Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent liver condition worldwide, affecting approximately 30% of the population globally. MASLD often coexists with hypertension, central obesity, type 2 diabetes and dyslipidaemia, yet globally, national treatment strategies are still being established. Pharmacological options are limited and lifestyle modification to achieve weight loss through combining diet, physical activity (PA) and structured exercise remains the cornerstone of MASLD management. The Mediterranean diet (MedDiet) is an evidence-based dietary approach for MASLD prevention and treatment; however, its application in culturally and linguistically diverse, non-Mediterranean populations requires adaptation. In fact, the need for cultural adaptation for all lifestyle interventions (diet, PA and sleep) needs better acknowledgement and implementation. There are limited interventions which combine all lifestyle behaviours and even fewer that consider cultural safety and appropriateness. Furthermore, limited healthcare staffing resources, geographical location and health system pressures highlight the need for more accessible and cost-effective delivery methods. This review summarises evidence on MedDiet for MASLD in multicultural populations, explores the synergistic benefits of combining with PA and sleep interventions and provides practical recommendations for culturally tailored approaches. Finally, we outline future directions for research and healthcare delivery, emphasising the urgent need for holistic, culturally safe, culturally responsive, efficient and digitally enabled strategies to address the growing global burden of MASLD.

Objectives/Goals: The impact of genetic alterations on survival in patients with neuroendocrine prostate cancer (NEPC) is unclear. This study assessed how genetic alterations and tumor mutational burden (TMB) affect overall survival (OS) in patients with NEPC treated at Mayo Clinic. Methods/Study Population: Demographic, clinicopathologic, and genomic data from patients with NEPC treated at Mayo Clinic (2015–2025) were abstracted from electronic medical records. Patients had consented to research and received at least one cycle of therapy. Descriptive statistics summarized patient characteristics, and survival was estimated with Kaplan–Meier analysis. OS was compared by disease type (de novo vs treatment-emergent NEPC), TMB (high vs low), and RB1, TP53, and PTEN alteration status. Results/Anticipated Results: Among 66 patients in the study, the average age at NEPC diagnosis was 67.5 years. There were no significant differences between the age at diagnosis of de novo and treatment emergent NEPC (t-NEPC). t-NEPC made up 77.3% of the cohort. Median follow-up was 46.5 months (IQR 28–120). The most common alteration was TP53. RB1 alterations were associated with significantly shorter OS compared to patients without RB1 alterations (mOS Not Reached (NR) vs 13.8 months; p = 0.0056). Similarly, patients with high TMB had worse overall survival (mOS NR vs 14.9 months; p = 0.077). We did not observe worse OS in patients with alterations in TP53 or PTEN. RB1 alteration and high TMB were the strongest predictors of worse survival. Discussion/Significance of Impact: RB1 alterations and high TMB predict poor survival in patients with NEPC, highlighting potential biomarkers for risk stratification. TP53 and PTEN did not significantly affect OS. Early genomic profiling and targeted management of actionable alterations such as BRCA and ATM may improve survival and inform future translational studies.

Invasive, non-native plants frequently restructure ecosystems by homogenizing vegetation and altering trophic interactions, but the ecological consequences of invader removal are less predictable. Removal can redistribute light, nutrients, and detrital resources, initiating community reassembly that extends beyond vegetation recovery and may facilitate secondary invasions. We used a single-site invasive-removal field study to examine how management of European buckthorn (Rhamnus cathartica L.) reshaped vegetation structure, litter accumulation, and faunal communities in a postindustrial forest preserve in western New York State, USA. Across 18 plots representing managed, not-treated, and regrown R. cathartica conditions, we quantified herbaceous vegetation, leaf litter biomass, and the abundance of arthropods, pollinators and small mammals. Rhamnus cathartica removal was associated with a 10-fold increase in herbaceous plant cover and species richness, producing structurally complex understories and higher arthropod and pollinator abundance. However, managed plots also supported 3- to 5-fold higher densities of the invasive European fire ant (Myrmica rubra)—corresponding with increased leaf litter in managed plots. Ant abundance was positively associated with thicker, more persistent litter layers rather than canopy openness, and increasing M. rubra density, in turn, corresponded with reduced pollinator abundance. Detritivore and rodent responses were more closely linked to vegetation structure and litter conditions than to ant abundance.

