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Off-label antipsychotic use for behavioral symptoms in pediatric attention-deficit/hyperactivity disorder (ADHD) poses safety concerns, and evidence to support such use is limited. This study aims to investigate the risk of off-label antipsychotic use associated with comorbid disruptive behavior disorder (DBD) among a cohort of youth with ADHD. A cohort study was conducted using IQVIA PharMetrics Plus for Academics data from 2007 to 2020. Youth 5 to 15 years of age at the index ADHD visit were included in the cohort. The index ADHD visit meets at least 1 of the following criteria: (1) 1 inpatient ADHD visit, (2) 2 outpatient ADHD visits within 90 days, or (3) an ADHD medication prescription fill within 30 days of an outpatient ADHD visit. We excluded youth who had a diagnosis of DBD or a US Food and Drug Administration (FDA)–approved indication for antipsychotics at baseline. Youth were followed up until antipsychotic initiation or were censored at a loss of coverage, receipt of an FDA-indicated diagnosis, or end of the study. A Cox proportional hazards regression model with DBD as a time-varying covariate estimated the hazard of antipsychotic use after the index ADHD visit. Of 41,098 youth with ADHD who met the study criteria, 4557 were diagnosed with DBD during follow-up. The incidence of antipsychotic initiation was 19.6 (95% CI, 18.7– 20.5) per 1000 person-years. After adjustment for baseline covariates, the hazard ratio of antipsychotic initiation associated with DBD was 4.64 (95% CI, 4.15–5.18). Antipsychotic use among youth with ADHD is more likely in the presence of DBD, suggesting that an off-label use is for behavior problems.

Biomarkers reflect physiological states and disease progression in the human body. Their precise detection is crucial for accurate and effective diagnosis. Functional hybrid microbeads (FHMBs) with electrical, magnetic, and/or optical responsiveness have emerged as versatile platforms for signal amplification, transduction, and conversion. This review summarizes recent advances in microfluidic strategies for producing FHMBs, with emphasis on incorporating functional nanoparticles (NPs) into microdroplets. We discuss the advantages of microfluidics in generating monodisperse droplets, controlling composition, encapsulating functional NPs, and forming FHMBs through solidification processes. Key droplet‐generation strategies are summarized, encompassing passive and active mechanisms, as well as both on‐chip and off‐chip approaches, followed by an overview of solidification methods driven by physical or chemical processes. We classify FHMBs into four functional categories: electrical, optical, magnetic, and mixed response, based on their material composition, fabrication methods, and practical applications. Finally, we discuss the current challenges and suggest future research directions to advance the development of improved platforms for FHMBs production. Functional hybrid microbeads with electrical, magnetic, and/or optical responsiveness have emerged as versatile platforms for biotechnology. This review highlights recent advances in microfluidic technologies for producing such microbeads, with a focus on incorporating functional nanoparticles in microdroplet systems. We further outline challenges and identify opportunities to improve microfluidic bead production.

Background Understanding restrictive cardiomyopathy (RCM) in children is limited, and currently, no prognostic model is available for assessing risk stratification in pediatric RCM. The authors elaborated on the clinical and genetic characteristics of pediatric RCM and developed a prediction model to assess the 1-year risk of major adverse cardiovascular events (MACE), aiding in determining the optimal timing for heart transplantation (HTx). Methods This multicenter retrospective cohort study collected data on children with RCM from 14 centers in China, with patient enrollment from January 1, 2013, to December 31, 2022, and follow-up concluding on August 1, 2023. It analyzed clinical and genetic characteristics and followed patients longitudinally for the development of MACE (including cardiac death, HTx, or equivalent events). A logistic regression model was developed to predict MACE one year post-diagnosis, with internal validation using bootstrapping. The model’s performance was evaluated in terms of its discrimination, calibration, and clinical utility. Results The study included 185 children with a median diagnosis age of 5.4 years (IQR, 3.1–9.4), and 110 (59%) were male. Significant heart failure was the primary clinical feature. TNNI3 mutations were present in 61% of cases, the most common in pediatric RCM. During the follow-up period, 114 patients (62%) experienced MACE, with the median MACE-free survival time for the entire cohort being 2.1 years post-diagnosis (IQR, 0.6–5.4). A prediction model was developed to estimate the one-year risk of MACE using four easily accessible clinical parameters: heart failure classification, brain natriuretic peptide levels, cardiac troponin levels, and a modified score for ST-segment deviation. Internal validation with bootstrapping confirmed accuracy, showing an optimism-adjusted C statistic of 0.78 (95% CI, 0.72–0.85) and a Brier score of 0.17 (95% CI, 0.14–0.21), with a calibration slope of 0.90 (95% CI, 0.63–1.27). Decision curve analysis indicated high net benefit across HTx treatment thresholds from 8.5% to 78.3%. Conclusions This model utilizes accessible clinical parameters to assess individual risk for MACE in pediatric RCM, potentially improving precision in healthcare strategies and supporting more informed clinical decision-making.

