Vagus nerve stimulation (VNS) is an established neuromodulatory therapy approved for epilepsy, depression, obesity, stroke rehabilitation, rheumatoid arthritis, migraine, and cluster headaches. Its therapeutic potential has expanded dramatically, with growing evidence supporting its efficacy across a wide spectrum of neurological, psychiatric, cardiovascular, immunological, metabolic, and gastrointestinal disorders. Despite this progress, the field has lacked a comprehensive synthesis that unifies mechanistic insights with translational applications across organ systems. This review addresses that gap by systematically integrating current knowledge in the multifactorial mechanisms through which VNS modulates central and peripheral functions, including neuromodulator release, synaptic plasticity, autonomic regulation, neuroimmune control, and endocrine integration. In addition, this review identifies key limitations of VNS, including biological heterogeneity, technical constraints, and methodological variability, and proposes future innovations such as selective fiber targeting, closed-loop systems, and artificial intelligence-guided personalization. By providing a rigorous, system-level overview of VNS mechanisms and their translational relevance, this article serves as a foundational resource for advancing the science and clinical deployment and helping illustrate future directions for precision neuromodulation and bioelectronic medicine.

A throwback on 25 years in pannexin research.

Lead is known to exert toxic effects on nearly all tissues and organ systems, with the nervous, gastrointestinal, and haematopoietic systems being particularly vulnerable. In humans, lead interferes with haemoglobin synthesis, leading to anaemia, and its disruption of porphyrin metabolism can trigger abdominal pain due to vasospasm. Cases due to lead poisoning are an uncommon presentation in healthcare facilities and often overlooked as a cause of anaemia and abdominal pain. Although occupational exposure remains a well-established source of lead poisoning, non-occupational factors, such as the use of metal cookware, are gaining importance as potential contributors in daily life. We report a case of a 48-year-old man presenting with a two-month history of crampy abdominal pain, fatigue, and constipation. After a detailed history and physical examination, other possible causes were excluded and revealed his recent use of a new cookware to ferment rice. Subsequent testing showed an elevated blood lead level of 87.2 μg/ dL. The patient recovered after chelation therapy. Lead poisoning can cause nonspecific symptoms like abdominal pain, anaemia, and neuropathy, often leading to misdiagnosis. Delayed diagnosis may result in irreversible harm. It should be considered in emergency cases of unexplained abdominal pain after ruling out common causes. This case highlights the importance of paying attention to subtle, often overlooked aspects of a patient’s daily routine. Maintaining a broad differential diagnosis and asking targeted questions can be crucial in identifying uncommon causes and achieving a timely, potentially life-saving diagnosis.

Broiler production is a major contributor to global food supply and economic growth, yet housing systems vary significantly in their ability to support welfare, productivity, and sustainability. This review compares conventional, enriched, free-range, and organic housing systems, highlighting their strengths, limitations, and welfare implications. Conventional indoor systems, while efficient, are often linked to welfare problems such as lameness, contact dermatitis, heat stress, and restricted behaviour due to high stocking densities and limited stimulation. Enriched systems, which incorporate perches, platforms, barriers, and manipulable materials, can promote natural behaviours, activity, and leg health, though their impact depends on enrichment design and bird genotype. Free-range and organic systems offer outdoor access and support natural foraging and exploration, but introduce challenges related to weather, predation, parasites, and inconsistent litter quality. Welfare outcomes across systems are strongly influenced by ventilation, lighting, stocking density, enrichment strategies, and breed selection, with slower-growing genotypes showing better suitability for enriched and outdoor environments. Overall, no single housing system provides optimal outcomes across welfare, productivity, and sustainability. Progress in broiler production will require integrated approaches that balance welfare with environmental and economic considerations, supported by continued innovation in housing design and management.

Fire-retardant phase-change material composites: A review of organic and inorganic systems for thermal safety

Sparse nonlinear identification for control-oriented modeling of an organic Rankine cycle system

Molecular-weight dependence of the dispersing efficiency for comb-shaped acrylic polymers in aqueous organic pigment systems

Ratiometric fluorescent sensing of copper (II) by a new covalent organic framework-based platform.