eSource – particularly EHR-to-EDC – is an emerging paradigm in clinical research that enables automated transfer of electronic health record (EHR) data into electronic data capture (EDC) systems, with the potential to reduce site burden, improve data quality and accelerate oncology clinical trial workflows. However, widespread implementation remains limited due to technical, regulatory and operational barriers. To address these challenges, the European Institute for Innovation through Health Data (i~HD) launched the eSource Scale-Up Task Force in 2024. This multi-stakeholder initiative brings together leading oncology centres and pharmaceutical sponsors to establish a consensus-driven roadmap for eSource adoption. Central to this effort are three foundational resources: readiness criteria for early adopters, a performance indicator framework for monitoring success and an operational playbook to guide implementation. This article provides a structured overview of the Task Force’s objectives, collaborative model and outputs, with specific attention to its focus on interoperability, regulatory alignment and real-world validation. While initially developed for oncology, the Task Force’s framework is applicable across therapeutic areas characterized by data-intensive workflows.

Spread of invasive species can be impacted by their mode of reproduction (asexual vs. sexual) as well as the mating system (outcrossing vs. selfing). This is especially the case in the evergreen wintercreeper vine [Euonymus fortunei (Turcz.) Hand.-Maz.], which was originally brought to the United States for horticultural purposes and is now considered invasive across the Midwest. Wild wintercreeper populations consist primarily of a single polyploid genotype, the ornamental ‘Coloratus’ cultivar, but it is still unknown how this species produces its fruit during the fall. We examined the reproductive mode and mating system of wintercreeper by collecting leaves and fruits from 12 wild plants in an urban location of Cincinnati, OH. In this genetic survey, we used microsatellite markers to identify the pollen donor of each embryo within the seeds. Polyembryony was relatively common, with 37.4% of seeds each containing two to four embryos. Many of the 382 embryos extracted were produced asexually through apomixis (50.0%) or were sexual products of outcross fertilization (34.3%) or self-fertilization (15.7%). In seeds with multiple embryos, larger embryos were most likely to be outcrossed, with winged burning bush [Euonymus alatus (Thunb.) Siebold ‘Compactus’] as the most likely pollen donor, and apomixis increasing in successively smaller embryos. Single embryos within seeds were more often outcross fertilized (52%). The fact that all wild adult wintercreeper plants consist of a single genotype is consistent with the production of these apomictic offspring. However, lack of sexually produced wild plants, despite their appearance in the embryonic stage, warrants further study. This is the first report of polygamous apomixis in this species, and research is continuing into how this reproductive strategy may influence invasive spread of the species.

Aims: Specialist eating disorder units (SEDUs) are unique among psychiatric units, in that there is a high incidence of electrolyte derangements due to the pathophysiology of refeeding. This requires careful monitoring of blood parameters with frequent venepuncture which often can be difficult due to strict mealtimes and post meal supervision as well as required group attendance in the SEDU.

Audit data demonstrated that the medical team spent about 3 hours every day and therefore 15 hours per week attempting to obtain blood samples from patients due to inefficient processes. Patients were often unavailable due to other commitments and so a maximum of 4 blood tests were obtained each day.

The primary aim of the project was to reduce the amount of time spent obtaining blood samples on the SEDU. Our secondary aims were to reduce patient uncertainty around venepuncture and to improve patient satisfaction.

Methods: A ‘phlebotomy clinic’ was implemented twice a week to replace daily venepuncture. The clinic was made up of 5-minute appointments and scheduled based on the published weekly ward schedule to avoid any protected mealtimes and group activities. The clinics took place at the start of the week to allow more time for results to be analysed and actioned.

Universal consent was gained from our patient group by discussion at the community meeting. It was agreed that a list of appointments would be published on the notice board and patients would be reminded about the clinic at morning check in.

