One acyl hydrazide, adipic acid dihydrazide (ADH), was tested on a mouse model of breast cancer and showed nice contrast in the tumor region. We also prepared a derivative, acyl hydrazone, which showed the furthest shifted labile proton (6.4 ppm from water) and excellent contrast properties. Overall, our study expands the catalog of diaCEST agents and their application in cancer diagnosis.Chemical exchange saturation transfer (CEST) MRI is a versatile molecular imaging approach that holds great promise for clinical translation. A number of compounds have been identified as suitable for performing CEST MRI, including paramagnetic CEST (paraCEST) agents and diamagnetic CEST (diaCEST) agents. DiaCEST agents are very attractive because of their excellent biocompatibility and potential for biodegradation, such as glucose, glycogen, glutamate, creatine, nucleic acids, et al. However, the sensitivity of most diaCEST agents is limited because of small chemical shifts (1.0–4.0 ppm) from water. To expand the catalog of diaCEST agents with larger chemical shifts, herein, we have systematically investigated the CEST properties of acyl hydrazides with different substitutions, including aromatic and aliphatic substituents. We have tuned the labile proton chemical shifts from 2.8–5.0 ppm from water while exchange rates varied from ~680 to 2340 s Chemical exchange saturation transfer (CEST) MRI is an alternative method based on contrast mechanisms, which is “switched on” by applying selective saturation using radiofrequency pulse(s) at the frequency of labile protons on solute molecules which exchange with water +) 999.5384, found 999.5369.terature , 1.72 g,1) from 1.8, 2.4, 3.0, 3.6, 4.2, and 4.8 μΤ. One hundred two offsets between ±10 ppm were acquired with a 0.2 ppm stepsize to produce saturation images, plus one at +40 ppm. Other imaging sequence parameters: matrix size 64 × 64; slice thickness 1.5 mm; TR/TE 6000/4.6 ms. For B0 inhomogeneity calculation, water saturation shift referencing (WASSR) images were acquired using B1 = 0.5 μΤ with 31 offsets from −1.5 to +1.5 ppm with a 0.1 ppm stepsize.Acyl hydrazides and acyl hydrazone were dissolved in 0.01M phosphate-buffered saline (PBS) at different concentrations and titrated to various pH values ranging from 5.7 to 7.5. The samples were kept at 37 °C during imaging. In vitro CEST MRI experiments were performed on a horizontal bore 9.4 T Bruker Biospec system . For phantoms, a transmit-receive volume coil with an inner diameter of 40 mm was used. CEST images were acquired using a continuous-wave RF saturation pulse of 3s followed by a RARE imaging sequence. CEST data were acquired using six different saturation power . Prior to imaging, the tail vein was cannulated, permitting intravenous injection in the MRI scanner. Mice were warmed, and their respiration rate was monitored throughout the duration of the imaging experiment. A T2w image was obtained using a multi-slice RARE sequence. RARE factor = 8, TR/TE = 2 s/20 ms, field of view = 28 mm2 × 20 mm2, matrix size = 256 × 256, slice thickness 1.5 mm. For CEST data acquisition, 4 s long cw saturation pulses were applied with B1 = 3.6 μΤ using 31 offsets from −7.0 to +7.0 ppm with stepsize 0.2 ppm and one offset of +40 ppm for 72 offsets. WASSR images were collected for generating B0 maps using 31 offsets from −1.5 to +1.5 ppm with stepsize 0.1 ppm and B1 = 0.5 μT. After completion of the initial Z-spectrum, the mouse was injected with 100 μL of 500 mM (~435 mg/kg) ADH, and the line was flushed with 100 μL saline. No adverse events were noted in any of the mice receiving ADH injections. Post-contrast Z-spectra were acquired sequentially up to 34 min post-injection. The time taken for each set of 72 offsets was 8 min and 24 s, and the other sequence parameters were as follows: TR/TE 7000/4.6 ms; number of averages = 1; matrix size = 64 × 64; field of view 28 mm2 × 20 mm2.All animal experiments were performed under a protocol approved by the Jinan University Animal Care and Use Committee. Tumor xenografts of murine 4T1 breast cancer were established in three 4-week-old female Balb/c nude mice (Charles River Laboratories) through the subcutaneous injection of 2 × 10asym = (S(−Δω) − S(+Δω))/S0, where S+Δω and S−Δω were the MRI signals with RF irradiation at particular offsets +Δω and –Δω, respectively, and S0 is the signal acquired without RF saturation. Both S+Δω and S−Δω were corrected pixel-wise for B0 inhomogeneity using the WASSR method as described previously [All post-processing was performed using custom-written script implemented in MATLAB . Saturation transfer (ST) contrast was calculated by applying magnetization transfer ratio asymmetry analysis with MTReviously .asym values at the maximum CEST offsets for the set of 6 saturation field strengths were fit numerically using the Bloch equations to estimate the exchange rates (kex).The exchange rates for the labile protons were estimated using the quantifying exchange using saturation power (QUESP) method as described previously . In brie4 cells per well for 24 h at 37 °C and in an atmosphere of 5% CO2. Then, the medium was removed and the cells were washed with PBS (×2). Afterward, the cells were exposed to different concentrations of ADH  in each well. The cells were grown for a further 24 h. Then a standard CCK-8 assay was carried out to evaluate the cell viability. Briefly, 10 μL of the CCK-8 solution was added to each well of the plate, and the cells were allowed to grow for another 3 h. The absorbance ) was measured at 450 nm using a microplate reader . The measured absorbance value (OD) of the wells was then used to calculate the cell viability via the formula4T1 cells were cultured in completed RPMI 1640 media  and seeded into 96-well plates (100 μL/well) at a density of 1× 10In conclusion, we have identified a number of compounds from the acyl hydrazise–hydrazone scaffold, which produces strong CEST contrast from 2.8–6.4 ppm from water. We have also demonstrated that one compound from this scaffold (ADH) allows the detection of altered perfusion in a mouse model of breast cancer. Our study expands the catalog of compounds suited as CEST agents, which will accelerate the clinical translation of CEST MRI in the future.


