Regular physical activity remains a cornerstone of cardiovascular health; however, prolonged, high-volume endurance training may paradoxically increase the risk of atrial fibrillation (AF). While this association is well established in male population, sex-specific evidence in women is still limited, despite their rapidly growing participation in endurance sport. Epidemiological studies consistently demonstrate a J-shaped association between exercise exposure and AF relative risk in both sexes. Women appear to have a broader protective window, tolerating substantially higher exercise doses (estimated up to ~83 MET-h/week in cohort studies, equivalent to approximately 10-12 h of moderate-to-vigorous endurance training per week) before AF risk begins to rise, whereas men show a risk increase at lower exposure levels. At the extreme end of the spectrum, elite female endurance athletes may also experience elevated AF relative risk, confirming that the upper inflection of the J-curve applies to both sexes. Mechanistic evidence indicate that atrial structural remodelling occurs similarly in men and women, yet sex hormones and autonomic tone appear to modulate arrhythmogenic vulnerability. Overall, current evidence supports sex-aware clinical counselling, promoting the cardiovascular benefits of endurance exercise in women while considering potential risk at very high training loads.

Centralization of complex cancer surgery may improve outcomes but can also generate treatment delays, reduced access, inequalities, and fragmentation of care. Developed after the Surgical Oncology Meeting held on 7-8 May 2026 and refined through iterative discussion, this position paper proposes a network-based Hub-and-Spoke model designed to balance quality, equity, continuity, and sustainability. We argue that modern networks should move beyond case volume alone and incorporate procedure- and disease-specific referral criteria, minimum requirements for specialized centers, multidisciplinary decision-making, rescue capacity, outcome monitoring, equity safeguards, shared-care pathways, patient navigation, virtual tumour boards, workforce planning, digital support, and patient-centred performance indicators. However, the boundary between a coordinated network and pure centralization is fragile. Unidirectional referral may overwhelm hubs, deprive spokes of expertise, and worsen inequities; active governance is therefore essential. The multidisciplinary team represents the cognitive backbone of the network, but protocol-driven decisions, hierarchy, variable competence, and diffusion of accountability may limit personalized care. These shortcomings should be addressed through structured audit, transparent documentation, and tolerance of justified dissent. In the operating theatre, deviations from preoperative plans should not automatically be viewed as failures, but as expressions of clinical judgment under uncertainty, provided they are documented, explainable, and aligned with patient values. Ethical surgical practice also requires resisting technology-driven innovation that prioritizes institutional prestige over meaningful benefit. This paper is intended as a working map rather than a definitive code. The success of the Hub-and-Spoke model should be judged by the performance, equity, and accountability of the entire network for all patients.

Aphids (Hemiptera: Aphididae) are important agricultural pests and exhibit strong ecological adaptability, allowing them to persist under stress, disperse to new habitats, and rapidly increase population size. Recent advances in functional genomics have identified microRNAs (miRNAs) as key post-transcriptional regulators involved in these processes, yet their roles have remained fragmented across studies. Here, we synthesize current evidence into a "three-stage framework", encompassing population maintenance under stress, dispersal to new habitats, and population expansion upon establishment. We highlight how miRNAs regulate detoxification pathways (e.g., P450s, UGTs, ABC transporters), mediate interactions with host plants and symbionts, and integrate hormonal signaling networks including insulin, juvenile hormone, and ecdysteroid pathways. This framework identifies candidate miRNAs, target genes, and signaling pathways that may recur across different ecological contexts, including stress responses, dispersal-related plasticity, and reproductive regulation. However, direct evidence demonstrating that candidate shared miRNA regulators coordinate multiple life-history stages remains limited and requires further experimental validation. We critically evaluate the strength of functional evidence, distinguishing experimentally validated miRNA-target interactions from prediction- or expression-based associations. Finally, we discuss emerging applications of miRNA-based pest control, including artificial miRNAs, RNAi technologies, and nanocarrier delivery systems. By linking molecular mechanisms with ecological outcomes, this review provides a synthesis and highlights miRNAs as important regulators of aphid adaptation and candidate targets for sustainable management strategies.

