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By 2050, more than 61 million people worldwide are expected to lose their vision due to conditions like age-related macular degeneration, glaucoma, diabetic retinopathy, and uveitis (Bourne et al. 2021). This anticipated rise highlights the urgent need for more effective treatment options. While progress continues in developing new pharmacological agents, treating ocular diseases with these therapies remains particularly challenging due to the eye's unique and complex anatomy. This is largely due to the limitations of current drug delivery methods, including systemic administration, topical delivery application, transscleral/periocular drug delivery, and intravitreal injections, which are associated with low bioavailability, side effects, and rapid drug clearance. Given these challenges, microneedles have emerged as a promising alternative. Their minimally invasive nature and ability to precisely target the anterior and posterior segments make them well suited for enhancing therapeutic outcomes while reducing systemic exposure and potential side effects, as well as improving patient adherence (Kang-Mieler et al. 2017; Gadziński et al. 2022). The purpose of this review is to discuss recent advancements, key challenges, and strategies for microneedle-based ocular drug delivery systems, with an emphasis on their potential to treat both anterior and posterior eye diseases.

Proniosomes represent an advanced composite vesicular platform that integrates non-ionic surfactants, lipids, and biodegradable carriers to significantly improve drug solubility, stability, and transmembrane delivery. These dry powdery formulations are transformed into multiscale niosomes upon contact with a hydrated medium to achieve controlled release and enhanced drug permeability. This seminal review delineates the transformative potential of proniosomal systems in treating various diseases, detailing diverse routes of administration, formulation techniques, mechanisms of action, as well as their advantages and limitations. Proniosomes address major issues such as systemic toxicity, poor solubility, and erratic absorption while maintaining green chemistry principles owing to their biodegradable constituents. By critically analyzing the potential for industrial translation, this review highlights the knowledge gap on clinical studies, scalability, and regulatory issues. The translation potential has even been further enhanced by recent developments in bioconjugation and nanotechnology, such as ligand-anchored proniosomes that enable active targeting. The topic's relevance is evident, as proniosomes complement next-generation biotechnology tools, such as mRNA delivery, while offering a sustainable alternative to liposomes. By compiling the most recent data, this review strives to catalyze innovation in novel drug delivery, making it essential for researchers and pharmaceutical developers.

This article examines the global issue of vaccine hesitancy in Brazil and South Africa, two economically unequal BRICS nations. Despite their established immunization programs, both countries are grappling with coverage decreases, leading to outbreaks. The role of vaccine hesitancy in this scenario is significant. This qualitative study aims to understand childhood vaccine hesitancy in these contexts, highlighting social and behavioral drivers. In-depth interviews were conducted in Sao Luis (Brazil), Florianopolis (Brazil), and Cape Town (South Africa), involving 42 caregivers from diverse socioeconomic backgrounds, race/color, and gender, with children up to 6 years old. Thematic analysis method was used to analyze the empirical data. The drivers of vaccine hesitancy have been arranged across three domains: 'practical issues', prevalent among lower-income non-white families; 'social processes', as informed decisions reflecting neoliberal parenting values, found among higher-income white families; and, in the 'thinking and feeling about vaccines' domain, common fears of side effects and vaccines components are presented. These findings underscore the necessity of tailored health policies, taking into account the influence of historical, cultural, and social contexts. The study also highlights the crucial role of qualitative research in comprehending the intricate interplay of social and behavioral factors in health decision-making.

