace response, absence/presence of blepharospasm, and complications. Surgical eyes underwent intracapsular lens extraction or phacoemulsification, with or without vitrectomy. Results Cats were 1-13 years old (median 3 years) and predominantly male (82%). At presentation, 68% of eyes had ALL and 32% of eyes had SLL. Blepharospasm was observed in 25% of eyes, mostly in ALL. IOP was elevated (> 25 mmHg) in 38% of eyes overall, comprised of 62% SLL eyes (33 ± 5.7 mmHg) and 25% ALL eyes (54.8 ± 24.1 mmHg). Of SLL eyes followed ≥ 90 days, 73% progressed to ALL within a median of 15 days (5-174 days). Forty-four eyes underwent surgery and, of 42 with follow-up (median 284 days), 95% achieved comfort and 85% retained vision; however, 70% developed postoperative glaucoma within 68 ± 51 days that was still present in 35% of eyes at last recheck. Retinal complications occurred in 14% of operated eyes. Nonsurgical eyes also showed a high risk for IOP elevation. Conclusions Presumed PLI presents bilaterally in generally young cats, often with limited signs of ocular discomfort, but with a high risk of concurrent or delayed glaucoma. Lens extraction restores comfort and can preserve vision but does not prevent future IOP elevation.

Medicine

Occupational Burnout, Post-Traumatic Stress Disorder and Intention to Resign Among Nursing Personnel During Public Health Emergencies.

Zhao J et al. · Jul 1, 2026

Aim Studies have shown that nursing staff are prone to post-traumatic stress disorder (PTSD), occupational burnout and turnover tendency in public health emergencies, but the incidence of these three and their influencing factors during the outbreak of COVID-19 have not been clarified. The aim of this study was to explore the mediating mechanism of occupational burnout between PTSD and turnover intention in nursing staff in public health emergencies. Design The study was a cross-sectional survey involving 1087 nursing personnels from 17 provinces in China. Convenience sampling was employed to select nursing personnel from frontline clinical settings in 17 Chinese provinces from March to May 2023. After excluding 13 invalid questionnaires, 1087 valid questionnaires were obtained, resulting in an overall validity rate of 98.8%. Methods Civilian version of Post-traumatic Stress Disorder Questionnaire (PCL-C), Maslach Burnout Inventory-General Survey (MBI-GS) and Turnover Intention Questionnaire (TIQ) were used respectively. Post-traumatic stress symptoms, occupational burnout and turnover tendency were assessed. Ethical review approval: Approval unit: Medical Ethics Committee of Beijing Huilongguan Hospital; Approval number: 2023-23-Science and Technology. Results 15.8% of nursing personnel had PTSD, 71.8% had occupational burnout and 63.7% had turnover intention. The scores of occupational burnout and turnover intention of nursing personnel with PTSD were higher than those without PTSD. Each dimension of PTSD was positively correlated with all dimensions of occupational burnout and nurse resignation (all p Conclusions During public health emergencies, during the COVID-19 pandemic, nursing personnel had PTSD, occupational burnout and turnover intention. PTSD plays a significant direct and indirect role in nurse turnover. Therefore, it should be a standard practice to monitor and manage PTSD among nursing personnel and provide proactive support systems in order to retain personnel and promote the best nursing practice standards during public health emergencies. Patient or public contribution No patient or public contribution.

Health Professions

Childhood Material Hardship Linked to Adolescent Neurocognition: A Computational Modeling Approach.