Hip fractures in older people are a common health problem often associated with malnutrition that might affect outcomes. Screening for malnutrition is not a routine examination in emergency departments (ED). This analysis of the EMAAge study, a prospective, multicenter cohort study, aimed to evaluate the nutritional status of older patients (≥ 50 years) with hip fracture, factors associated with malnutrition risk, and the association between malnutrition and the six-months mortality.Risk of malnutrition was evaluated using the Short Nutritional Assessment Questionnaire. Clinical data as well as data on depression and physical activity were determined. Mortality was captured for the first six months after the event. To assess factors associated with malnutrition risk we used a binary logistic regression. A Cox proportional hazards model was used to assess the association of malnutrition risk with six-month survival adjusted for other relevant risk factors.N = 318 hip fracture patients aged 50 to 98 (68% women). The prevalence of malnutrition risk was 25.3% (n = 76) at the time of injury. There were no differences in triage categories or routine parameters measured in the ED that could point to malnutrition. 89% of the patients (n = 267) survived for six months. The mean survival time was longer in those without malnutrition risk (171.9 (167.1–176.9) days vs. 153.1 (140.0–166.2) days). The Kaplan Meier curves and the unadjusted Cox regression (Hazard Ratio (HR) 3.08 (1.61–5.91)) showed differences between patients with and patients without malnutrition risk. In the adjusted Cox regression model, risk of death was associated with malnutrition risk , older age (70–76 years: HR 2.5 (0.52–11.99); 77–82 years: HR 4.25 (1.15–15.62); 83–99 years: HR 3.82 (1.05–13.88)) and a high burden of comorbidities (Charlson Comorbidity Index ≥3: HR 5.4 (1.53–19.12)).The sample consisted of Risk of malnutrition was associated with higher mortality after hip fracture. ED parameters did not differentiate between patients with nutritional deficiencies and those without. Therefore, it is particularly important to pay attention to malnutrition in EDs to detect patients at risk of adverse outcomes and to initiate early interventions. Hip fractures are a common musculoskeletal injury in older people with a serious impact on the patient’s daily life. Consequences are reduced mobility, loss of independence, impaired quality of life, and increased morbidity . PatientOld adults are particularly prone to nutritional deficiencies due to their age-associated physiological changes and decreasing physiological reserves , thus thFew studies have addressed malnutrition in older patients in emergency departments (ED), and especially in Germany there is too little data on the prevalence of malnutrition in ED patients with hip fractures and its correlation with mortality. Previous studies have reported a prevalence of malnutrition in older ED patients up to 29% –22 whichThe aim of this study was to determine the prevalence of self-reported signs of malnutrition in a cohort of older ED patients with hip fracture (≥ 50 years), to explore factors associated with risk of malnutrition, and to analyze the association between risk of malnutrition and six-month mortality.N = 318 patients aged 50 years and older  with a hip fracture admitted to the EDs of six hospitals between June 2017 and June 2019  and was registered in the German Clinical Trials Register (DRKS-ID: DRKS00014273). Written informed consent was obtained from all study participants. The authors confirm that all methods were carried out in accordance with good clinical practice.The following clinical parameters were extracted from the hospital information systems using an electronic clinical report form: Manchester Triage System category , vital signs , Glasgow Coma Scale (GCS) , ICD diaShort Nutritional Assessment Questionnaire (SNAQ) was used to screen for the risk of malnutrition (“(1.) Did you lose weight unintentionally? More than 6 kg in the last 6 months (3 points) or More than 3 kg in the last month (2 points)? (2.) Did you experience a decreased appetite over the last month? (1 point) (3.) Did you use supplemental drinks or tube feeding over the last month? (1 point).” The SNAQ instrument classifies patients into three groups: normal nutritional status (0–1 points), moderate risk of malnutrition (2 points) and severe risk of malnutrition (≥ 3 points).The following variables were constructed by using self-reported patient data: The standardized questionnaire the utrition . It incl2) by using the formula BMI = body weight / height2. Physical activity before the fracture was assessed with the question: “How often do you do things that are slightly or moderately strenuous?” . Furthermore, participants were asked to report the frequency of previous falls (six months before the fracture). The Patient Health Questionnaire 4 (PHQ-4) was used to screen for symptoms of depression and anxiety . For continuous variables, with means and standard deviations (SD) or median and interquartile range (IQR) are reported. Effect sizes of group differences are given as standardized mean differences.Descriptive parameters are given as absolute and relative frequencies  with 95% CI. The model was adjusted for age, gender and CCI score. In addition, Kaplan–Meier survival curves were created for patients with and without the risk of malnutrition. Survival time was calculated as the number of days from initial hospital stay to six-months follow up.For all analyses, risk of malnutrition was used as a binary variable combining moderate and severe risk. For the multiple models, age was categorized into four groups: 50–69 years; 70–76 years; 77–82 years and 83–99 years.EQ-5D-5L . The models were done using N = 318 hip fracture patients aged 50 to 98 years , 68% were women. For n = 300 participants, complete information on their risk of malnutrition could be obtained according to the SNAQ instrument. An involuntary weight loss of more than 6 kg within six months or more than 3 kg in the previous month was found in 18% (n = 54) and 6.7% (n = 20) of the patients, respectively. A quarter of the patients reported a loss of appetite in the previous month. Oral nutritional supplements were used by 6.3% (n = 19) of the patients. According to the SNAQ score, 22.3% (n = 67) of the study cohort showed a severe risk of malnutrition, followed by 3% (n = 9) with a moderate malnutrition risk. Compared to well-nourished patients, patients with risk of malnourishment were older and had a lower BMI (n = 19) showed a BMI below 20 kg / m2 (≤ 70 years) and 20.8% (n = 56) below 22 kg / m2 (> 70 years).The characteristics of the study population are shown in ower BMI : 7.1% , and reduced muscle mass as well as etiologic parameters such as reduced food intake, food reduction for more than 2 weeks, or any chronic gastrointestinal diseases and inflammation . A higher BMI was recently found to be a nutritional risk factor for malnutrition in older adults . The sponsor is not involved in the design and conduct of the study, data collection, analysis, and interpretation of data or in writing this manuscript. We acknowledge financial support from the Open Access Publication Fund of Charité – Universitätsmedizin Berlin and the German Research Foundation (DFG).