Wound infections represent a prevalent complication during the physiological sequence of tissue repair. Microneedles, as an emerging transdermal drug delivery platform, can achieve long-term intelligent management of infected wounds after loading microspheres. We herein present a microsphere-loaded microneedle patch consisting of chitosan (CG) grafted with gallic acid and polyvinyl alcohol (PT) cross-linked by TSPBA, PLGA microspheres loaded with mangiferin (MF) and an antibacterial metal phenolic network coating composed of gallic acid and silver. The multifunctional microneedle system demonstrates outstanding bactericidal efficacy，stimuli-responsive drug release of MF through pH/ROS-triggered mechanisms ，and microenvironment modulation capabilities in infected wound beds. By the 14th day, the experimental group exhibits a wound area that was merely one-fourth the size observed in the control group, showcasing a pronounced enhancement in the healing rate. The proposed methodology delineates an innovative design paradigm for developing bioresponsive microneedle systems capable of maintaining controlled pharmacokinetics while orchestrating regenerative processes in microbially compromised wounds.

In this work, the TBTPY-Py aggregation-induced emission (AIE) molecules with N and S have been examined as a corrosion inhibitor for N80 mild steel in 15 wt.% HCl solution was evaluated using weight loss method and electrochemical measurements. The corrosion inhibition capability of TBTPY-Py increased with the rising concentration, and the optimal corrosion inhibition efficiency reached 96.98% at 50 mg/L. The real-time fluorescence observation combined with electrochemical impedance test revealed that the AIE intensity and corrosion inhibition efficiency increased synchronously, TBTPY-Py molecules can act as the fluorescence indicator to visualize the adsorption of TBTPY-Py molecule on metal surface. The adsorption behaviour and corrosion mechanism of inhibitor molecule were further studied using atomic force microscopy, water contact angle, X-ray photoelectron spectroscopy, Fourier transform infrared spectroscopy, scanning electron microscope and energy Dispersive Spectrometer. Results confirmed the chemisorption of TBTPY-Py molecules on the steel surface to form a hydrophobic protective layer, thus inhibiting metal corrosion.

Background and Aim: Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal disorders characterised by ineffective haematopoiesis and an increased risk of progression to acute myeloid leukaemia. In the Democratic Republic of Congo (DRC), healthcare institutions face major diagnostic challenges due to minimal infrastructure, limited access to testing equipment, and a shortage of trained professionals. This study analyses MDS diagnostic practices in the DRC, identifies unmet needs, and proposes strategies for improving early and accurate detection. Methods: A comprehensive literature review was conducted using international databases (PubMed, Google Scholar, and Scopus) alongside local health reports. The research synthesised data from peer-reviewed articles, hospital-based studies, and World Health Organisation (WHO) guidelines, with a focus on MDS diagnosis in sub-Saharan Africa, particularly in the DRC. Results: The findings reveal persistent diagnostic barriers in the DRC, including limited availability of bone marrow aspiration tools, under-resourced laboratories, and a lack of trained hematopathologists. MDS diagnosis largely depends on peripheral blood analysis and basic marrow examinations, leading to frequent underdiagnosis and misclassification. The absence of standardised diagnostic protocols and inconsistent reporting practices further hampers accurate disease identification. Moreover, brown pigmentation in cases of acute myeloid leukaemia can obscure proper diagnosis, underscoring the need for timely and precise detection methods. Conclusion: MDS diagnostic evaluation in the DRC is hindered by systemic and technical limitations, including infrastructure deficits and workforce shortages. Addressing these issues requires strengthening laboratory capacity, expanding access to diagnostic technologies, and investing in specialist training through international collaborations and local educational initiatives. There is an urgent need for a national diagnostic guideline tailored to the DRC’s healthcare context to ensure accurate classification and improve patient outcomes.

A document by Yugo Kawakami. Click on the document to view its contents.