Currently, increasing attention is being paid to the extraction and utilization of materials with special biological activities in nature or for medical applications. Owing to their unique biological characteristics and diverse application potential, microalgae are among the most promising materials in the field of biomedicine. Because of their diverse morphology and readily functionalizable surface, they can efficiently carry drugs and achieve targeted drug release. This can avoid major challenges of other methods related to toxicity, biocompatibility, and immunogenicity, which is important for the treatment of various diseases, particularly those related to hypoxia. Despite the distinct advantages of microalgae over other biomaterials, several challenges persist in their practical application. Herein, we comprehensively describe the current state of research on the microalgae drug-delivery system (MDDS). In particular, we explore various microalgae-based strategies and methods to improve the load capacity and stability of DDS, and to achieve target positioning and tracking. With further research on microalgae, their application prospects in DDSs will broaden. In the future, researchers will continue to explore the features and advantages of microalgae; develop more efficient, safe, and accurate DDSs; and provide more options for clinical treatments. Continued progress in microalgal cultivation technology and reduction in large-scale production costs will expand the clinical applications of MDDSs.

Background: Effective disaster management requires healthcare professionals to function not only as responders but also as trainers who can disseminate knowledge and skills. In low-resource settings such as Tanzania, structured train-the-trainer (ToT) programs tailored to physicians remain limited. This study aimed to design, implement, and evaluate a trainer development program for Tanzanian emergency medicine physicians using the ADDIE instructional design framework to transparently link needs assessment to role-adapted objectives, learning activities, and evaluation.

Methods: A mixed-methods design was applied, combining pre-training surveys, post-training assessments, and thematic feedback analysis. The program, conducted on 21-22 November 2024 at the Urla International Emergency Disaster Training and Simulation Centre, followed the ADDIE model (Analysis, Design, Development, Implementation, Evaluation). Twenty Tanzanian physicians (mean age 35.9 years, 60% female, mean experience 8.2 years) participated. Participants were grouped as Emergency Medicine Specialists/Medical Officers (n=8) and General Practitioners/Resident Physicians (n=12), with tailored objectives focusing on leadership, teamwork, disaster planning, and trainer skills.

Results: Participants achieved a mean post-training MCQ score of 17.68 out of 20, corresponding to an overall correct response rate of 88.4%. Scenario-based and interactive learning methods were highly valued, while insufficient training duration and limited technical infrastructure were identified as challenges. Emergency medicine specialists prioritized leadership and coordination skills, whereas general practitioners and residents emphasized educational strategies and program development.The program was feasible and well received, and participants achieved high immediate post-course knowledge scores and reported strong perceived value of scenario-based and trainer-focused learning activities. The findings support role-adapted ToT models for physicians; however, objective measurement of educator and leadership competencies and follow-up assessment of cascade training implementation are needed to determine sustained trainer development.

This study examined whether COVID-19 Vaccine Hesitancy (VH) and COVID-19-related factors interact to influence COVID-19 booster doses uptake among university students in Canada, from a syndemic perspective. A cross-sectional survey was conducted among 4453 students at the University of Waterloo in 2024. VH was measured toward both COVID-19 primary and booster doses. Change in VH scores were computed to capture shifts in hesitancy over time. Logistic regression models assessed the main effects of VH and COVID-19-related factors on booster uptake. Interactions were tested using additive and multiplicative scales. Increased VH was associated with a 23% decrease in booster uptake. Younger ages, not being hospitalized due to COVID-19, not receiving the influenza vaccine, noncompliance with COVID-19 guidelines, and belief in conspiracy theories predicted lower booster uptake. Significant interactions were found between change in VH scores and COVID-19 diagnosis and hospitalization history, guideline adherence, and conspiracy beliefs. For students who did not receive booster doses, the change in VH was greater among those who reported following public health guidance than those who did not. Similarly, for students who did not receive booster doses, the change in VH was greater among those who reported not believing in conspiracy theories compared to those who did. The findings support a syndemic model, indicating that VH and COVID-19-related experiences jointly influence booster uptake. Targeted interventions such as rebuilding trust, addressing misinformation, and reducing stigma may improve booster uptake even if not all barriers are addressed. Further research is needed to examine these interactions.