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Ward rounds are a cornerstone in the educational experience of junior doctors and an essential part of teaching patient care. Here, we aimed to assess the doctors’ perception of ward rounds as an educational opportunity and to identify the obstacles faced in conducting a proper ward round in Sudanese hospitals.th to the 30th of January 2022 among house officers, medical officers, and registrars in about 50 teaching and referral hospitals in Sudan. House officers and medical officers were considered the learners, while specialist registrars were considered the teachers. Doctors’ perceptions were assessed using an online questionnaire, with a 5-level Likert scale to answer questions.A cross-sectional study was conducted from the 15A total of 2,011 doctors participated in this study . The participants were aged 26.9 ± 3.2 years, and females constituted about 60% of the sample. An average of 3.1 ± 6.8 ward rounds were conducted per week in our hospitals, with 11.1 ± 20.3 h spent on ward rounds per week.Most doctors agreed that ward rounds are suitable for teaching patient management (91.3%) and diagnostic investigations (89.1%). Almost all the doctors agreed that being interested in teaching (95.1%) and communicating appropriately with the patients (94.7%) make a good teacher in ward rounds. Furthermore, nearly all the doctors agreed that being interested in learning (94.3%) and communicating appropriately with the teacher (94.5%) make a good student on ward rounds. About 92.8% of the doctors stated that the quality of ward rounds could be improved. The most frequently reported obstacles faced during ward rounds were the noise (70%) and lack of privacy (77%) in the ward environment.Ward rounds have a special value in teaching patient diagnosis and management. Being interested in teaching/learning and having good communication skills were the two major criteria that make a good teacher/learner. Unfortunately, ward rounds are faced with obstacles related to the ward environment. It is mandatory to ensure the quality of both ward rounds' teaching and environment to optimize the educational value and subsequently improve patient care practice.The online version contains supplementary material available at 10.1186/s12909-023-04404-z. Ward rounds—sometimes referred to as “walking tightrope”- are a very complex entity that provides a chance for information exchange, demonstration of communication skills, and approach to appropriate clinical decision making , 2. The Although ward rounds are considered a rich learning opportunity for medical students, and a good strategy, this learning method is prone to multiple problems. The greatest challenges in conducting proper ward rounds include lack of time due to increasing workload, noisy wards, patients not being available, reduced training time, learners at different training levels; and on the other hand, the attending physician is responsible for delivering best patient care practice at the same time , 2. AccoAnother factor that contributes into the complexity of understanding the efficacy of ward-rounds as a teaching method, are factors related to ward environment: such as the complexity of hospital environment, lack of order, large student numbers per health facility and hence, per patient, factors related to the teaching staff: such as their training to conduct ward rounds, and their preparedness for the ward rounds themselves. And factors related to students, such as: their preparedness for the ward rounds and their interaction. All these factors contribute to a complex healthcare setting that can affect the quality and efficacy of ward rounds and their benefit to students. (Unique problem).st November 2017 which has an impact on reducing the time into which both patient care services and training conducted.In recent years, new educational strategies have been implemented, such as clinical skills lab, sessions facilitated by small groups, and problem-based learning sessions. However, there is still is a necessity to put effort into improving the quality and the educational value of ward rounds to achieve the highest benefit from this cornerstone learning method. In Sudan, the process of improving ward rounds is hampered by a lack of original research studies in literature, as well as the fact that literature on this topic addresses ward rounds that were conducted in different settings, such as different types of wards, different hospitals, different countries and further, different levels of training including teachers , 3. FactHence, drawing on the premises above, and the insufficient literature that attends to this problem in Sudan, this study aims to assess the quality and efficacy of ward rounds as a learning method and educational opportunity and to identify the obstacles to conducting a proper ward round in Sudanese hospitals. It represents the first of its type in Africa and the Middle-East. It also provides an overview of successful rounds’ structural components and common difficulties for attending Sudanese physicians who want to improve their performance.A cross-sectional analytic study was conducted between the 15th and 30th of January 2022, focusing on house officers, medical doctors, and registrars in Sudanese teaching and referral hospitals. The study included approximately 50 hospitals, 26 of which were located in Khartoum, the capital of Khartoum state, and 24 hospitals in Sudan’s other 17 states. In this study, house officers and medical officers were regarded as learners, while medical specialist registrars were regarded as teachers.Doctors working in hospitals and not registered as trainees by Sudan Medical Council (SMC) were excluded from the study.th January 2022 to 30th January 2022.A conventional non-probability random sampling was done for all house officers, medical officers, and registrars within Sudanese teaching and referral hospitals between 15A well-structured self-administered questionnaire was distributed by a team of more than 40 doctors to collect data in both Google forms  and hard copies to all participants. A minimum sample size of 288 was estimated using the online Rao soft