Background: The AHOPCA (Asociación de Hemato-Oncología Pediátrica de Centro América) Wilms tumor (WT) treatment guidelines, adapted from NWTS-4 and -5 and recommending upfront nephrectomy (UN), were modified to include 4 to 6 weeks of preoperative chemotherapy (POC) in frail patients with advanced disease. We aim to describe the outcomes of this implemented approach. Procedure: A retrospective analysis of prospectively collected data from newly diagnosed patients with unilateral WT between 2012 and 2018. Results: Of 353 eligible patients, 247 (70%) received POC. POC group had higher initial tumor volume (median 590 ml vs. 308 ml, p<0.0001) and more stage IV disease (30% vs. 3%, p<0.0001) compared to UN group. During POC, there were 4 deaths, 14 abandonments and 11 progressive diseases. After response assessment, 62% showed partial tumor response with median tumor volume reduction to 257 ml. Two-hundred eighteen (88.2%) underwent nephrectomy. Tumor rupture/spillage occurred in 17.9% of UN and 18.8% of POC group; Local stage III was found in 55% of UN and 68.3% of POC group. Anaplasia (focal and diffuse) was present in 13.6% (17% UN and 11.9% POC). The 5-year abandonment-sensitive event-free survival (asEFS) and abandonment-sensitive overall survival (asOS) rates were 69%±2.5% and 75%±2.4%, respectively. The asEFS rates were 75%±4.3% for UN and 66%±3.0% for POC (p=0.07). Conclusions: Many AHOPCA patients presented with unresectable advanced disease, necessitating the use of POC. POC effectively reduced tumor volume and facilitated safe surgery in fragile patients. Adopting the standard SIOP WT neoadjuvant approach could enhance staging and risk stratification in AHOPCA.

Primary ciliary dyskinesia (PCD) is a heterogeneous genetic disorder characterized by structural and functional abnormalities of motile cilia, leading to chronic oto-sino-pulmonary symptoms and progressive lung damage. Markers of early lung disease in PCD may help to identify individuals who may benefit from closer monitoring or earlier, more aggressive interventions. Multiple Breath Washout (MBW) offers a noninvasive assessment of ventilation distribution inhomogeneity. Whether MBW could serve as a marker of early lung disease in PCD or could be used as an efficacy endpoint in clinical trials in PCD remains to be established. This narrative review evaluates current literature on the role of MBW in early detection and tracking of PCD-related lung disease progression, focusing on its sensitivity compared to spirometry and to the results obtained in different PCD genotypes and phenotypes. Current evidence suggests that LCI outperforms spirometry in detecting early lung abnormalities, but it may also be overly sensitive in this population. The role of LCI in long-term disease monitoring remains uncertain, requiring more robust longitudinal data. Alternative MBW indices, such as S cond and S acin, might offer additional insights into the source of ventilation heterogeneity along the respiratory tract but need further validation. The correlation of MBW with imaging modalities, though inconsistent, underscores the potential value of LCI as a non-invasive marker for tracking PCD lung disease, supporting further research to confirm its clinical utility in PCD management.

