Nursing education has undergone a significant transformation as a result of artificial intelligence (AI). Chatbots, specifically ChatGPT, have emerged as vital AI technologies within the nursing domain as it is a computer program designed to simulate human conversation through text or voice interactions. This study aims to conduct a bibliometric analysis to gain insights into the publication trends, citation impact, and thematic evolution in nursing education and practice concerning ChatGPT and chatbots. A comprehensive bibliometric analysis was performed using VOSViewer, concentrating on citation networks for data analysis and visualisation. A review of LENS.org identified 344 relevant research publications regarding chatbots and ChatGPT within the nursing discipline, all of which were utilised in the study. The study examined various aspects, including types of publications, prominent authors, leading journals, participating nations, institutions, and the impact of ChatGPT on nursing practice. The primary objectives included categorising the papers, identifying the most influential authors, delineating the prominent areas and institutions in the field, and examining the impact of ChatGPT on nursing education and practice. The findings indicate that ChatGPT positively impacts nursing education by enhancing learning experiences, improving communication, and aiding clinical decision-making. The findings indicate that journal articles accounted for 76% of publications, with the U.S. leading in research output. The findings indicate that ChatGPT positively impacts nursing education by enhancing learning experiences, improving communication, and aiding clinical decision-making. Future research should focus on establishing frameworks for integrating ChatGPT into nursing education, addressing ethical implications, and assessing the long-term impacts on patient care.

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most prevalent chronic liver disease worldwide, affecting approximately 32%-38% of the adult population and posing a growing public health burden. MASLD represents a continuous disease spectrum ranging from simple steatosis to metabolic dysfunction-associated steatohepatitis (MASH), progressive hepatic fibrosis, cirrhosis, and ultimately hepatocellular carcinoma (HCC). The pathological core of MASLD lies in disruption of hepatic lipid metabolic homeostasis, characterized by an imbalance among de novo lipogenesis, fatty acid β-oxidation, and very-low-density lipoprotein (VLDL)-mediated lipid export. This metabolic disequilibrium subsequently drives inflammatory injury and fibrotic progression. Among the multiple regulatory pathways involved, thyroid hormone (TH) signaling has emerged as a central regulator of hepatic metabolic homeostasis. The liver is a major peripheral target organ of TH action, where TH predominantly exerts its metabolic effects through thyroid hormone receptor β (TRβ). Large-scale epidemiological studies and meta-analyses have demonstrated that hypothyroidism is significantly associated with increased MASLD prevalence, more severe histological injury, and advanced hepatic fibrosis, suggesting that dysregulation of TH signaling may participate throughout the entire MASLD disease spectrum. At the molecular level, TH regulates hepatic lipid metabolism by coordinating suppression of lipogenesis, enhancement of mitochondrial fatty acid oxidation, and promotion of VLDL assembly and secretion through integrated genomic actions of the T3-TRβ axis and non-genomic signaling pathways. Across different stages of MASLD, TH signaling exerts stage-dependent protective effects. In the steatosis stage, TH improves metabolic flexibility by modulating insulin sensitivity, glucose metabolism, and lipid droplet clearance, thereby alleviating early lipotoxic stress. During progression to MASH, TH attenuates inflammatory amplification by improving mitochondrial homeostasis, suppressing activation of the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome, and modulating the gut-liver axis microenvironment. In advanced stages, TH signaling influences hepatic stellate cell activation and extracellular matrix deposition, partly through interaction with the transforming growth factor-β (TGF-β)/SMAD pathway, while alterations in intrahepatic TH availability, mediated by dynamic changes in iodothyronine deiodinase 1 (DIO1), contribute to fibrosis progression and hepatocellular dedifferentiation. In hepatocellular carcinoma, coordinated downregulation of TRβ and DIO1 establishes a tumor-associated hypothyroid state that promotes metabolic reprogramming and tumor progression. The clinical relevance of TH signaling in MASLD has been underscored by the recent approval of Resmetirom, a liver-targeted TRβ‑selective agonist, for the treatment of non-cirrhotic MASH with moderate-to-severe fibrosis (F2-F3). This approval represents a landmark transition from mechanistic understanding to metabolism-centered precision therapy in MASLD. Clinical trials have demonstrated that Resmetirom not only improves key histological endpoints, including MASH resolution and fibrosis regression, but also favorably modulates atherogenic lipid profiles, highlighting the therapeutic potential of selectively targeting hepatic TH pathways. This review systematically summarizes the multidimensional regulatory roles of TH across the MASLD disease spectrum and discusses emerging diagnostic and therapeutic implications of TH-based interventions, aiming to inform future mechanistic research and optimize clinical management strategies.