sample size calculator, using a 95% confidence interval, 50% response distribution, 5% margin of error, and an estimated population size of 15,000. This was done after distributing the form to 30 participants first, and recording their responses and feedback to see how each participant interpreted the question. Their feedback, if any, was considered when making changes to the questionnaire based on this pilot experiment. The questionnaire used in this study can be found as [Additional file Before beginning the process, data collectors were given detailed explanations for each question. An introduction page contains information about the principal investigators’ identities, links to their official profiles, contact information, and the purpose of the study and its significance to the scientific community. To ensure anonymity and confidentiality, participants’ IP addresses were not collected, and only the principal investigator had access to the survey account. The survey is expected to take 3 to 5 min to complete. Questions were answered using a five-level Likert scale, with free text for descriptive answers for some variables.The questionnaire contained the following domains: socio-demographic data, the educational value of current ward rounds, assessment of ward rounds as a learning and teaching opportunity, obstacles to learning and teaching ward rounds, the effect of the ward rounds structure on learning and teaching, and the effect of the teacher and learner on the educational opportunities of ward rounds.P-value < 0.05, as well as a 95% confidence interval (CI) not including the null value, was considered statistically significant. The Chi-square test or Fisher exact test was used to find if there was a significant difference between the groups.Data was manually entered, cleaned, and analyzed using the R software version 4.0.2. The results were presented in figures and tables as numbers (percentages) and mean . The overall response rate was 67% 2,011/3,000). A total of 2,011 doctors participated in this study; 882 (43.9%) were house officers, 697 (34.7%) were medical officers, and 432 (21.5%) were registrars. The participants had a mean age of 26.9 ± 3.2 years, and females constituted about 60% of the sample. The majority of the participants were from the Department of Medicine (27.2%), followed by Paediatrics (21.7%), Surgery (19.2%), and Obstetrics and Gynaecology (16.5%). The overall number of rounds conducted per week was 3.1 ± 6.8, with a total of 11.1 ± 20.3 weekly hours. Each unit contained an average of 3.6 ± 3.8 registrars and 6.8 ± 7.5 house officers. Characteristics of the study participants were summarized in Table 1/3,000. A large majority of the doctors agreed that ward rounds are suitable for teaching patient management (91.3%), diagnostic investigations (89.1%), history taking (88.3%), physical examination (87%), communication skills (85.9%), time management skills (73.7%), and record keeping 72.3%). A fewer percentage of the doctors agreed that ward rounds are suitable for teaching basic sciences (56.4%). A summary of the doctors' perception of the educational value of ward rounds is available in Table .3%. A feA high percentage of the study participants (92.8%) agreed that ward rounds could be made into a better learning experience. The reported obstacles faced on ward rounds were the lack of privacy (77%) and noise (70%) in the ward environment. Moreover, over half of the participants reported a lack of nurses (65%), a large number of patients 63.5%), changes in team structure (62.5%), lack of time (58.6%), and patient complaints (58.4%) as challenging obstacles. The patients' meal time (42.5%) or unavailability (45.7%) and not knowing the patients (37.6%) were only reported by a minority of the doctors as obstacles. The doctors’ perception of the obstacles faced on ward rounds was summarized in Table .5%, chanThe participants were asked about the characteristics that make a good teacher in ward rounds. Nearly all the participants agreed on being interested in teaching (95.1%), communicating appropriately with the patients 94.7%), understanding the learning needs (94.4%), communicating appropriately with the students (93.4%), providing feedback (93.1%), and approachability (91.6%). Additionally, most of the participants agreed on teaching patiently (87.5%), teaching in the presence of registrars (87.4%), taking time to explain (85.2%), slow steady teaching with interest (85%), being respected by the learners (82.4%), choosing interesting topics (79.6%), and having experience in teaching medical students (71.4%). Teaching in the presence of many registrars, avoiding intimidating manners, and being known by the students were chosen by a fewer percentage of the doctors . A summary of the doctors' perception of the characteristics that make a good teacher in ward rounds is available in Table .7%, undeFurthermore, the doctors were asked about their perception of what makes a good learner in ward rounds. Almost all the participants agreed on communicating appropriately with the teacher 94.5%), being interested in learning (94.3%), and communicating appropriately with the patients (93.9%). The majority agreed on having good knowledge (87.9%) and not being in a hurry (87.2%). Moreover, about half of the doctors agreed on being known by the teacher (53%). The doctors' perception of what makes a good learner in ward rounds is summarized in Table %, being The purpose of this study was to evaluate the effectiveness and quality of the ward round as a teaching tool for house officers, medical officers, and registrars in Sudan, while also identifying the barriers to a good ward round.n = 697) of the participants were medical officers, 21.5% (n = 432) were registrars, and 43.9% (n = 882) were house officers, this could be attributed to the fact that the number of house officers and medical officers is higher than registrars in hospitals as they are the base of the pyramid in the hospital. The participants' average age was 26 years + \- 3 years, and 60% of them were female. Participants in a study by Claridge [2,011 doctors made up the study's sample, which is the highest sample size among research with similar goals that we are aware of . 