Title: Potassium Peril: A Rare Case with Review of Literature of Hyperkalemic Paralysis as a presentation of Obstructive Uropathy and CKDAuthor: Dr. Sunidhi Rohatgi 1, Abulkalam A. Sirajwala2, M.D., Patel Rahenuma Y.3,Affiliations: 1 MBBS, Medical College Baroda, India, email id: sunidhirohatgi@gmail.com2 M.D., Medical College Baroda, India, email id: asirajwala263@gmail.com3 MBBS , Government Hospital, Bharuch, India, email id: renupatel2603@gmail.comFunding : Self funded.There is no conflict of interest .This case report has passed through the ethics approval committee of the medical college.Written patient consent was taken.We give our consent to reproduce material from other sources.Correspondence address: 233 Rajeev Gandhi Special, Jhalawar Road, Kota, Rajasthan-324005, India.E Mail id: sunidhirohatgi@gmail.comPhone: +91-8824696633.KEY CLINICAL MESSAGE:Hyperkalemic periodic paralysis is a rare disease, It is divided into two types Primary and secondary. Primary is autosomal dominant caused by mutation in the SCN4A gene that codes for voltage-gated sodium channels Na1.4, which alters the usual structure and function of sodium channels. Secondary hyperkalemic periodic paralysis is caused secondary to chronic renal disease, Addison’s disease, rhabdomyosis, or excessive ingestion of potassium supplements or potassium rich foods such as potatoes or bananas. In the present case, a 55 year old male patient with chronic renal disease and hydronephrosis, hypertension presented with both upper and lower limb weakness mimicking GBS like symptoms, having high potassium levels in blood and high Serum Creatinine and Urea levels with no cardiac arrythmias. HYPP is a rare presentation of hyperkalemia in Chronic Kidney Disease.Keywords:Hyperkalemia, Periodic paralysis, Chronic renal disease, Hydronephrosis.INTRODUCTION-Hyperkalemic Periodic paralysis is an autosomal dominant muscle channelopathy with nearly complete penetrance. It is characterized by recurrent episodes of muscle weakness associated with elevated levels of blood potassium (1,2). It was first discovered by Tyler et al in 1951, in a study of seven generations of individuals with typical periodic paralysis in the absence of hypokalemia(3).HYPP is a rare condition begins in childhood and can continue until middle adulthood or may even last into late adulthood. It presents as muscle weakness, ranging from mild weakness to paralysis. During these episodes, it is common to have higher than normal blood levels in potassium. (4). It is divided into hereditary (Primary) and acquired (secondary) forms.The disease affects approximately 1 in every 2,00,000 individuals. (5).In the present case a male patient 55 years age presented in medicine emergency with bilateral upper and lower limb hemiparesis due to hyperkalemia manifesting as a rare presentation of Chronic Kidney Disease with hydronephrosis and recent history of hypertensionBlood investigation showed raised serum potassium level with raised serum creatinine and urea levels.CASE HISTORYA elderly male patient aged 55 years presented to us in medicine emergency with high grade fever associated with burning micturition since 8 days, easy fatigability, weakness in bilateral lower limbs since 4 days, which increased over course leading to fall at home and which was bilaterally symmetrical and involved proximal muscles. There were also complaints of decrease in appetite, nausea, and vomiting for 4 days. The patient noticed a drop in urine output since last 2 days.Blood pressure level was 160/100 mm Hg at the time of admission.Patient did not have any complaints of breathlessness, altered sleep pattern, hiccups, chest pain, pedal edema, fever, abdominal pain, altered behaviour. Reflexes in Lower extremities were absent. Both upper limb reflexes were decreased grade +1.CNS examination-Higher Functions- normalCranial Nerves- NormalMotor- Power: upper limb- grade 2 ; lower limb- grade 0Involuntary movements- noneSensory: NormalReflexes- upper limb +1: lower limb grade 0 (absent)Autonomic function- NormalCerebellar Function- NormalMeningeal irritation- NoneBack and Spine- NormalPeripheral nerves and vessels- NormalHe was diagnosed with hypertension 7 days before his presentation. Ultrasonography showed size of Right kidney 155 x 80 mm in size, bulky showing gross hydronephrosis with severe thinning of renal parenchyma, thickness being 2.2 mm. Multiple calculi at renal pelvis of average size 10-12 mm were present. Left kidney measured 88 x 45 mm in size, corticomedullary junction being attenuated, tiny calculi at poles of average size 3-4 mm.DIFFERENTIAL DIAGNOSIS:1) Hypokalemic Periodic paralysis, 2) Thyrotoxicosis Periodic paralysis, 3) Andersen-Tawil syndrome. The differentiating features of these are :Hypokalemic Periodic Paralysis: Thers is a defect of the alpha-1 subunit of dihydropyridine-sensitive calcium channels and sodium channel protein type 4 subunit (SCN4A) encoded sodium channels in skeletal muscle. (6). It is the most common presentation of Periodic paralysis. Incidence is 1 in 1,00,000 people. It begins in late childhood with frequency of attacks ranging from weeks to months. Each episode may last several hours to days. Between the attacks Potassium levels are normal, but if it persists between attacks, then it may be due to secondary to renal potassium loss. Electrocardiogram shows increase in amplitude of U waves, decrease in amplitude of T-wave and depression of ST segment. (4,7).Thyrotoxicosis Periodic Paralysis: It may be associated with potassium ion channels defect, mutation in gene encoding Kir 2.6 which is regulated by Thyroid hormones. T3 and T4 increases sensitivity of beta adrenergic stimulation resulting in increased acitivity of Na-K ATPase in the skeletal muscle membrane leading to influx of potassium into the cells and decreased level in serum. (8). Onset is between 20-39 years of age, commonly seen at night or early morning or summer. Symptoms may last for several hours to days, can be triggered by excessive physical activity , stress, high carbohydrate intake, cold exposure, infection, alcohol intake, corticosteroid, bronchodilator, menstrual cycle. (9). Characteristic is hypokalemia, generalized muscle weakness, proximal muscles, lower extremities, myalgia ( 10).Andersen-Tawil syndrome: It is caused by mutation on the Kir 2.1 encoding gene. (11). Patient have a triad of periodic paralysis, Ventricular arrythmias and dysmorphic features (short stature, clinodactyly, hypertelorism, micrognathia). ECG shows prolonged QT interval . Potassium may be low, normal or even high. It is 10 times rarer than hypokalemic periodic paralysis. (11).