Zhang YL et al. · Jul 1, 2026

Childhood material hardship, including insecurity in housing, utilities, food, and medical care, is a critical factor influencing cognitive functioning and mental health outcomes. However, past research on material hardship is limited by cross-sectional data and reliance on conventional behavioral measures of cognitive functioning that suffer from poor reliability and lack of specificity. To address these gaps, this study used a well-validated computational model of cognition to examine individuals' drift rate, which is hypothesized to be driven by the efficiency of evidence accumulation (EEA) for decision-relevant information, a key process that supports higher-order cognitive functioning. Here, we examined how material hardship during childhood was associated with adolescent drift rate, and whether drift rate was linked with attention difficulties. 187 adolescents recruited from the Future of Families and Child Wellbeing Study were included in the analyses. Adolescents exposed to greater material hardship showed lower drift rate, suggesting less effective processing. Growth curve modeling revealed that initial exposure to material hardship, but not changes across childhood, was associated with drift rate in adolescence. Lower drift rate was also associated with concurrent attentional problems and served as a significant indirect pathway linking material hardship to adolescent attention. This is the first longitudinal study that examined the associations among childhood material hardship exposure, adolescent drift rate, and attentional difficulties. Our results suggest that challenges to essential living conditions in childhood may impact cognitive processes underlying goal-directed behavior in adolescents. These findings highlight the application of computational models to reveal specific cognitive processes impacted by adversity. SUMMARY: Existing research on material hardship and cognitive functioning is limited by reliance on cross-sectional task-based performance, resulting in inconsistent findings. We applied the diffusion-decision model to decompose trial-wise performance into underlying cognitive processes, including drift rate, a key evidence accumulation process underlying goal-directed behavior. Greater cumulative childhood material hardship, beyond exposure to other adversity, is associated with lower drift rate, which is linked with greater attentional problems in adolescents. Findings were specific to drift rate, not average response time or accuracy, emphasizing the value of computational methods in capturing cognitive changes associated with material hardship.

Health Professions

Spatial Distribution and Host-Specific Patterns of Avian Haemosporidian Infections in a Semi-Arid Region of Northeastern Iran.

Mirbadie SR et al. · Jul 1, 2026

Background Avian haemosporidians (Haemoproteus, Plasmodium, and Leucocytozoon) and erythrocytic bacteria (e.g., Aegyptianella) are globally widespread, yet their epidemiology in Iran's semi-arid ecosystems remains understudied. Objective This study provides the first survey of avian blood parasites in Semnan Province, Iran, integrating microscopic and spatial analyses to identify host and environmental factors influencing infection patterns. Methods From September 2022 to December 2023, 263 healthy birds from ten species were examined. Giemsa-stained blood smears were screened microscopically. Infection hotspots and risk factors were identified using Kruskal-Wallis tests, logistic regression, and spatial mapping. Results Overall infection prevalence was 22.1% and was dominated by Haemoproteus spp. (18.6%), followed by Plasmodium spp. (1.5%), Leucocytozoon spp. (1.1%), and Aegyptianella spp. (0.8%). Pigeons exhibited the highest infection rate and were nearly three times more likely to be infected than other species (OR = 2.78, 95% CI: 1.38-5.60, p = 0.004). Spatial analysis revealed infection clustering in Shahroud County, which exhibits relatively higher humidity and vegetation cover compared with other parts of the predominantly semi‑arid Semnan Province. These findings highlight the potential influence of local climatic and ecological factors on the distribution of avian haemosporidian parasites. Although infection appeared slightly higher during spring and summer (9.6% and 7.3%, respectively) compared with autumn (3.4%) and winter (1.9%), the observed differences were not statistically significant (p > 0.05). Conclusions This baseline study provides important epidemiological data and establishes a framework for future molecular and vector‑based investigations of avian blood parasites in the Middle East.

Immunology and Microbiology

Wild Pedigree exploreR (wpeR): Streamlined Analysis and Visualization of Wild Pedigrees in Time and Space.