Replicating biological systems using non-living materials, from the foundational molecular level to complex tissue structures, is central to abiotic mimicry. Enzymes play a vital role in these systems; however, replicating their enzymatic power with minimal components remains a key challenge. Here we show that gallium in the liquid state exhibits nuclease-like activity with preferred cleaving sites. The mechanism involves nucleotide-biased adsorption and hydroxyl radical-assisted phosphodiester hydrolysis. Compared with previously reported artificial metallonucleases, the liquid gallium uniquely integrates its oxide layer for substrate adsorption and its metallic core with electrons as a cleavage active center, forming a ligand- and cofactor-free artificial nuclease platform. Moreover, their activity is tunable through synthesis parameters and external stimuli, enabling programmable control with spatial or temporal precision. This work presents a minimalistic yet functional approach to enzyme mimicry, expanding the design space for abiotic enzymatic systems and offering potential opportunities in therapeutic applications, synthetic biology, and biomaterials. Replicating enzyme function with minimal components is a major challenge in abiotic mimicry. Here, the authors show that liquid gallium droplets act as tunable artificial nucleases, cleaving DNA with nucleotide bias via oxide-mediated adsorption and hydroxyl radical-assisted hydrolysis.

Liquid biopsies have emerged as a key tool that enables personalized medicine, enabling precise detection of biochemical parameters to tailor treatments to individual needs. Modern biosensors enable real-time detection, precise diagnosis, and dynamic monitoring by rapidly analyzing biomarkers such as nucleic acids, proteins, and metabolites in bodily fluids like blood, saliva, and urine. Despite their potential, many biosensors are still constrained by mono-functionality, sub-optimal sensitivity, bulky designs, and complex operation requirements. Recent advances in stimuli-responsive smart materials present a promising pathway to overcome these limitations. These materials enhance biomarker signal transduction, release, or amplification, leading to improved sensitivity, simplified workflows, and multi-target detection capabilities. Further exploration of the integration of these smart materials into biosensing is therefore essential. To this end, this review critically examines and compares recent progress in the development and application of physical, chemical, and biochemical stimuli-responsive smart materials in biosensing. Emphasis is placed on their responsiveness mechanisms, operational principles, and their role in advancing biosensor performance for biomarker detection in bodily fluids. Additionally, future perspectives and challenges in developing versatile, accurate, and user-friendly biosensors for point-of-care and clinical applications using these smart materials are discussed. Graphical abstract

Fairmaire is a medicinal insect that has been used for a long time by minority ethnic groups in Yunnan, China, due to its immunomodulatory function. However, its potential applications in cosmetics have not been reported. experiments were used to verify whether the extracts of Fairmaire (EBR) have the effect of inhibiting TYR activity and eliminating melanin deposition. Subsequently, experiments were conducted to verify further the potential application of the EBR in whitening. To explore the whitening components of the EBR, we employed UHPLC-Q-TOF MS to identify the compounds present in the EBR and utilized network pharmacology to compare them with the genes involved in whitening in the database, thereby obtaining the intersection of compound targets and whitening targets. Then, protein-protein interaction network analysis, gene ontology enrichment and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were carried out to explore the main components of the whitening effect of the EBR. Further, molecular docking and molecular dynamics simulation were used to verify the correlation between the main components of the EBR and the essential target molecules. and studies have found that the EBR exhibits anti-oxidation, TYR-inhibiting activity, and the elimination of melanin deposition. Subsequently, 1538 metabolites were identified by UHPLC-Q-TOF MS analysis, indicating that EBR is a rich source of bioactive compounds. Among them, 82 kinds of phenols and flavonoids may be derived from external enrichment or self-synthesis. Network pharmacology revealed 41 genes related to pigmentation and TYR inhibition. Molecular docking and molecular dynamics simulation confirmed that myricetin, luteolin, apigenin and quercetin have a high binding affinity with TYR, which may regulate melanin production by inhibiting TYR activity. In this study, we identified the primary whitening active ingredients of and utilized network pharmacology and molecular dynamics simulation to investigate the mechanism underlying the whitening effect of EBR. This work reveals that insect extraction may have broad application prospects in the preparation of cosmetics. To our knowledge, this is the first report identifying the flavonoids quercetin, luteolin, myricetin, and apigenin as whitening-active components in insects.