A real-world pharmacovigilance study of modafinil events in the FDA Adverse Event Reporting System (FAERS).

Digital twins are emerging as transformative tools in modern healthcare, representing a paradigm shift toward precision medicine by offering living, data-driven computational replicas of patients or organs that evolve with real-time information. As solutions to the growing demand for personalised, precision-based therapeutic approaches, digital twins play a particularly significant role in transplantation, which is characterised by its data-rich care pathway, time-critical decisions, and complex lifelong immunologic management, making it an ideal environment for precision medicine applications. This narrative review examines how digital twins are being conceptualised and applied across the entire transplant lifecycle, from donor assessment and organ preservation through to operative planning, immunosuppression management, and long-term surveillance, while proposing a pragmatic roadmap for clinical translation. We conducted targeted literature searches between June and October 2025, focusing on digital twin applications in transplantation, machine perfusion technologies, precision immunosuppression dosing, immune modelling, and virtual organ systems. We prioritised scoping reviews, mechanistic studies, clinical investigations, and authoritative technology sources. Foundational applications include liver virtual twins for living donor transplantation, data streams from normothermic machine perfusion platforms enabling organ quality assessment, model-informed precision dosing systems for tacrolimus approaching closed-loop control, and conceptual immune system twins for rejection risk prediction. Evidence ranges from mechanistic simulations and preprints to early clinical pharmacokinetic and pharmacodynamic studies, though rigorous prospective validation remains limited. Digital twins hold substantial promise for augmenting transplant decisions throughout the clinical pathway, but require rigorous validation, interoperable data infrastructure, and governance frameworks aligned with safety and equity principles before widespread adoption.

Abnormal upregulation of SPP1 promotes fibrotic scar after peripheral nerve repair (FS-PNR) by driving M2 macrophage polarization.

Sickle cell disease.

Adverse drug reactions (ADRs) to Antiretroviral Therapy (ART) among people living with HIV/AIDS (PLWHA) can significantly affect treatment adherence, viral suppression and contribute to HIV-related morbidity and mortality. ADRs to long-term ART use is not well understood in resource-constrained countries like Nigeria. This study identified the determinants and outcomes of ADRs to ART among PLWHA in Nigeria. Secondary data analysis of the 2014 to 2018 National Pharmacovigilance records was conducted using 3,397 individual case safety reports (ICSRs). The outcome variables were the actual adverse drug reactions reported (e.g., headache, dizziness, anaemia) and the seriousness of the ADR (Serious vs. Non-serious ADR). In contrast, the explanatory variables included the patient's age, sex, weight, duration of ADR, concomitant medicines used, and ART regimen. ADRs were determined using the WHO System Organ Classification, which groups ADRs by the organ system or body part affected. Data were analysed using multivariate logistic regression, with a p-value set at 5%. The mean age of the participants was 34.7 ± 11 years, and the majority were female (71.5%). The most commonly reported ADRs were neuropsychiatric disorders (29.8%), skin and appendage disorders (17.1%), peripheral nervous system disorders (6.7%), musculoskeletal disorders (4.3%), and anaemia (2.1%). On multivariate analysis, factors associated with development of neuropsychiatric disorders were female were female gender (AOR = 1.43, 95% CI (1.20-1.71): p < 0.001), Efavirenz-based therapy (AOR = 5.58, 95% CI: (4.41-7.05) p < 0.001), older age [16-35 years [AOR = 3.34; 95% CI: (1.72-6.48); p-value: <0.001, [36-50 years: AOR = 2.32; 95% CI: (1.19-4.52); p-value: 0.014; > 50 years AOR = 2.77; 95% CI: (1.36-5.63); p-value: 0.005] Use of Tenofovir [AOR = 1.65; 95% CI: (1.20-2.30); p-value: 0.002], and Zidovudine [AOR = 1.44; 95% CI: (1.13-1.85); p-value: 0.003] were associated with cutaneous adverse drug reactions. Anaemia was associated with the use of Zidovudine [AOR = 32.56; 95% CI: (4.41 - 7.05); p-value: <0.001], but was inversely associated with cotrimoxazole use [AOR = 0.58; 95% CI: (0.42- 0.79); p-value: 0.001]. Some (22%) of the patients recovered from ADRs; 1.2% were fatal, while 71.5% outcomes were unknown. ADRs were common among ART patients in Nigeria., with female gender, older age and types of ART regimen being major determinants of ADRs Active surveillance is necessary to ensure early detection of ADRs among patients on ART and thereby prevent ART-associated morbidity and mortality.

