Zinc oxide (ZnO)-containing nanomaterials may elicit toxic responses in environmental organisms such as earthworms. In this study, we investigate the time-dependent gene expression and metabolomic response in earthworms exposed to ZnO and Mn-doped ZnO (ZnO:Mn) nanomaterials (both at 850 mg/kg soil) and MnCl2.

Cross-border artificial intelligence (AI) cooperation is expanding, but evidence on its effect on domestic technological capability in recipient economies is scarce. Drawing on absorptive capacity theory, we create a composite AI absorptive capacity index for 10 Association of Southeast Asian Nations (ASEAN) economies, encompassing innovation foundations, application foundations and industrial support. We measure bilateral AI cooperation intensity via co-publications, co-patents and investment linkages. Using a 2015-2025 bilateral panel with fixed-effects and three-way fixed-effects models, we find a positive association between cooperation intensity and absorptive capacity, robust across all three index dimensions and to sample restrictions and winsorization. Heterogeneity analysis shows that China-related cooperation offers no general premium. A more favourable link emerges only in economies with weaker initial industrial foundations, and it is fragile under stricter sample restrictions. The findings imply that the developmental value of AI cooperation hinges not on cooperation volume but on embedding external knowledge into domestic learning, application and industrial adaptation systems.

Purpose: Studies have demonstrated that medication and diagnostic imaging (DI) use and, more broadly, health care resource utilization, are not necessarily concordant with clinical practice guidelines. However, these studies did not evaluate the concurrent presence of clinical manifestations. This study therefore aimed to investigate the association between medication intake and DI, and health outcomes including pain, disability, physical, and mental health-related quality of life in people with chronic whiplash-associated disorders (WADs). We also aimed to evaluate whether medication intake and DI use differed based on specific presenting clinical manifestations (pain classification category [nociceptive, nociplastic, or neuropathic], psychologic features, pain cognitions, and sleep). Method: This cross-sectional study investigated people attending a multidisciplinary chronic pain centre in Calgary, Canada, between October 2019 and December 2021 who attended for evaluation of chronic symptoms arising from a motor vehicle collision. Participants completed a series of questionnaires that evaluated various health domains (pain intensity/interference; disability; physical and mental health-related quality of life; depression, anxiety, and stress; post-traumatic stress; pain catastrophizing; and sleep) at intake, and anonymized results were entered into a registry database with their informed consent. Results: Different classes of medication intake, use of multiple medications, receiving CT, ultrasound, or MRI scans and multiple DI utilization were associated with worse health outcomes. Increased medication intake was also associated with increased DI utilization. In concert, these results suggest that increased health care resource utilization was associated with worse health outcomes - both physically and psychologically - in chronic WAD. Conclusions: Our results indicate that medication intake and DI were not matched to clinical manifestations, and thus further education of health care providers is warranted to assist with appropriate health care resource utilization. These results also suggest that chronic WAD guidelines are required inclusive of recommendations for appropriate utilization of medication and referral for DI.

Purpose: Dry needling (DN) regulations among the Canadian physiotherapy colleges were compiled to make recommendations toward a national guideline. Method: DN regulatory data extracted from regulatory body websites using an environmental scan framework was checked by an independent reviewer. Colleges were contacted to fill gaps identified from the web. Extracted content was compared to recommendations from two Canadian DN reviews to identify gaps in regulation. Results: DN regulation is done through legislation (two colleges), practice guidelines (one), or both (seven), depending on the college and its provincial or territorial jurisdiction. Three colleges have prerequisites for DN courses, four have approved DN courses, nine require specific course content, three require minimum course hours, nine require registration or rostering, and three have continued competency expectations. No colleges have evidence-based guidelines to inform requirements or meet all DN recommendations. Conclusions: Heterogeneity in regulation likely represents gaps that may potentially expose the public to risk. Physiotherapy colleges could review their regulatory process, address these gaps if they are deemed related to increase risk, and ultimately come to a consensus on what are the safest regulations of practice for Canadian physiotherapists.

Purpose: Self-leadership, or leading oneself, is a critical component of leadership linked to improved individual performance, team effectiveness, and patient and organizational outcomes. This qualitative study explores physical therapist clinicians' perceived value of self-leadership in their clinical practice and their interactions with inter-professional team members. Method: Purposeful sampling was used to recruit participants via the maximum variation strategy. Eleven licensed physical therapist clinicians with 2-39 years of clinical experience in five different clinical settings participated. Participants engaged in individual, semi-structured interviews that were audio-recorded and transcribed verbatim. Study rigour was addressed through the use of multiple coders, memoing, and member checking. Results: Four main themes emerged: developing expertise, pursuing professional growth, discovering and amplifying voice, and advocacy. The "why" behind the actions of those interviewed was to influence patient outcomes and quality of care and to address role identity as a physical therapist across multiple contexts. Conclusions: This is the first known exploration of the perceived value of self-leadership capacity in physical therapist clinicians. The study results suggest that leadership must be reframed as self-leadership, the precursor to leading others, so physical therapist clinicians can lead at all levels in everyday practice.