BACKGROUND

Continuing Medical Education (CME) serves as a cornerstone for maintaining clinical competence and improving patient care. In the Philippines, CME has become increasingly digital, with the UP Med Webinars emerging as a leading platform for physician education over the past decade. Despite this growth, there has been limited evaluation of how well these webinars align with national health priorities, particularly those reflected in PhilHealth hospital admissions and claims data, which provide insights into the country's disease burden and healthcare utilization patterns.

This study aimed to determine the extent to which the topics and reach of UP Med Webinars correspond with the Philippine health system’s most pressing clinical demands. Specifically, it aimed to analyze the trend in number of webinars by year; analyze the distribution of webinar topics by medical field; assess physician attendance as a proxy for clinical interest and engagement; evaluate the alignment between UP Med Webinar content and national health priorities based on PhilHealth’s top conditions, procedures, and reimbursed claims.

The study used a qualitative content analysis of all Continuing Professional Development (CPD)-accredited UP Med Webinars from 2015 to 2024, supported by descriptive statistics. Webinar titles were coded thematically and categorized by topic and medical field. Attendance figures were analyzed to identify high-demand topics. These results were compared with PhilHealth Claims Reports (2020–2024), focusing on the top reimbursed medical diagnoses and procedures, to assess alignment with disease burden and health service delivery trends. These findings can help inform strategic planning for CME programs to ensure they remain responsive to the country's evolving public health needs.

From 2015 to 2024, a total of 686 CPDaccredited UP Med Webinars were conducted, attended by 685,994 participants. The annual number of webinars and attendees steadily increased, peaking during the COVID-19 pandemic (2020–2022) with heightened demand for virtual CME and pandemic-related topics. Internal Medicine consistently emerged as the most frequently covered field, accounting for 54.1% of webinars and 48.8% of total attendance, followed by Obstetrics and Gynecology (14.4% of webinars; 19.6% of attendance) and Pharmacotherapeutics (6.0% of webinars; 6.9% of attendance). Certain fields, including COVID-19 and Psychiatry, attracted disproportionately high attendance despite fewer sessions, indicating strong interest during periods of public health urgency. The top 10 webinar topics included Diabetes, Pregnancy, Cancer, Hypertension, Reproductive Health, COVID-19, Heart Disease, Antimicrobial Treatment, Vertigo, and Vaccination, reflecting a mix of chronic disease management, maternal health, infectious diseases, and emergent health concerns.

Comparison with PhilHealth claims data (2020– 2024) revealed a high disease burden in Internal Medicine, Obstetrics, and Pediatrics, with top medical conditions including Pneumonia, Dengue, Hypertensive emergencies, and Stroke. These findings indicate a strong alignment between the most covered webinar topics and national healthcare utilization trends, particularly in high-burden clinical areas.

Findings suggest that the UP Med Webinars have generally aligned with national health priorities, as indicated by PhilHealth claims data, particularly in highburden fields such as Internal Medicine and Obstetrics. However, gaps in coverage for certain high-priority conditions and procedures point to opportunities for more inclusive and data-driven CME planning. Aligning CME content with evolving health system needs can enhance its relevance, support clinical practice improvements, and ultimately contribute to better population health outcomes in the Philippines.

The profunda femoris artery (PFA) originates from the femoral artery, supplying crucial blood flow to thigh muscles, hip joint, and femur. We report a rare unilateral anatomical variation involving an accessory profunda femoris artery (APFA) originating 0.5 cm from the mid-inguinal point (MIP) and a main PFA arising 3.6 cm from the MIP. The APFA supplies the pectineus, adductor longus, and adductor magnus muscles, and gives off the superficial circumflex iliac artery. The main PFA gives rise to circumflex and perforating branches. This variation highlights the complexity of human anatomy and has significant clinical implications, particularly in vascular surgery, plastic surgery, and interventional radiology. Understanding anatomical variations, such as dual PFAs, is crucial for preventing complications during vascular procedures like catheterization and SCIP flap reconstruction. Preoperative assessment and intraoperative adaptability are essential to mitigate risks of arterial injury, dissection, or inadequate perfusion.