The present study assessed the added diagnostic value of histopathology in complementing molecular detection of World Organization for Animal Health-listed viral pathogens during Colombia's national shrimp health surveillance program. Pooled samples of pleopods from 1,470 whiteleg shrimp Penaeus vannamei (5 animals/pool for a total of 294 pooled samples) were screened for white spot syndrome virus, Taura syndrome virus, and yellow head virus using standardized PCR/reverse transcription PCR assays in accordance with Instituto Colombiano Agropecuario protocols. A subset of 81 shrimp was taken for whole-body histopathology analysis following standardized protocols and a semiquantitative G0-G4 lesion grading scale. Lesions were classified by organ system, and histopathological findings were compared to molecular results. All PCR assays were negative, with internal and external controls performing as expected. Using histopathology, lesions were identified in 77% of the shrimp examined, and lesions were primarily mild. Frequent findings included integumentary and gill colonization by Zoothamnium spp.; hepatopancreatic tubular necrosis with hemocytic granuloma-like reactions compatible with bacterial infection; intranuclear inclusion-like bodies, possibly of parvoviral origin; and focal myofiber necrosis, with organisms consistent with microsporidia. Autolysis was common but did not preclude lesion interpretation. Histopathology provided diagnostic information that was not captured by targeted molecular assays, revealing subclinical, opportunistic, and nonviral processes relevant to shrimp health. Incorporating histopathology into routine surveillance programs enhances pathogen detection and strengthens health assessments to certify disease-free status of shrimp production systems, as recommended by the World Organization for Animal Health.

KIT signaling is a fundamental regulatory pathway that preserves cellular homeostasis and controls cell development and fate across a wide range of organs and cell types. Consistent with this pleiotropic role, mutations in c-KIT/Kit have been associated with a wide range of phenotypes, including sterility, piebaldism, nevus formation, mastocytosis, and multiple malignancies. The contribution of c-KIT/Kit to reproductive function has attracted sustained attention for several decades, underscoring its essential role in fertility and gonadal biology. KIT expression is observed in oocytes - localized to the oocyte membrane and the cytoplasm - as well as in theca cells and interstitial cells, suggesting a multifaceted role in follicular development. Notably, all Kit mutant models develop primary ovarian insufficiency (POI) with variable onset, characterized by endocrine dysfunction, impaired folliculogenesis, and eventual female infertility. These findings collectively establish KIT signaling as a critical regulator of ovarian integrity, as both gain- or loss-of-function mutations in Kit consistently recapitulate POI-associated phenotypes. However, despite substantial progress, the precise molecular mechanisms by which KIT signaling integrates these pathways to preserve primordial follicle survival and prevent POI remain incompletely understood. Here, we summarize current knowledge of KIT expression and the functional consequences of Kit mutations, with particular emphasis on oocytes across ovarian cell populations and in comparison to other organ systems in humans and mice. We further evaluate the physiological and pathological significance of ovarian KIT signaling in female fertility and highlight crucial knowledge gaps that must be addressed to fully elucidate its role in maintaining ovarian function.

A porphyrin-based covalent organic framework system doped with Fe2+ and dihydroartemisinin (DHA) has been developed for enhanced antitumor therapy. This platform enables coordinated generation of reactive oxygen species (ROS) including DHA-derived radicals, Fe2+-driven chemodynamic therapy (CDT), and porphyrin-mediated photodynamic therapy (PDT), which collectively amplify oxidative stress and significantly improve therapeutic efficacy.