Purpose: Hybrid training programmes (MPT-PhD) were developed at four Canadian universities to support aspiring clinician-scientists in the physiotherapy field. The purpose of this study was to qualitatively explore the experiences of MPT-PhD trainees to understand (1) the supports needed to be successful within this programme, (2) the associated barriers that can arise within this programme, and (3) careers and opportunities available after graduation. Method: An interpretive descriptive approach was used to interview individuals in various stages of the MPT-PhD programme in Canada. Interviews were conducted by two researchers. Results: A total of nine participants from three of the four programmes completed interviews. Overall, participants had a positive experience in the programme but noted barriers: lack of clinician-scientist placements, lack of programme structure, and poor work-life balance. Integrating their experiences led to recommendations to set clear milestones: having at least one placement in a clinical setting related to their research, creating social connections with other students, and facilitation of clinician-scientist positions both within and beyond academia. Conclusion: Although preliminary, the results provide an understanding of the MPT-PhD student experience. Findings serve as a first step toward improving and supporting MPT-PhD students' needs as they develop into clinician-scientists.

Episodic memory is one of the cognitive domains most vulnerable to age-related changes and the early stages of neurodegenerative syndromes. In Brazilian clinical practice, however, the interpretation of memory performance frequently remains restricted to the quantitative analysis of delayed recall, without adequate consideration of the underlying neurocognitive mechanisms. This study aimed to critically examine the neurobiological foundations of the distinction between hippocampal consolidation deficits and executive retrieval impairments mediated by prefrontal circuits, discussing their diagnostic and gerontological implications. This integrative narrative review is grounded in recent national and international literature (2019-2024) and integrates evidence from neuroimaging, theoretical models of memory, and clinical data relevant to aging. Differentiating hippocampal consolidation deficits from executive retrieval impairments, integrated with the assessment of functional capacity, is proposed as a clinically actionable, mechanism-based framework for improving diagnostic accuracy in aging within heterogeneous sociocultural contexts such as Brazil.

The gender of examiner/experimenter can influence patients' pain experiences because of social and interpersonal dynamics. However, the magnitude and direction of this influence is unclear. This systematic review and meta-analysis investigated whether the gender of the examiner affects pain perception and reporting. After registration in PROSPERO (CRD42023473445), electronic searches were conducted in PubMed, Web of Science, PsycINFO, and CINAHL to identify clinical and experimental studies published up to March 18, 2025 that evaluated the impact of examiner gender on pain-related outcomes, eg, pain threshold, tolerance, and intensity. Two independent reviewers conducted abstract screening, full-text assessment, quality appraisal with the Newcastle-Ottawa Scale, and data extraction. Examiner gender was operationalized in the studies as a female/male classification corresponding to biological sex. A random-effect meta-analysis was conducted to estimate pooled effects for each pain variable. Of 3919 identified records, 27 studies (19 experimental and 8 clinical) that included 2494 participants met the inclusion criteria. Meta-analytic results showed that pain tolerance was significantly higher when assessed by male examiners (Hedges g = -0.25, 95% CI [-0.45, 0.05], I 2 = 9%). A small but significant effect was found for higher pressure pain thresholds with female examiners (Hedges g = 0.20, 95% CI [0.04, 0.36], I2 = 0%), whereas no significant effects were observed for cold or heat pain thresholds. Pain intensity did not differ between female and male examiners. In conclusion, the results present meta-analytic evidence that examiner gender can influence how pain is perceived and reported. Incorporating such examiner-participant dynamics into experimental designs and clinical assessments is important for advancing pain research.

Accurate identification of functional lymphatic vessels is essential for lymphaticovenular anastomosis (LVA) but it remains challenging. Contrast-enhanced ultrasound (CEUS) is increasingly used for preoperative mapping; however, failure to detect vessels of adequate caliber often leads to deferral of LVA. We report a case where CEUS indicated no suitable lymphatic vessels intraoperatively, yet a high-quality LVA was successfully performed using preoperative indocyanine green (ICG) lymphography-guided exploration. Preoperative ICG mapping revealed limited linear channels and dermal backflow, guiding targeted incisions. Intraoperatively, functional lymphatic vessels and suitable venules (0.3-0.4 mm) were identified despite failed CEUS-guided localization, and end-to-end anastomosis was completed. Postoperatively, maximal interlimb circumference difference decreased from 2.5 to 1.7 cm, with symptomatic relief. This is the first case demonstrating that when CEUS-guided intraoperative localization fails, individualized ICG findings can guide empirical incisions to identify better lymphatic vessels for LVA. A multimodal approach may improve patient outcomes.