34.7% , diagnostic investigations (89.1%), history taking (88.3%), physical examination (87%), communication skills (85.9%), time management skills (73.7%), and record keeping 72.3%), according to the vast majority of doctors. Only 56.4%) agreed that teaching basic sciences may be done during ward rounds. Table .3%, acco% agreed .3%, diagThe majority of participants in the survey 92.8%) thought that ward rounds might be improved as a learning opportunity. This collective opinion was common throughout the literatute. In a paper by Khan et al. , most pa% thoughtRegarding barriers to effective learning on ward rounds, the lack of privacy (77%) and noise in the ward environment (70%) were the most common reported problems faced on ward rounds. More than half of the participants identified lack of nurses (65%), a high patient volume in the wards 63.5%), changes in the team structure (62.5%), a lack of time (58.6%), and patient complaints (58.4%) as obstacles to learning. Fewer participants were bothered by the patients' lunchtimes (42.5%), availability (45.7%), and lack of familiarity (376%) with the patients as barriers, as was the case in the study by laskaratos . Table 3.5%, chanA systematic review by Khalaf et al. reported barriers to effective learning during ward rounds from 7 studies. As in our study, the barriers included lack of time, interruptions due to the environment, and hierarchies. Other barriers reported in the systematic review included workloads, unarranged schedules, the service-oriented nature of the ward rounds, lack of feedback, and the lack of opportunities to ask questions and be engaged in patient management . As for When asked about what qualities make a good ward round teacher, the participants largely concurred on being enthusiastic about teaching (95.1%), communicating effectively with patients 94.7%), comprehending students' learning needs (94.4%), communicating effectively with them (93.4%), giving feedback (93.1%), and being approachable (91.6%). The majority of participants also agreed on several other points, including teaching slowly and steadily with interest (85%), taking the time to explain things (85.2%), teaching in front of registrars (87.4%), being respected by the students (82.4%), picking engaging topics (79.6%), and having experience instructing medical students (71.4%). Fewer doctors agreed upon characters such as to teach in front of plenty of registrars, stay away from aggressive behaviors and get to know the students . Table .7%, compLaskartos et al. obtained results that are similar to our findings in the literature. Increased time spent on educating, as in spending more time with each patient and having consultants explain the reasoning behind decisions, was a recurring trait . ParticiPhysicians teaching the ward rounds were also questioned about their opinions on what constitutes a good ward-round learner, in the final section of the questionnaire. Virtually all participants believed that it is important to communicate well with the teacher 94.5%), that learning is interesting (94.3%), and that it is important to communicate effectively with patients (93.9%). The majority concurred that having solid information (87.9%) and not rushing was preferable. Also, about half of the doctors (53%) agreed that the students knew them personally was an important factor. Details in Table %, that lIn the literature, a critical element of effective ward rounds for students was the ability to grasp how experienced physicians arrive at their conclusions . MoreoveWhile it is the job of the teacher and the students to design an effective ward round, the goal of this area's investigation was to reflect the perspectives of both parties. It mostly has to do with how juniors and seniors are now positioned on the ward rounds, how they are organized, and if there is enough time available for instruction either during the round or in pre- or post-ward round sessions. Most trainees stated that successful ward rounds have a variety of critical traits, including a supportive learning environment, clinical teaching, effective teaching techniques, articulating expectations, and team management. It is worthy of mention as well that there were multiple papers that supported the use of ward-round tools to create a structured approach to teaching , 12.In overview, this study has many strong points, as it is the first study to be based on such a large sample size that covers an area of wide geographic distribution with a very comprehensive questionnaires—in comparison to other questionnaires in the literature -. It also assesses the perceptions of both the teacher and the student. It aids in identifying the underlying causes of issues that might be encountered when conducting a ward round, most of which can be resolved by following basic organizational principles like ward round structure, or by utilizing professionalism's most essential virtue, time management. However, its drawback was that its questionnaire was distributed electronically. Secondly, because the study relied on a survey-based methodology, there may have been some response bias because participants who were interested in the topic were more likely to complete the questionnaire truthfully. The study makes no comments about consultants' participation.The results of other studies that were conducted internationally generally agree with the results of this study, which supports the conclusions made in this study and other studies; and confirms that the quality of ward-round teaching is a global issue that is being addressed with nearly identical key controlling factors.House officers, medical officers, and registrars of Medicine, Paediatrics, surgery, and Obstetrics and Gynaecology from 50 hospitals around Sudan reported that the overall number of wards rounds they attend per week was 3.1 ± 6.8, which is higher than the average rounds per week reported in the literature. The large majority believed that ward rounds are highly suitable for teaching patient management, and diagnostic investigations, and just suitable to teach history taking, physical examination, communication skills, time management skills, and record keeping. A few agreed that ward rounds are suitable for teaching basic sciences.Participants agreed that ward rounds could be made into a better learning experience, but obstacles to good ward rounds were: "lack of privacy" and "noise in the ward environment". Other obstacles included" lack of nurses", "a large number of patients in wards,” and others. Most important characteristics for a good teacher ward rounds were “being interested in teaching”,” good communication skills with the patients”,” understanding the learning needs of the students”, and “providing feedback". Ward rounds teachers agreed that good ward-round students "communicate appropriately with the teacher", "are interested in learning", and "communicate appropriately with the patients".Ward rounds continue to be a powerful educational tool that requires the collaboration of healthcare professionals to protect and prioritize its quantity, quality, and patient experience. Future research should include new educational programs to improve teaching in ward rounds and assess the impact of these new interventions.Additional file 1.