As human space exploration advances, understanding how different gravity levels affect skeletal muscle is critical for long-term health. Among the major organ systems, skeletal muscle is particularly sensitive to gravitational unloading, yet the gravity threshold required to maintain homeostasis remains unclear. Using the Multiple Artificial-gravity Research System aboard the International Space Station, mice were exposed to graded gravity levels, microgravity, 0.33g, 0.67g, and 1g, and their muscles were analyzed postflight. In the gravity-sensitive soleus, the cross-sectional area was preserved at 0.33g, while the slow-to-fast myofiber transition was partially suppressed at 0.33g and fully prevented at 0.67g. Functional measures, including forelimb grip strength and electrical impedance myography, indicated that 0.67g was sufficient to maintain muscle performance. Plasma metabolomics identified 11 metabolites with gravity-dependent changes, suggesting potential biomarkers for monitoring physiological adaptation. Collectively, these results identify 0.67g as a critical threshold for mitigating spaceflight-induced muscle atrophy and myofiber type transitions.

Chemical fertilizers and pesticides have greatly enhanced agricultural productivity over the last half-century, but their unselective application has been responsible for environmental pollution, soil degradation, pest resistance, and human health issues. Hence, there has been increasing interest in environment-friendly methods like Integrated Pest Management (IPM), biofertilizers, and organic farming. Biofertilizers—consisting of beneficial microorganisms like bacteria, fungi, and algae—increase nutrient availability due to nitrogen fixation and mineral dissolution, and provide a sustainable source of chemicals. Organic farming and organic amendments enhance soil fertility, microbial diversity, and ecosystem services, and sustain or enhance crop quality. Organic systems, in earlier research, were shown to have yields equal to conventional systems under favorable conditions, but it requires more labor and higher input costs. Recent research has highlighted the application of biofertilizers and microbial inoculants in tree crops, namely citrus, apricot, olive, pomegranate, and apple, and has noted improved growth, yield, fruit quality, nutrient uptake, and disease resistance. A combination of synergistic inputs like amino acids, humic substances, PGPR, mycorrhizal fungi, and organic amendments further increases crop productivity and stress tolerance. Emerging technologies such as nanomaterials, microbial endophytes, and controlled environment agriculture hold further promise for sustainable productivity. Long-term experiments reaffirm that mixed and organic fertilization methods equal or surpass the nutritional and yield capacity of inorganic fertilizers, but these have lower environmental effects. It indicates the potential of organic and biological inputs in sustainable horticultural production, especially for perennial tree crops, and stresses their role in addressing future food demand against altered climatic and demographic scenarios.

Performance of sustainable alternative management of apple orchards in the Weibei Upland, China: A comparative economic-emergy-environmental analysis.

Diagnostic errors remain common in abdominal pain, a frequent yet challenging presentation. We sought to compare diagnostic error profiles between abdominal and non-abdominal pain and to identify abdominal pain-specific, potentially modifiable targets in physical examination, diagnostic testing, and differential diagnosis. We conducted a retrospective secondary analysis of a systematically coded database of diagnostic error case reports. Adult pain cases were categorized as abdominal or non-abdominal after excluding pediatric and non-pain cases. Errors were classified using the Diagnostic Error Evaluation and Research (DEER), Reliable Diagnosis Challenges (RDC), and Generic Diagnostic Pitfalls (GDP) taxonomies. Frequencies of codes and contributing factors were compared. Of 163 cases, 55 involved abdominal pain and 108non-abdominal pain. The abdominal pain group had more RDC codes per case (3.1±1.8 vs. 2.5±1.7; p=0.032). Misinterpretation of physical findings and diagnostic tests, particularly imaging, was more common. Presentations with non-specific features or findings that masked/mimicked other conditions were also more frequent. Most physical examination errors (78 %) and imaging errors (82 %) reflected misinterpretation rather than underordering. Diagnostic errors in abdominal pain often involve misinterpreting physical and imaging findings and difficulty distinguishing among diseases within the correct organ system. Strengthening bedside diagnostic skills, fostering structured comparison of same-organ differential diagnoses, and ensuring reliable radiology support may reduce these errors and enhance patient safety.