The amount of time spent obtaining blood samples was self-reported by doctors at the end of the week and patient satisfaction was graded using a qualitative questionnaire.

Results: Implementation of the phlebotomy clinic saved 13 hours of time per week. Over three separate phlebotomy clinics, the average time spent obtaining blood samples was 35 minutes with 25 minutes of admin time and an average of 6 blood samples were taken at each clinic. Patient adherence to appointment times varied between clinics with a range of 66–100% adherence and this impacted the efficiency of the clinic. Patient questionnaires demonstrated that 100% of patients preferred the new format.

Conclusion: We concluded that the implementation of a formal ‘phlebotomy clinic’ significantly improved efficiency of venepuncture on the SEDU allowing more time to be spent engaging in other aspects of patient care. In addition, patient satisfaction improved and we believe that this in turn can greatly benefit the therapeutic relationship.

On what appeared to be a normal day off the Pacific coast of California, Scott Thomas was relaxing on his boat and enjoying a peaceful day of leisure. His wife had just gone below to grab two beers when he noticed a strange fog approaching. He stood up, and for a moment, the fog enveloped him. The cloud passed, and when his wife returned, she saw that Scott seemed to be covered with glitter. The couple thought nothing of this until the impossible began to happen: Thomas began to shrink; he had been transformed into The Incredible Shrinking Man.

Two valuable new documentaries on atomic weapons and their human legacy offer new light on the inner world of atomic testing and weapons manufacture and the impact of the bomb on atomic test areas in the United States, on Bikini, and Hiroshima.

Almost immediately after 9/11, cultural tropes that had long been associated with the nuclear attacks on Hiroshima and Nagasaki were relocated to new roles as descriptors of the attack on New York City. Where once terms like “ground zero” referred to the detonation points of the nuclear weapons that were dropped in Japan, Ground Zero now refers to the site where the World Trade Center towers once stood in lower Manhattan. This appropriation of framing mechanisms from Hiroshima and Nagasaki to New York City was nothing new: it held true to an American tradition that began in August of 1945. When Americans felt that bifurcated sense of victory and vulnerability upon the news of the bombing of Hiroshima, it was a short journey for the word Hiroshima to take on a second, shadow meaning in American culture–it became shorthand for fears of an inevitable nuclear attack on America itself–and almost always the target of this imagined attack was New York City. While Lifton and Mitchell claim that, “Hidden from the beginning, Hiroshima quickly disappeared into the depths of American awareness,” we have found instead that it became ubiquitous in American culture and remained so throughout the Cold War and beyond, particularly as shorthand for America as nuclear victim, not nuclear perpetrator. This same inclination can be seen in early press coverage of the Fukushima nuclear disaster in Japan last year. A great deal of press coverage in the United States was focused on the dangers of radioactive contamination on the American West coast, on America as vulnerable and a victim. This inversion of the history of Hiroshima and Nagasaki took a firm hold on the American imagination once the former Soviet Union developed nuclear weapons of their own in late 1949. However, even with the end of the Cold War, the 9/11 attacks reinvented notions of an American Hiroshima as the inevitable follow-up to the attacks on the World Trade Center and the Pentagon.

[Editor's note: See the Japanese film footage of the devastation of Hiroshima on August 6, 1945 and its aftermath, the Bikini tests of July 1946 and the rapturous account of the American announcer shown in an American newsreel below. This film includes the first images of hibakusha seen in the United States.]

“Once a photograph of the Earth, taken from outside, is available - once the sheer isolation of the Earth becomes known - a new idea as powerful as any in history will be let loose.” –Fred Hoyle, 1950