Bayesian imaging algorithms are becoming increasingly important in, e.g., astronomy, medicine and biology. Given that many of these algorithms compute iterative solutions to high-dimensional inverse problems, the efficiency and accuracy of the instrument response representation are of high importance for the imaging process. For efficiency reasons, point spread functions, which make up a large fraction of the response functions of telescopes and microscopes, are usually assumed to be spatially invariant in a given field of view and can thus be represented by a convolution. For many instruments, this assumption does not hold and degrades the accuracy of the instrument representation. Here, we discuss the application of butterfly transforms, which are linear neural network structures whose sizes scale sub-quadratically with the number of data points. Butterfly transforms are efficient by design, since they are inspired by the structure of the Cooley–Tukey fast Fourier transform. In this work, we combine them in several ways into butterfly networks, compare the different architectures with respect to their performance and identify a representation that is suitable for the efficient representation of a synthetic spatially variant point spread function up to a  Images of astronomical objects are the result of measurements by physical instruments and intricate post-processing. In this procedure, instrument responses play an important role as they build the connection between the signal, i.e., the quantity of interest, and the observables.Python software package for the numerical application of information field theory In addition to measuring the ability to represent the true inhomogeneous point spread function, we want to test the speed of the butterfly network implementation in an application. Therefore, we use the Python and thus has a huge overhead, whereas the matrix-vector multiplication is written in C and is highly optimised. Implementing the butterfly convolution in C should increase its speed significantly. However, this changes at higher resolution, where the butterfly convolution is considerably faster than the full matrix-vector mutliplication, despite being implemented in a slower language. This is due to the different scaling of the number of operations involved and their parameters. Since the number of parameters in a full matrix multiplication scales with Since the previous sections show that the efficient representation of instrument responses using butterfly networks is indeed possible up to a certain representation error, this section presents a small imaging application with a trained butterfly network and a synthetic generated data set.As already explained in As a model for the prior distribution lgorithm  with fouIn order to see that the algorithm has converged and is working correctly, one can also compare the data (not shown) with the reconstructed signal response see d by lookThe need for efficient response representations in imaging led to the development of the models presented in this work, which were inspired by earlier research on butterfly matrices . The effTo improve the computational performance through GPU support and parallelization, more advanced machine learning platforms such as TensorFlow  or PyTor


This article was migrated. The article was marked as recommended.Videos are increasingly used in medical education. They are effective for teaching difficult-to-grasp concepts that rely heavily on visuospatial processing ability such as anatomy, surgical procedures, and physical exam maneuvers. Common pitfalls of existing videos include lackluster audiovisual quality, poor camera angles, absence of formal teaching as narration, or excessive length. This article serves to assist educators who wish to produce educational clinical encounter videos that maximize student learning. We detail 12 tips focused on improving the quality of clinical educational videos, mitigating cognitive load within a video, and understanding the technicalities of video production. These tips are based on review of existing literature on neurocognitive learning theories and the succeeding Cognitive Theory of Multimedia Learning (CTML), as well as our experience in producing educational videos. With advancements in technology, there is a growing number of videos designed to heavily supplement or completely replace traditional textbook- and lecture-based learning in educational curricula, such as in massive open online courses .www.khanacademy.org) focus on elucidating the pathophysiology of diseases, diverting students’ attention away from the importance of clinical encounters intrinsic load, the inherent difficulty of the material; (2)germane load, the processing power necessary to make sense of new information and integrate it into previous knowledge; and (3)extraneous load, the burden from unnecessary distractions in the video. Therefore, student learning can be maximized by managing these three appropriately  models how the human brain processes multimedia . CTML deriately .Further details on modifying cognitive load are discussed in tips 8 and 9.weeding  is a master document which divides the content from the script, and temporally organizes it into side-by-side columns: action , speech (audio component), and cinematography/post-production. This helps those involved in production to visualize what the video will look like at every second.off-loading andsynchronizing . It also include notes on post-production editing, which will be helpful in the editing phase.Shot list Storyboards are organized in a chronological order. However, to facilitate a practical filming day and decrease the time required to move equipment, re-sort the scenes into a shot list (Supplementary 2) which is based on room setup: camera lens and position, location, availability of actors, and equipment location. Then film based on the priority of the shots.Shot map A shot map is a bird’s-eye view of the room that shows the equipment and different camera angles (Supplementary 3) which is a useful reference for room set-up and filming. Assign letters to each camera angle and reference them in the shot list and storyboard.Doctors It is helpful to find clinicians with good articulation who are experts in the topic of the video. Viewers pick up tips and tricks through observations, such as ways of positioning patients that best elicit the tested response, style of holding equipment, and organization of reporting findings.Actors/Patients Choose a patient or actor who best demonstrates the desired physical exam traits. For example, if trying to demonstrate a pupillary light reflex, it is best if the patient has light-coloured irises so there is better contrast between the pupil and iris. To prevent finding incidental “abnormal” physical exam findings on the day of filming, screen the patient/actor beforehand.If the objective of the video is to present pathology, try to find a patient with the condition, as mimicking pathologies may look unnatural and depreciate the overall impression of the video. If a patient with the condition cannot be found, alternatives include using a pre-existing video demonstrating the pathology, or acting out the finding, stating it is an actor’s representation of the condition to the best of their ability.Evaluate your budget and access to video filming resources such as equipment and members with video-production skills. Many institutions have an IT or Media department that can provide equipment and technical support, as well as general guidance for creating digital educational content. Alternatives include purchasing  or rentiFilming site Pick a sound-proof location such as clinical examination rooms in hospitals or teaching units in University buildings . Must consider the crew’s comfort level, fatigue, hunger, and attitude throughout filming.