The sural nerve (SN) is a sensory nerve in the lower limb with notable variability in its origin, course, and branching patterns. This variability has important implications for diagnostic procedures, nerve grafting, and surgical planning, yet it remains underexplored in Southern African populations. This cadaveric study examined 90 lower limbs from 45 embalmed adult human cadavers (24 males, 21 females) at the University of Pretoria in South Africa. Each specimen was assessed for SN formation type, anatomical location, and morphometric data, including its contributing branches (medial sural cutaneous nerve [MSCN] and lateral sural cutaneous nerve [LSCN]). Measurements were recorded, and bilateral symmetry and sex-based differences were analyzed. Four SN formation types were identified, with Type 1 (union of MSCN and LSCN) being most common (62.2%). Formation most frequently occurred in the middle third of the leg (38.9%), although distribution across the middle, lower, and ankle levels was more evenly spread than in other populations. Bilateral symmetry in SN formation was seen in only 40% of cadavers. The average SN length was 100.1 mm and the mean distance from the lateral malleolus was 27.2 mm. This study confirms high anatomical variability of the SN among South African cadavers, and understanding such variation is crucial for clinicians performing nerve grafting or procedures in the distal leg. These findings may enhance surgical planning and education by emphasizing region-specific anatomical variation.

Initial gastrointestinal endocrine cells (GIECs) likely appear at the proximal and distal sites of abdominal intestines and may take a close topographical relation with neural elements in the gut. We examined immunohistochemically-stained sections from 10 fetuses at approximately 8–18 weeks of gestational age (36–155 mm of crown-rump length). Irrespective of whether physiological herniation was present (early 5 specimens) or absent (the other 5), the duodenum and jejunum had well-developed mucosa with villi containing abundant flask-like chromogranin-positive cells. In the earlier 5 specimens, the rectum, standing up to a level of the umbilicus, had a lumen and villi with a few positive cells, but the colon carried neither the lumen or chromogranin-positive cells. The initial GIECs seemed to appear in the basal payer of the epithelium at the distal and proximal foci depending on double pathways of neural crest cell migration. Less number of the colic chromograninpositive cells, more than 5-times difference in density relative to small intestine, was seen in the larger 5 specimens. The appearance of GIECs was delayed at the anal transitional zone (a border area between the columnar and squamous epithelia).The reactivity of neuronal nitric oxide synthase was restricted in the myenteric plexus, whereas clusters of slender calretininpositive cells existed in the lamina propria or core of villi in the duodenum and colon. Relatively small, round or oval positive cells were also seen in the basal layer of the columnar epithelium. Therefore, calretinin-positive cells might exist closely to GIECs in the developing villi.

Pancreatic cancer is one of the most lethal malignancies, primarily due to late-stage diagnosis and limited therapeutic options. Cancer stem cells (CSCs) contribute to tumor heterogeneity, therapy resistance, and recurrence through activation of developmental pathways such as Hedgehog, Wnt, Notch, JAK-STAT, and Hippo. Identifying CSCs is therefore essential for understanding pancreatic ductal adenocarcinoma (PDAC) pathogenesis and advancing targeted therapies. This study compares the expression of key CSC-associated markers (CD44, CD117, OCT3/4, and c-Myc) in PDAC, fetal, and adult pancreas to elucidate CSC dynamics. Immunohistochemistry for CSC markers (CD44, CD117, OCT3/4, and c-Myc) was performed on PDAC tissues and control pancreatic samples (fetal pancreas 28–36 weeks and adult pancreas) to evaluate marker expression. Proliferative potential was assessed using CK7 and Ki-67 expression patterns. CD44 showed strong membranous and cytoplasmic expression in PDAC, moderate in fetal pancreas (epithelial/ductal regions), and minimal expression in adult tissue. CD117 was mainly restricted to stromal cells in PDAC, also present in fetal tissue but low in adults.c-Myc and Ki-67 were moderately expressed in PDAC, significantly higher than the control samples. CK7 demonstrated strong cytoplasmic staining in PDAC, moderate expression in adults, and weak expression in fetal samples. CD44 and c-Myc re-expression in PDAC supports their role as CSC-associated markers and potential drivers of tumor progression. CD117’s stromal localization suggests tumor–stroma interactions. These findings highlight developmental reactivation of CSC markers in PDAC, with implications for early detection and targeted therapy.