Simčič G et al. · Jul 1, 2026

Advances in non-invasive genetic sampling and long-term genetic monitoring programmes have enabled collection of large individual genotype datasets for many wildlife populations, often accompanied by rich field metadata that place the genotyped individuals in time and space. These datasets allow reconstruction of multigenerational pedigrees and have the potential to provide valuable insights into population demography, reproduction, dispersal, social structure and genetic processes. But while the tools for construction of pedigrees keep improving, their interpretation remains challenging. Integrating multigenerational pedigree data with field metadata creates significant complexity, yet specialized tools to facilitate the interpretation of such datasets remain scarce. Here we introduce wild pedigree exploreR (wpeR), an R package designed to simplify exploration, organization and interpretation of complex pedigrees. The package enables users to link reconstructed pedigrees with genetic sample metadata, enabling evaluation of biological plausibility of inferred relationships, but also allowing exploration of other characteristics of individuals and populations in spatial and temporal contexts. wpeR implements a linear workflow through which the pedigree data is imported, formatted, organized into families and integrated with field metadata. The resulting dataset can be visualized through temporal plots that track individuals and families over time, as well as with spatial outputs representing parent-offspring relationships and individual movement patterns as geographic features that can be either directly visualized on maps within R, or exported to be further explored with common GIS tools. wpeR allows exploration of lineage relationships within their ecological context, bridging the gap between statistically reconstructed pedigrees and their biological interpretation. It provides a scalable and flexible framework for analyzing these complex data, providing a practical tool for researchers and managers working with genetic monitoring datasets.

Biochemistry, Genetics and Molecular Biology

Synthesis, Characterization, Antioxidant Evaluation, Cytotoxicity Studies, and Molecular Docking of Novel Sulfonamide Derivatives.

Bouraoui O et al. · Jul 1, 2026

A series of novel sulfonamide derivatives (4a-i) was synthesized via a three-step sequence involving Schiff base formation, sodium borohydride reduction to the corresponding secondary amines (2a-i), and subsequent treatment with p-toluenesulfonyl chloride in the presence of sodium carbonate. The structures of all intermediates and final products were unambiguously confirmed by FT-IR, 1 H NMR, 13 C NMR, and HRMS analyses. The antioxidant activity of the target compounds was assessed using the DPPH radical scavenging assay with BHT as a reference standard. Among the synthesized derivatives, compound 4d exhibited the most pronounced antioxidant activity, surpassing BHT at concentrations of 37.5 and 62.5 µg/mL. The cytotoxicity of the compounds was evaluated against human ovarian carcinoma (A2780) and prostate cancer (LNCaP) cell lines using the MTT assay, with docetaxel as a positive control. Compounds 4g, 4h, and 4i demonstrated the highest cytotoxic potency against both cell lines, with compound 4h displaying a log IC 50 value of 1.343 µg/mL against LNCaP cells. Structure-activity relationship analysis suggests that the methoxy substituent enhances cytotoxic activity, likely through increased lipophilicity and electron-donating effects facilitating interactions with biological targets. Molecular docking studies were performed to further rationalize the observed biological activities.

Biochemistry, Genetics and Molecular Biology

Prevalence of Gestational Diabetes Mellitus and Its Associated Risk Factors Among Pregnant Women Attending a Tertiary Care Hospital in Bangladesh.

Shahid MM et al. · Jul 1, 2026

Background Gestational diabetes mellitus (GDM) is an increasingly important public health problem associated with adverse maternal and fetal outcomes. The burden of GDM is rising in South Asia, including Bangladesh, yet data from tertiary care settings remain limited. Objective To determine the prevalence of gestational diabetes mellitus and identify its associated risk factors among pregnant women attending a tertiary care hospital in Bangladesh. Methods This hospital-based analytical cross-sectional study was conducted from January to June 2025 among pregnant women attending antenatal clinics at a tertiary care hospital in Bangladesh. A consecutive sampling technique was used, and 650 eligible pregnant women undergoing oral glucose tolerance testing (OGTT) were enrolled. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Sociodemographic, anthropometric, clinical, and obstetric variables were collected using structured interviews and medical records. Independent-samples t-tests, chi-square tests, and multivariable logistic regression analyses were performed using SPSS version 23. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated. Women with GDM were significantly older and had higher obesity prevalence and BMI compared with non-GDM women. Family history of diabetes, polycystic ovary syndrome (PCOS), previous delivery of a baby weighing > 3.5 kg, and history of eclampsia were significantly associated with GDM. Multivariable logistic regression identified increasing maternal age, family history of diabetes, and PCOS as independent predictors of GDM. Conclusion GDM is highly prevalent among pregnant women attending tertiary care facilities in Bangladesh. Advanced maternal age, positive family history of diabetes, and PCOS are important independent predictors. Early risk-based screening and preventive interventions may help reduce maternal and fetal complications associated with GDM.

Medicine