•Camera person. Responsible for operating camera and mic and assure audiovisual quality. Responsible for creating a back-up of the video after filming. Realizing there is missing or improper footage after-the-fact can be devastating, as finding the time and resources to re-film can be a hurdle in production.•Continuity person. Records details about props, lighting, and actors’ movements to ensure consistency between different takes of one scene as well as in between different scenes. Maintaining continuity reduces the visual distraction for viewers and is a form ofweeding.Filming The general rule is to film more coverage than needed . If possible, use two cameras simultaneously, with different camera angles or positions. This saves time and ensures continuity. Ensure all your shots are in focus.Frame your shot Generally, aim for the smallest frame which will capture what is necessary for your scene. For example, if the clinical exam involves the upper body, it is not necessary for the legs to be in frame. Follow the rule of thirds to create an aesthetically pleasing frame, and leave enough room above the heads of the actors.Angles The 180-degree rule delineates that when filming two subjects and changing views, the camera angles should not exceed 180 degrees from each other to maintain a consistent point of view for viewers. The 30-degree-rule states that when changing angles the camera angles should be at minimum 30 degrees apart from each for a change in angle to be worthwhile.Panning When filming, anticipate the movements of participants/actors. For scenes where large movements are required, either be prepared to pan with the movements, or film with a wider lens or camera set-up further away for a wider frame.Cutting with purpose Cutting between scenes or angles can be used as a form ofsignalling. Cuts which are made at the maximal point of intensity of a scene, such as when the demonstrator reaches over to test the patient’s muscle, can highlight and draw attention to the importance of that particular movement.To organize your video clips, name them based on the pre-created shot list labels to maintain consistency and minimize confusion. When editing (see Supplementary 4 for softwares), avoid distracting texts or animations. Be consistent with colour schemes, font, and formatting of words. To avoid difficult to read text overlaying a background, use a stroke or shadow function . Ensure Chunking Chunk topics into separate videos to provide a natural break between concepts. Divide your video content into additional chunks separated by title screens  dampen distracting high frequency noises, which reduces cognitive load throughweeding. Use narrators and actors who have a voice that is pleasing and soothing for all listeners. A conversational and enthusiastic tone, rather than an over-rehearsed and robotic tone, can enhance learners’ engagement with the video , it may be appropriate to host your video privately for students of that locale. However, if significant resources are invested for high production and lasting educational value for as many students as possible, then consider public international host websites.Studies show that perceived benefits in learning are correlated with customizability: ease of use , and abiAdditional considerations include:•Cost of hosting•Hyperlinking possible to direct students to certain timestamps for ease of reference•Built-in download functionality•Password protection for sensitive content•Ability to control comments & likes/dislikes (helpful to prevent inappropriate anonymous commentary)•Monetization of your video via ads•Metadata and statistical trackingConsent forms Institutions often have pre-written media consent forms that you can rework. Consider your intended video hosting platform, as clinicians/actors/patients may consent to institution-wide sharing but not international distribution.Hosting Servers Clear any conflicts of interests or information-hosting guidelines as per your institution. Certain institutions do not allow the hosting of information in an out-of-country server and some have pre-existing agreements with certain companies. It is important to abide by hosting guidelines as infringement will result in removal of content.Audio Copyright With an abundance of music easily downloadable from the internet, it is possible to mistakenly use music that has been copyrighted. Avoid incidental copyright infringement and risking getting your video removed by using free creative commons sources, such as freemusicarchive.org.Long-Term Ownership Once published, a person or a group must take ownership and responsibility of the video for the future. On a public host server (such as YouTube), there may be issues that arise such as copyright infringement, other channels re-uploading your video without consent, or hyperlinks included in your video requiring updating in the future. Long-term faculty and IT departments are ideal for assuming long-term responsibility of these videos.To overcome common low response rates on feedback surveys, embed the video within a survey form so students do not have to click an extra link to provide feedback. Place the video between pre- and post-viewing questions (“How knowledgeable are you about this topic?”) to assess the subjective amount of learning the video provided. Additionally, word questions in a direct and active manner such as “Describe one thing that you would improve” as opposed to “Is there any improvement you would suggest, if so what?” Free comment feedback can provide valuable information on qualitative improvements to your video.Feedback responses are often polarized to extreme likes and dislikes. To mitigate this selection bias, metadata and video statistics can be used to analyze all views and viewers of a video. Many hosting sites provide statistics to the content uploader such as number of total persons who viewed the video, average time of a viewing, demographic of the audience , and if viewing patterns change temporally. This is an often overlooked tool to assess effectiveness of the video but can supplement standard feedback survey responses.As videos are incorporated into educational curricula, a greater emphasis will be placed on quality and ability to efficiently and effectively teach students in a flipped-classroom setting. The 12 tips we provide are designed to guide medical educational video production, with focus on integrating educational theory (CTML), the technicalities of video production, and illustrating clinical encounters.