Background Conduct disorders (CD) are among the most frequent psychiatric disorders in children and adolescents, with an estimated worldwide prevalence in the community of 2–4%. Evidence-based psychological outpatient treatment leads to significant improvement in about two-thirds of cases. However, there seems to be considerable variation in rates of CD diagnoses and implementation of evidence-based interventions between nations. The aim of this study was to compare administrative prevalence and treatment patterns for CD in children and adolescents seen in health care systems across four Western countries (Denmark, Germany, Norway, and the USA). Methods Cross-sectional observational study using healthcare data to identify children and adolescents (aged 0–19 years) with an ICD-10 code for CD within the calendar year 2018. Within each country’s study population, the prevalence of CD, psychiatric comorbidity, psychopharmacological treatment, and psychiatric hospitalisation was calculated. Results The prevalence of diagnosed CD differed 31-fold between countries: 0.1% (Denmark), 0.3% (Norway), 1.1% (USA) and 3.1% (Germany), with a male/female ratio of 2.0–2.5:1. The rate of psychiatric comorbidity ranged from 69.7 to 86.1%, with attention-deficit/hyperactivity disorder being most common. Between 4.0% (Germany) and 12.2% (USA) of youths with a CD diagnosis were prescribed antipsychotic medication, and 1.2% (Norway) to 12.5% (Germany) underwent psychiatric hospitalisation. Conclusion Recognition and characteristics of youths diagnosed with CD varied greatly by country. In some countries, the administrative prevalence of diagnosed CD was markedly lower than the average estimated worldwide prevalence. This variation might reflect country-specific differences in CD prevalence, referral thresholds for mental health care, diagnostic tradition, and international variation in service organisation, CD recognition, and availability of treatment offers for youths with CD. The rather high rates of antipsychotic prescription and hospitalisation in some countries are remarkable, due to the lack of evidence for these therapeutic approaches. These findings stress the need of prioritising evidence-based treatment options in CD. Future research should focus on possible reasons for inter-country variation in recognition and management of CD, and also address possible differences in patient-level outcomes.

The accelerating global crisis of antimicrobial resistance (AMR) demands rapid and accurate methods for antibiotic susceptibility testing (AST). Conventional phenotypic assays remain the gold standard but are hindered by long culture times, while genotypic tests cannot reliably predict phenotypic resistance. In recent years, metabolism‐based AST has emerged as a promising alternative, enabling the rapid detection of bacterial responses to antibiotics through shifts in metabolic activity. These approaches bridge molecular speed with phenotypic precision, allowing susceptibility determination within hours, or even minutes, without requiring cell proliferation. In this review, we summarize the latest advances in metabolism‐based biomarkers for rapid AST. First, we discuss how antibiotics influence bacterial metabolism, linking resistance mechanisms to metabolic activities. We then summarize emerging metabolic biomarkers, categorized by their physiological underpinnings: nutrient uptake, respiratory activity, metabolic reprogramming, and enzymatic function. Finally, we list key challenges and future directions toward deployable metabolism‐based AST platforms. Metabolic differences emerging after antibiotic exposure provide rapid phenotypic signals of susceptibility and resistance. This review summarizes metabolic biomarkers for rapid phenotypic AST, associated with nutrient uptake, respiratory activity, metabolic reprogramming, and enzymatic function.

Brand names on food packaging and the diagnosticity of brand names have notable effects on consumer preferences. However, their effects on healthy food consumption are not clear. The objective of this study was to investigate the effect of healthy brands and the diagnosticity of brand names on consumers’ subjective ratings of different calorie foods. In two studies, participants viewed 32 pictures of high- and low-calorie food product packaging from healthy and unhealthy brands and rated their feelings and willingness to pay online. Study 1 used real brand names, and Study 2 used fictional brand names and added press releases to manipulate diagnosticity. The present study demonstrated that participants perceived foods from healthy brands as healthier but less delicious and were more willing to buy low-calorie foods from healthy brands. Moreover, only when the brand name was of high diagnosticity were high-calorie foods rated as more likable, and did the willingness to pay for low-calorie foods increase. Collectively, these findings highlight the influence of the healthy brand on consumers’ subjective ratings of food. It is also inspiring for healthy food marketing.

In the wake of the COVID-19 pandemic, the scientific community has been galvanized to unravel the enigmatic role of bioaerosols in the transmission of infectious agents. This literature review, anchored in the extensive Web of Science Core Collection database covering the period from 1990 to 2023, utilizes a bibliometric approach to chart the dynamic landscape of bioaerosol research. It meticulously documents the paradigm shifts and burgeoning areas of inquiry that have emerged in the aftermath of the pandemic. This review meticulously maps out the sources and detection strategies of pathogens in a variety of ecosystems. It clearly shows that impaction and filtration sampling methods, followed by colony counting and PCR-based detection techniques, were predominantly used in the scientific works within the previous three decades. It synthesizes the progress and limitations inherent in a range of models for predicting aerosol-mediated pathogen spread and provides a comparative analysis of eDNA technology and traditional analytical techniques for bioaerosols. The accuracy of these detection methods and forecasting models is paramount for the early recognition of transmission risks, which, in turn, paves the way for prompt and effective disease mitigation strategies. By providing a thorough analysis of the historical progression and current state of bioaerosol research, this review illuminates the path ahead, identifying the critical research needs that will drive the field’s advancement in the years to come.