Case Report Series:

IntroductionThalassemia major is a serious genetic blood disorder characterized by the body’s inability to produce sufficient hemoglobin, resulting in severe anemia that necessitates regular blood transfusions for survival [1]. A common complication in patients with beta-thalassemia is iron overload, primarily due to  frequent blood transfusions in transfusion-dependent thalassemia (TDT) and enhanced intestinal absorption linked to ineffective erythropoiesis and hepcidin suppression in non–transfusion-dependent thalassemia (NTDT) [2]. Cardiac complications remain the leading cause of morbidity and mortality in these patients [3].While serum ferritin is commonly used to assess iron levels, it can be unreliable when used alone due to factors like inflammation [4, 5]; therefore, noninvasive imaging techniques are also employed to diagnose and monitor iron overload across different organs [2]. Hemoglobinopathies are among the most prevalent single-gene disorders globally, with about 1–5% of the population carrying a thalassemia gene mutation.  Although thalassemias are traditionally more common in the Mediterranean, Middle East, Indian subcontinent, and Southeast Asia, increased migration has raised its prevalence in Europe and North America, making it a global health concern [6]. Addressing thalassemia is crucial due to its significant impact on health, Including severe anemia, growth retardation, and various complications such as iron overload, organ damage, and reduced quality of life [7]. Despite advances in transfusion practices and iron management, iron overload and related complications remain a challenge for patients with TDT [4]. This report highlights a rare case of transfusion-dependent thalassemia major with severe bone marrow hemosiderosis, aiming to contribute to the medical understanding of iron overload complications.

The Online Directory Management System is a novel concept of an integral digital directory management system. The concept aims at an efficient and impeccable distributed directory management system over network. The concept came to building up as an entity as it felt like a good for many in the digital society. The application replaces the conventional directory and personal profile management system using catalogue keeping, book keeping and such practices. The digital application is reduced as much as possible to avoid errors while managing the data and ensure the security and protection data. Every online application or web-oriented firms, whether big or small, has challenges to overcome and managing the information of, various stakeholders. This application is potential to be accommodated into different websites as an add on plugin extension. Thus, the application would have a very wide range of application. This system can lead to error free, secure, reliable and directory management system. It enhances any system as a potential and reliable directory

Early detection of breast cancer is critical for improving patient outcomes. This study builds and evaluates a Random Forest model to classify breast tumors as malignant or benign using the Wisconsin Diagnostic dataset. Key contributions include visual data analysis and high model accuracy (96.49%). The model's strong performance suggests AI's potential in diagnostic processes and lays the groundwork for future clinical applications.

One of the many novel features of the COVID-19 mRNA injections is their inherent self-adjuvanticity. It is believed that the adjuvant activity of the lipid nanoparticles (LNPs) containing ionizable or cationic lipids can explain their superiority in the induction of adaptive immune responses. Several studies have provided evidence of various immunostimulatory effects via the mRNA-LNP complexes or their individual compounds. Specifically, a 2023 study in Nature Communications implicated the mRNA compounds acting as adjuvants for the cellular immunity of mRNA technologies. In addition, this study found these injections trigger some unexpected antigen processing pathways which remained unaccounted for by the authors. A recent rational analysis of these unexpected processes identified a significant potential for adverse implications with clinical and environmental ramifications. These concerns have not been described elsewhere. Very recently, a Nature Communication study revealed some results that are difficult to align with the modus operandi of these platforms and their inherent adjuvanticity. Several logical arguments are provided to identify the nature of these gaps and how they can be explained by the unaccounted immune activation processes identified earlier. In all, this study extends the previous theoretical considerations related to several underappreciated findings about the modus operandi of mRNA technologies and seamlessly aligns existing gaps and apparently paradoxical data from recent studies. Poorly understood aspects of antigen processing and adjuvanticity converge to cause unaccounted immune responses towards targeted and off-target (self)antigens and challenge specificity and type (immunogenic vs. tolerogenic) of mRNA vaccine immunity.

Intelligent transportation research exhibits a reproducibility crisis in the modern age, with multimodal data and growing interest in connected computing. The crisis is exacerbated by a lack of design of experiment adoption, fragmented data practices, and ad-hoc software toolchains.