Rice yield is directly influenced by spikelet number, a trait governed by both genetic and hormonal regulatory pathways. In this study, we demonstrate that GNA, a GRAS family transcription factor, acts as a key positive regulator of spikelet development in rice. Through map-based cloning, transgenic manipulation, and molecular assays, we show that GNA enhances grain number per panicle by repressing OsCKX2, a cytokinin oxidase gene responsible for cytokinin degradation. Chromatin immunoprecipitation, luciferase activity assays, and electrophoretic mobility shift assays (EMSA) confirm that GNA directly binds to the OsCKX2 promoter, suppressing its transcription and thereby elevating endogenous cytokinin levels. Notably, GNA physically interacts with DEP1/dep1, and this interaction further enhances the GNA-mediated repression of OsCKX2. Overexpression of GNA significantly increases spikelet number, pedicel branching, and grain yield per plant, accompanied by the activation of cytokinin-responsive genes. These findings reveal a previously uncharacterized DEP1-GNA-OsCKX2 regulatory module that links G-protein signaling with cytokinin signaling and panicle morphogenesis, providing a promising genetic target for rice yield improvement and molecular breeding.

Objective: To investigate the associations of the neutrophil/albumin ratio (NAR) with type 2 diabetes mellitus (T2DM) in women with a history of gestational diabetes mellitus (GDM).

Methods: We conducted a cross-sectional study involving 782 participants from the National Health and Nutrition Examination Survey. Logistic regression analyses were performed to explore the relationship between NAR and T2DM, adjusting for various confounding factors across different models. Interaction analyses examined the modifying effects of socio-demographic characteristics on the relationship between NAR and T2DM. Mediation analyses were utilized to investigate whether key laboratory indicators and insulin resistance indices mediated the association between NAR and T2DM.

Results: Higher NAR levels were positively associated with T2DM risk. (OR[95%CI]:1.649[1.181,2.309], p = 0.003). Mediation analyses revealed that the effect of NAR on T2DM was entirely mediated through the regulation of red cell distribution width (RDW Coefficient[95%CI]: 0.009[0.001,0.024], p = 0.020) and high-density lipoprotein cholesterol (HDL-C Coefficient[95%CI]: 0.038[0.017,0.067], p < 0.001). Besides, significant interactions and differences were observed in the relationship between NAR and T2DM risk based on body mass index (BMI) (NAR*BMI: interaction coefficient: -0.651, interaction p = 0.027). In individuals with 25 kg/m² ≤ BMI < 30 kg/m², NAR increased the risk of T2DM by regulating the insulin resistance index (HOMA-R) (β[95%CI]: 2.220[0.653,3.787], p = 0.007).

Conclusion: This study revealed that among women with GDM history, NAR may influence the risk of T2DM through the modulation of RDW and HDL-C. Furthermore, NAR and BMI had a significant interaction affecting T2DM risk, particularly prominent in women with 25 kg/m² ≤ BMI < 30 kg/m². Within this subgroup, NAR elevated the risk of T2DM via HOMA-R.

Objective: Benign prostatic hyperplasia (BPH) is a common urinary disease in elderly men, with acute urinary retention (AUR) severely impacting quality of life. Urodynamic abnormalities and prostate-specific antigen (PSA) levels reflect urinary obstruction and prostate enlargement/inflammation. This study was to correlate the two factors with AUR in BPH patients.

Methods: A total of 120 BPH patients were divided into AUR group and non-AUR group, with 60 cases in each group. Clinical, laboratory, and urodynamic data were collected. Independent variables with significant differences in univariate analysis were included in multifactorial logistic regression analysis. The diagnostic value of urodynamic parameters and PSA for AUR in BPH patients was assessed. A spline regression model was established to analyze the relationship between AUR and PSA.

Results: Elevated levels of urodynamic parameters volume at first desire to void (FDV), bladder compliance (BC), total PSA (tPSA), and free PSA (fPSA) were independent risk factors for AUR in BPH patients. FDV and tPSA showed high predictive efficacy, while BC and fPSA relatively weaker. tPSA was positively correlated with both FDV and BC. fPSA was positively correlated only with FDV.

Conclusion: FDV and BC with tPSA and fPSA are significantly elevated in BPH patients with AUR and show a strong association.