Inappropriate concentrations of elements in formulae for infants may lead to adverse health effects. Selenium (Se) is a trace element essential for the proper development of infants. It is naturally present in human milk and is also added to infant formulae. However, both insufficient and excessive Se intake may be harmful. The aim of this study was to determine Se concentrations and chemical forms in 148 formulae for infants available on the Polish market and to assess their nutritional safety. Se concentrations were determined using inductively coupled plasma mass spectrometry (ICP-iCRC-MS). Se speciation was performed using a HPLC system coupled to ICP-iCRC-MS. The Se concentrations in most analyzed formulae were in good agreement with the recommended EU limits (median 4.5 µg/100 kcal, range 0-15.6 µg/100 kcal). However, the estimated daily intake for 6-month-old infants exceeded the tolerable upper intake level in six formulae, indicating a potential health risk. Speciation analysis showed that the dominant Se forms were sodium selenite and sodium selenate, and their levels were mostly consistent with the manufacturers' declarations. Additionally, trace amounts of selenometionine (SeMet) and methyloselenocysteine (MeSeCys) were detected. Therefore, regular monitoring of the composition of infant formulae remains necessary. The detection of SeMet and MeSeCys provides new avenues for research on Se content and Se speciation in formulae intended for infants.

Embryogenesis is remarkably robust to temperature variability, yet the homeostatic mechanisms that offset thermal effects during early development remain poorly understood. We measured how acclimation shifts the upper thermal limit and profiled chromatin accessibility and gene expression in D. melanogaster embryos using single-nucleus multiome sequencing. Acclimation preserved shared primordial cell types yet rapidly shifted heat tolerance. Cool-acclimated embryos showed a homeostatic response characterized by increased accessibility at binding motifs for the transcriptional activator Zelda, along with enhanced activity of gene regulatory networks in a subset of primordial cell types including the gut, muscle, and nervous system. Cool-acclimated embryos also had higher expression of ribosomal and oxidative phosphorylation genes, suggesting a coordinated increase in translation and energy production to buffer slower biochemical kinetics in the cold. Our results indicate that maintaining developmental robustness across temperature requires homeostatic gene expression responses that may carry metabolic costs constraining upper thermal limits.

The incidence of esophageal adenocarcinoma (EAC) has steadily risen over the past several decades. Screening for EAC and its metaplastic precursor, Barrett's esophagus (BE), remains a challenge to prevent EAC development and decrease EAC-attributed mortality. Unfortunately, most BE is diagnosed at the time of diagnosis of EAC in the majority of patients with EAC, showcasing that current screening paradigms are neither widely accepted nor adequate. Historically, screening for BE with upper endoscopy was endorsed by major gastrointestinal society guidelines in the presence of gastroesophageal reflux disease symptoms and related risk factors. However, this method has limitations, including accessibility, cost, and tolerability. Nonendoscopic technologies, such as swallowable cell collection devices, methylated DNA marker assays, esophageal capsule endoscopy, and emerging molecular and physiologic biomarkers, represent newer technologies that may offset many of the limitations of traditional endoscopic screening and facilitate translation to broader settings to capture higher-risk patients. In this review article, we aim to provide a comprehensive, up-to-date summary of nonendoscopic screening tools for BE, contextualizing their advantages, limitations, and prospects for clinical implementation.

Experimentally derived critical thermal maxima values (CTmax) are widely used to estimate species' thermal tolerances and, increasingly, to predict their vulnerability to chronic warming and heatwaves. However, accumulating evidence from model taxa such as fish and insects suggests that CTmax is dynamic and sensitive to multiple environmental and methodological factors, potentially limiting its application as a fixed species-level metric. Here, we quantified CTmax in three habitat-forming kelp species (Laminaria digitata, Saccharina latissima and Laminaria ochroleuca) that occupy contrasting positions of their biogeographic range in the Western English Channel (northeast Atlantic). We assessed how methodological approach (whole plants vs. excised meristematic discs) and thermal history across multiple timescales (seasonal climatology and acute marine heatwaves, MHWs) shape upper thermal limits. Meristematic discs provided CTmax estimates comparable to whole plants in the two cool-water species (L. digitata and S. latissima), but significantly underestimated whole-plant tolerance in the warm-affinity species (L. ochroleuca). This divergence most likely reflected species-specific biology with L. ochroleuca relying more strongly on whole-organism integration and internal storage to maintain high thermal performance. Seasonal climatology influenced CTmax in both cool-water species, with pronounced declines in autumn relative to spring and summer, consistent with narrower thermal safety margins and cumulative stress accrued over summer. Exposure to an extreme simulated MHW caused substantial reductions in CTmax across all species, with the largest decline (> 7°C) observed in L. ochroleuca. Together, these results show that CTmax is highly plastic, shaped by species' biological traits, methodological approach and thermal history. Treating CTmax as a fixed trait risks misrepresenting population-level vulnerability of habitat-forming kelp species and, most likely, other marine ectotherms. Incorporating thermal history and organismal biology into thermal-tolerance assessments will improve predictions of the resilience of kelp species and the ecosystems they underpin, under future ocean warming.