Background and Purpose: Esophageal squamous cell carcinoma (ESCC) is one of the most common malignancies and causes cancer-related deaths globally, necessitating the identification of novel therapeutic targets and treatments. Sterol O-acyltransferase 1 (SOAT1) is one of key genes related to the cholesterol esterification and identified as a singularly up-expression gene in ESCC tissues. However, the anti-cancer effects and molecular mechanisms of SOAT1 on ESCC remains unclear. Experimental Approach: Therapeutic target was screened and identified using ESCC patients’ samples and bioinformatics. To evaluate the anti-cancer effect of SOAT1 on ESCC, multiple experiences were performed such as SOAT1 knockdown, molecular docking analysis, CCK-8, clone formation assays, bioinformatics analysis, Western blotting and real-time PCR arrays. Key Results: Knockdown of SOAT1 could inhibit cell proliferation, migration, and invasion. Then, molecular docking analysis was used to identify piperine as a potential inhibitor of SOAT1. Interestingly, the inhibition of SOAT1 obviously enhanced ferroptosis and the inhibitory of cell viability. Furthermore, the inhibition of SOAT1 synergistically enhanced the anti-cancer effect of cisplatin in ESCC. Further information mining revealed that the inhibition of SOAT1 enhanced ALF4-induced ALOX12B expression by reducing PI3K-AKT pathway. Next, we found that SOAT1 inhibitor piperine suppressed tumor growth without affecting mice weight in vivo. Conclusion and Implications: Together, this study indicated that the inhibition of SOAT1 enhanced ferroptosis by reducing PI3K-AKT pathway and subsequently up-regulating ALF4/ALOX12B. Thus, our findings strongly emphasize that SOAT1 holds great potential as a highly promising clinical therapeutic target in ESCC.

Introduction: A subperiosteal abscess in chronic suppurative otitis media may arise from direct erosion of the cortical bone or via transmastoid spread of infection through cribriform vessels. While subperiosteal abscesses typically present in the postauricular region over the mastoid bone, they can occasionally occur in atypical locations. Occipital abscess associated with cholesteatoma

The health risks associated with saturated and trans fats have intensified interest in alternative structuring systems for bakery fats. This study evaluated five natural waxes (beeswax, carnauba wax, rice bran wax, coconut wax, and soy wax) blended with extra virgin olive oil at 9% and 12% (w/w) and crystallized at 4 °C or −18 °C, to assess their functionality as margarine replacers in cake batters. Oleogels were characterized using UV-Vis spectroscopy, FTIR, XRD, rheology, and oil-holding capacity. Batter performance was assessed through creaming index, density, and color, while baked cakes were evaluated for texture profile (TPA), porosity, and surface color. Results showed that wax type, concentration, and crystallization temperature significantly influenced oleogel structure and batter behavior. Beeswax and rice bran wax formed semi-flexible crystalline networks that closely mimicked margarine in terms of aeration and stability, producing cakes with comparable porosity, texture, and visual attributes. Carnauba wax enhanced creaming stability but limited air incorporation, while soy and coconut waxes showed weaker structuring and reduced batter performance. Crystallization at −18 °C improved gel strength and network definition across most wax types. Overall, beeswax and rice bran wax oleogels demonstrated strong potential as clean-label, functional fat alternatives in aerated cake systems, offering structural and sensory properties similar to traditional margarine.

Achieving sustainable agricultural development is essential for ensuring stable global food supplies. Rural-urban migration, as a widespread socioeconomic phenomenon, introduces complexities and uncertainties to sustainable agricultural practices. This study constructs an analytical framework linking migration, large-scale farming, and sustainable agriculture, leveraging empirical evidence from 37,648 village-level samples in China. The findings demonstrate that rural-urban migration significantly enhances sustainable agriculture, as evidenced by increased mechanization and reduced fertilizer use, facilitated through large-scale farming. We further highlight the heterogeneity in large-scale farming decisions by agricultural entities under rural labor outmigration, shaped by economic rationality. Favorable production, distribution, and living conditions significantly amplify the positive impact of migration on large-scale farming, thereby contributing to enhanced sustainable agricultural outcomes. This study advances the understanding of the land-labor relationship under rural-urban migration and offers actionable insights for formulating policies to promote sustainable agricultural development.