In the aftermath of the atomic bombings of Hiroshima and Nagasaki, a majority of Japanese people came to see nuclear power as safe and productive even as there were misgivings about nuclear weapons. President Eisenhower's attempts in the 1950s to convince people about the potential of peaceful nuclear power were quite successful and, especially compared to carbon fuels, nuclear energy was considered a relatively inexpensive and environmentally friendly way for Japan to achieve energy self-sufficiency. Robert Jacobs’ essay reminds us of the important distinction between responses to nuclear energy, and to nuclear weapons, in the wake of Hiroshima and Nagasaki. The atomic bombings left room for optimism about the future of nuclear energy, but they also reinforced pessimism about the future of nuclear weapons. Jacobs examines how Western editorial cartoons from the 1940s and 1950s that responded to the atomic bombings of Hiroshima and Nagasaki gave birth to the visual icon of the whole earth. Well before photographs of the whole earth became a part of the cultural lexicon in the late 1960s, these cartoon renderings shaped how the earth came to be viewed and understood as a target and victim of nuclear weapons and war. Jacobs stresses the importance of the visual in environmental history, and underscores themes interwoven through many of these essays including the interconnectedness between present debates and battles over the past, and the multi-national or transnational nature of many environmental issues.

In September of 2012, Dr. Calin Georgescu, the United Nations Special Rapporteur on the implications for human rights of the environmentally sound management and disposal of hazardous substances and waste, submitted his report on the legacy of the nuclear weapon testing program of the United States in the Marshall Islands to the Human Rights Council of the UN. This long overdue report offers a harsh assessment of the history of American nuclear testing in the Pacific and the subsequent underplaying of both the health and welfare of the Marshallese, and the radiological contamination wrought by the 67 nuclear weapon tests (atmospheric and underwater) conducted there between 1946 and 1958.

On March 1, 1954 a Japanese tuna trawler was at sea in the Marshall Islands. Quite unexpectedly grey ash began to fall like snow and covered the boat and crew. It was not snow; it was radioactive fallout from a nuclear test that had been conducted by the United States hours earlier 90 miles from the exclusion zone proclaimed by the US. This nuclear explosion, known as the Bravo Test, was the first detonation of a deliverable hydrogen bomb. The 15 megaton bomb, approximately 1,000 times greater than the bomb dropped on Hiroshima, was the largest explosion in human history at the time. It would render several of the atolls that make up the Marshall Islands uninhabitable. March 1st is now called Nuclear Victims and Survivors Remembrance Day in the Marshall Islands. However, for the crew members of the trawler it was a mystery.

Globally, glaciers are changing in response to climate warming, with those that terminate in water often undergoing the most rapid change. In Alaska and northwest Canada, proglacial lakes have grown in number and size but their influence on glacier mass loss is unclear. We characterized the rates of retreat and mass loss through frontal ablation of 55 lake-terminating glaciers (>14 000 km2) in the region using annual Landsat imagery from 1984 to 2021. We find a median retreat rate of 60 m a−1 (interquartile range = 35–89 m a−1) over 1984–2018 and a median loss of 0.04 Gt a−1 (0.01–0.15 Gt a−1) mass through frontal ablation over 2009–18. Summed over 2009–18, our study glaciers lost 6.1 Gt a−1 to frontal ablation. Analysis of bed profiles suggest that glaciers terminating in larger lakes and deeper water lose more mass to frontal ablation, and that the glaciers will remain lake-terminating for an average of 74 years (38–177 a). This work suggests that as more proglacial lakes form and as lakes become larger, enhanced frontal ablation could cause higher mass losses, which should be considered when projecting the future of lake-terminating glaciers.

Radiation makes people invisible. We know that exposure to radiation can be deleterious to one's health; can cause sickness and even death when received in high doses. But it does more. People who have been exposed to radiation, or even those who suspect that they have been exposed to radiation, including those who never experience radiation-related illnesses, may find that their lives are forever changed – that they have assumed a kind of second class citizenship. They may find that their relationships to their families, to their communities, to their hometowns, to their traditional diets and even traditional knowledge systems have been broken. They often spend the remainder of their lives wishing that they could go back, that things would become normal. They slowly realize that they have become expendable and that their government and even their society is no longer invested in their wellbeing.

My book Nuclear Bodies: The Global Hibakusha has just been released by Yale University Press. The book is based on more than 10 years of research on the Global Hibakusha Project with my research collaborator Mick Broderick. This article provides a short overview of the book; you can learn more and watch some lectures at the book's website: Nuclear Bodies: The Global Hibakusha.