We present a rare anatomical variation of the deep femoral vein (DFV) originating from the popliteal vein (PV) with an associated aneurysm. The DFV arose from the PV at the adductor hiatus, exhibited an aneurysm, and coursed upward through the fourth osseo-aponeurotic opening of the adductor magnus muscle to enter the anterior thigh compartment before draining into the femoral vein. This unique variation likely resulted from developmental deviations during intrauterine life. The anomalous origin and aneurysm of the DFV may potentially cause venous hemodynamic disturbances, chronic venous insufficiency, increased risk of deep vein thrombosis, and potentially life-threatening pulmonary embolism. Anatomical variations of the DFV in terms of origin, course, or termination are rare but clinically relevant, especially in the context of vascular surgeries, imaging, and interventional procedures involving the femoral region.This case highlights the importance of recognizing venous anatomical variations and their clinical implications.

Tartrazine (TZ) is a synthetic azo dye extensively used as a food colorant, posing potential harm to human health. This study examined whether maternal exposure to TZ at an acceptable daily intake (ADI) dosage during lactation could induce neurotoxicity in male rat pups and to investigate the potential underlying mechanism. Twelve rat dams at postnatal day 2 (PND2) were split equally into control (received vehicle), and TZ-treated (received TZ 7.5 mg/kg) groups.Administration was through oral gavage, once daily for 20 days (from PND2 to PND21). The pups’ exposure to TZ was via breastfeeding. On PND22, male pups’ brain tissues were collected for histopathological, immunohistochemical, biochemical, and gene expression analyses. Maternal TZ exposure during lactation led to brain tissue damage in rat pups, with resultant neuronal atrophy, nuclear condensation, perineuronal halos, capillary congestion, wide pericapillary spacing, hemorrhage, and neuropil vacuolation in the prefrontal cortex, cerebellar cortex, and hippocampus. Also, lactational TZ exposure was associated with oxidative stress (raised malondialdehyde, reactive oxygen species with total antioxidant capacity decline);oxidative DNA damage (overexpression of 8-OHdG protein); endoplasmic reticulum stress (upregulated XBP-1, BIP, CHOP, and JNK genes); autophagy suppression (upregulated p62 gene, downregulated Beclin-1 gene, decreased LC3-II at both protein and gene levels); synaptogenesis impairment (decreased synaptophysin protein expression and increased acetylcholinesterase activity level); inflammation (raised TNF-α, IL-1β, IL-6 with IL-10 decline). In conclusion, this study highlights neurotoxic alterations in pups associated with low-dose TZ exposure through breastfeeding, focusing on the underlying molecular mechanisms. This is crucial for developing strategies to safeguard public health.

The nasal mucosa and submucosa likely contain both vascular beds against cold and dry air and resident immunoreactive cells against various antigens. Therefore, a specific fibrous structure seems to be necessary. Using histological specimens from 20 elderly cadavers, we examined the nasal mucosal and submucosal architecture. The ciliated columnar epithelium of the nasal mucosa was characterized by 1) a thick basal lamina, 2) few elastin-positive fibers beneath the epithelium, that was quite different from the nearby mucocutaneous junction area with a thick layer (0.3–0.8 mm) of elastic and oxytalan fibers corresponding to the skin dermis, 3) CD34-positive cells distributing diffusely in the submucosal tissue, and 4) few smooth muscle actin (SMA)-positive fibers beneath the epithelium. Some of submucosal fibrous structure appeared to express both elastin and CD34. CD34-positive arterioles were abundant beneath the ciliated epithelium, but they appeared negative for SMA antibody that cross-reacts with endothelium. Notably, the ciliated columnar epithelium was thin in the lateral wall of the nasal cavity, while the inferior concha carried the thick pseudostratified columnar epithelium.Strangely, the inferior or palatal wall of the nasal cavity was covered by the thick stratified epithelium. We found SMApositive mucosal venous plexus in the lateral wall of nasal cavity, but the submucosa was filled with glands in the inferior concha. Vascular beds might be replaced by glands in the nasal submucosa. The site-dependent difference in the mucosal morphology as well as the absence of vascular beds might be a result of secondary change with aging.