This note clarifies the prediction of the Momentum-First (M-First) framework regarding the anomalous velocity shifts observed during spacecraft fly-bys of Earth. The framework's foundational conservation laws, derived from the time-isometry of a stationary spacetime, are shown to mandate that the novel kinematic mechanisms of M-First are strictly conservative with respect to a particle's asymptotic speed. While the standard gravity-assist energy exchange is correctly described within the framework via a change of reference frame, the residual anomaly cannot be explained by these new gravitational effects. M-First thus makes a sharp, falsifiable null prediction for its own contribution, constraining the source of the fly-by anomaly to non-gravitational physics or effects beyond the stationary spacetime model.

We apply the Momentum-First (M-First) framework, in which gravity directly modifies a particle's fundamental momentum relation, to derive the governing quantum operator for a fermion in stationary spacetimes. The resulting unified core momentum operator, $\hat{M}_g$, is constructed from first principles, and its structure is uniquely fixed by the spacetime's symmetries, containing no free parameters. In the static limit, the operator's scalar component—the contextual fermic momentum—provides a quantitative, parameter-free resolution to the neutron star shallow heating puzzle by enhancing quantum tunneling rates. The operator's vectorial component, sourced by spacetime rotation, gives rise to novel, falsifiable spin-gravity couplings, including a gravitational spin-Hall effect. The ability of this single operator to resolve a persistent anomaly while predicting new, testable phenomena demonstrates the predictive power and internal consistency of the M-First paradigm.

Faunal habitat selection, or the disproportionate use of available resources, is closely linked to habitat composition and configuration across a seascape. However, the drivers of habitat selection operate across multiple scales and require a hierarchical approach to study. This study combines acoustic telemetry, field survey data, remote sensing, and machine learning to investigate the multi-scale (seascape and patch) habitat selection of Spotted Seatrout (Cynoscion nebulosus) in Florida Bay, Everglades National Park, USA. Spotted seatrout responded to both scales, as there were three patch-scale (Halodule cover, standard deviation of submerged aquatic vegetation (SAV) cover, and SAV species richness) and one seascape-scale (patch density) predictor in the top four. However, responses were scale-specific, exhibiting logistic responses to seascape-level variables and optimal responses to patch-level characteristics. This study highlights the importance of investigating habitat selection across multiple scales as climate change alters not only species ranges, but local seascapes as well.

Interspecific mating conflicts emerge when sympatric species mature simultaneously, requiring mechanisms for mate recognition and competition reduction. This study examines how cuticular hydrocarbons (CHCs), lipid-based mate attraction cues, resolve these challenges in five Ficus semicordata-associated fig wasp species. Species-specific CHC profiles with sexual dimorphism, combined with male mate choice, prevent crossbreeding while ensuring reproductive isolation. Functional groups sharing resource strategies exhibit convergent CHC patterns, yet seasonal changes and interspecific interactions drive phenotypic plasticity. Trophic-level CHC convergence reflects climate adaptation, revealing functional redundancy. Sex-specific adaptations arise: males optimize mate-search efficiency, whereas females prioritize offspring survival, mirroring their reproductive roles. This dual chemical system balances niche partitioning (via signature compounds) and environmental adaptability (via shared functional traits), illustrating how chemical traits mediate ecological adaptation and speciation in coexisting insect communities under spatiotemporal pressures.

Managing biodiversity for ecosystem stability amid environmental change is crucial, but local-scale knowledge often fails to align with regional management needs. Variation in species composition among communities (β-diversity) likely stabilizes ecosystem functions at larger spatial scales by promoting spatial asynchrony—where different communities respond asynchronously to environmental fluctuations. Both β-diversity and spatial asynchrony are scale-dependent, yet the role of spatial extent in shaping these relationships remains unclear. Using simulated landscapes from a highly replicated grassland biodiversity experiment, we demonstrate that when environmental heterogeneity is minimized, β-diversity promotes spatial asynchrony, enhancing stability at larger spatial scales. However, these relationships are scale-dependent, weakening with increasing spatial extent. Additionally, local-scale diversity remains influential even after accounting for its covariance with β-diversity. Our results, therefore, emphasize the importance of preserving β-diversity, particularly in small, abiotically homogeneous landscapes, and advocate for multi-scale conservation strategies that enhance ecosystem stability amid global environmental change.

Cadmium (Cd) is detrimental to agroecosystems due to its mobility and phytotoxicity, even at low concentrations. Phytoremediation is widely considered a cost-effective and eco-friendly (green) technique for cleaning Cd-contaminated soils. This process involves cultivating Cd hyperaccumulators that translocate and concentrate the metal from the soil to the roots and aboveground parts. Sedum alfredii Hance ( S. alfredii H) was first discovered in China as a novel hyperaccumulator of Cd, Zinc (Zn), and lead (Pb), characterized by fast growth and large biomass, compared to other Brassicaceae Cd hyperaccumulators. A regulatory network for Cd detoxification and accumulation in S. alfredii H has been identified as a key physiological and molecular mechanism. Recent progress in understanding the physiological and molecular mechanisms of Cd uptake, tolerance, and translocation has already been reviewed. The results show that the Cd uptake occurs through two processes: the soil–to–rhizosphere and rhizosphere–to–root. In the two processes, root exudates in the rhizosphere S. alfredii H, may correlate with heavy metal accumulation, and transporter expression levels in the root plasma membranes may play a key role in Cd hyperaccumulation in S. alfredii H. The plant tolerates Cd in the soil by adapting to Cd-induced oxidative stress. Membrane proteins are considered key transporters for Cd and Zn accumulation in the plasma membrane of S. alfredii H shoots.

TitleIs Mediterranean diet associated with severe asthma control? A multi-center cross-sectional study in Greece.To the Editor,Severe asthma is a heterogenous disease where different phenotypes and endotyping mechanisms are implicated1. Asthma control is an achievable target where some life-changing aspects like smoking cessation, diet and physical activity may also be involved2. The incidence of and mortality from various diseases have been linked to the Mediterranean diet (MD)3. In a previous small study among well-defined asthmatic patients with different severities, we found a trend between adherence to MD and asthma control in severe asthmatics. This trend lacked significance possibly due to the limited number of severe asthma subjects4. Based on the above finding we hypothesized that in a larger cohort of severe asthmatics, adherence to MD could influence asthma control. Therefore, we conducted a cross-sectional study to address the above association using a larger cohort of severe asthmatics, all Mediterranean inhabitants.This study was an observational, multicenter, cross-sectional study. Study methodology and parameters are provided on an online supplement. Adherence to MD during the previous year was assessed through an interviewer-administered Mediterranean Diet Adherence Screener (MEDAS), a 14-item validated questionnaire which aims to capture the consumption of the MD components5,6.Further information for MEDAS is provided on the online supplement. Statistical analysis is also described in the online supplement.The study sample consists of 315 adults with severe asthma (70% females) and mean age 56.6 years (SD=14.3 years) (Table 1). According to the Asthma Control Test (ACT), 68% of the participants had well-controlled asthma (ACT ≥ 20) and 87% did not receive cortisone treatment. Nearly half of the participants (52%) had atopy, 14% were diagnosed with diabetes mellitus and only 25% of them reported high adherence to the Mediterranean diet (MEDAS Score ≥ 10). In this sample of severe asthmatics in Greece, where the Mediterranean dietary pattern is generally prevalent particularly among older adults, higher adherence to MD was associated, albeit not statistically significantly, with well-controlled asthma (Odds Ratio (OR): 1.19, 95% CIs: 0.61, 2.34), after adjusting for a number of characteristics and clinical conditions that could confound the association. (Table 2). Obesity and type 2 diabetes were statistically significantly associated with poorer asthma control while use of biologics was statistically significantly associated with better asthma control (OR: 4.61, 95%CIs: 2.55, 8.32).From an earlier study of our group, there was some indication that MD might be associated with disease control among severe asthmatics4. The present study was carried out to address this hypothesis in a larger sample, yet through a cross-sectional design. Our results do not provide evidence for a beneficial effect of MD, over and beyond treatment and controlling for diet-related co-morbidities. The fact that the study sample is relatively young and adherence is rather low may not provide us with enough variance to detect such an association. This study does not allow us to draw firm conclusions on the association between MD and asthma control in severe asthmatics. However, three meaningful messages can be retrieved. The lack of association between MD and asthma control may decrease the likelihood of diet interventions conferring protection against severe asthma, second and most important biologics remained the cornerstone of treatment interventions for achieving asthma control and finally co-morbidities such as diabetes may influence asthma control in various ways (avoidance of systemic corticosteroids, lower dose of ICS and symptoms mimicking asthma).