•Perform a needs assessment prior to creating a video to gauge if your video is an improvement on the current existing medical education videos.•Incorporation of theories of learning, such as the Cognitive Theory of Multimedia Learning, improve the efficacy of student learning from videos.•Pre-production documents such as the script, storyboard, and shot list are cinematography tools which can help organize your content and greatly enhance the efficiency of filming day.•Edit your video adhering to theories of learning to maximize efficacy of learning and minimize the dead time.•Ensure there is long-term responsibility for the video as there may arise copyright or other issues that may require attention in the future.Shi, Ge is part of the MD graduating class of 2020 at the University of British Columbia at the Vancouver Fraser Medical Program.Lee, Siyoung is part of the MD graduating class of 2020 at the University of British Columbia at the Vancouver Fraser Medical Program.Yuen, Yue Ting is part of the MD graduating class of 2020 at the University of British Columbia at the Vancouver Fraser Medical Program.Liu, John is part of the MD graduating class of 2020 at the University of British Columbia at the Vancouver Fraser Medical Program.Rothman, Zachary is a Senior Producer and Creative Lead at MedIT at University of British Columbia’s Faculty of Medicine.Gillis, Stephen is an Associate Producer at MedIT at University of British Columbia’s Faculty of Medicine.Milaire, Paul is a Technical Producer at MedIT at University of British Columbia’s Faculty of Medicine.Dr. Henri-Bhargava, Alexandre, MD, CM, MScCH, FRCPC is a Clinical Associate Professor of Medicine (Neurology) at the University of British Columbia, based at UBC’s Island Medical Program (IMP) in Victoria, Canada. He is the site-specific discipline leader for neurology at the IMP. He is the Medical Director of the Neil and Susan Manning Cognitive Health Initiative. This review has been migrated. The reviewer awarded 4 stars out of 5 This is a useful introduction and guide to creating clinical encounter medical education videos. The paper focuses on the basics. Some more advanced users may find this too elementary, but many of these basics are the things that are frequently overlooked, by newbies as well as those who have been creating videos for some time. The authors have also found a good balance between theoretical concepts and practical experience for their source of information, and the support of the supplementary files is also useful.Although some greater emphasis could be placed on the managerial and evaluation aspects of the processing, one must also see the creation of such videos within the context of education institutions' current practice of rarely demanding that lectures notes and presentation slides undergo formal evaluation and assessment. The authors should add a note, however, indicating that some institutions may have educational protocols regarding teaching materials, especially their relationship to the curriculum, language suitability for their students, etc., and so video creators should have the required permissions and approval before and during the creation period. This is primarily because post-production editing may not always be feasible on some of these issues.It would also have been useful if the authors would encourage the creation of sub-titles, whether embedded or as a separate file, as this will add great value to any instructional video. If the video creators are intending to have sub-titles, however, they should take this aspect into account from the outset when framing their subjects.Overall, however, a useful guide.Reviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 4 stars out of 5 Thank you for the invitation to review this interesting paper. Videos are becoming an increasingly important part of education and are increasingly preferred by the current generation of students. A number of learning platforms provide access to good quality videos. My experience with creating videos has been limited to platforms which synchronize video and audio recording using a webcam or the computer camera and microphone with screen capture functionality. The twelve tips for creating videos have been well described. The authors have tried to relate their description with the theories of cognition. They have addressed a number of areas many of which may be unfamiliar to many faculty members and may require more detailed description. I am happy to note that many of the authors and medical students. The supplementary files are interesting. The tables aree also useful. I am of the opinion that commercial software which combines inputs from a camera, microphone and screen capture will allow an affordable option to create good quality videos especially for institutions which lack access to a good audiovisual department. All medical educators will find this article to be of interest.Reviewer Expertise:NANo decision status is available This review has been migrated. The reviewer awarded 3 stars out of 5 I had the opportunity to review this paper titled, "12 Tips for Creating High Impact Clinical Encounter Videos - with Technical Pointers". The authors have provided important tips on video production and post-production process. Many of the pitfalls have been identified, however, I would like to point out a few more important issues that should be discussed in the paper: 1) The support from the Institution; 2) The standardization of the Expert physician to the practical techniques as according to the Learning Objectives (LO) of the curriculum; 3) Standardization of the actor/Simulated Patient to the presenting pathological Signs and Symptoms of the disease; 4) a formative assessment to evaluate the reliability and validity of the video content learned to the LO specifications. It is a valuable paper but the needs for standardization, reliability, and validity must be considered in the video pedagogy.Reviewer Expertise:NANo decision status is available


Central to plant physiology, Mg2+ powers photosynthesis as an integral component of chlorophyll, bolstering growth and biomass accumulation. Beyond basic growth, it critically affects crop quality factors, from chlorophyll synthesis to taste, texture, and shelf life. However, Mg2 + deficiency can cripple yields and impede plant development. Magnesium Transporters (MGTs) orchestrate Mg2+ dynamics, with notable variations observed in horticultural species such as Cucumis sativus, Citrullus lanatus, and Citrus sinensis. Furthermore, Mg2+ is key in fortifying plants against environmental stressors and diseases by reinforcing cell walls and spurring the synthesis of defense substances. A burgeoning area of research is the application of magnesium oxide nanoparticles (MgO-NPs), which, owing to their nanoscale size and high reactivity, optimize nutrient uptake, and enhance plant growth and stress resilience. Concurrently, modern breeding techniques provide insights into Mg2+ dynamics to develop crops with improved Mg2+ efficiency and resilience to deficiency. Effective Mg2+ management through soil tests, balanced fertilization, and pH adjustments holds promise for maximizing crop health, productivity, and sustainability. This review unravels the nuanced intricacies of Mg2+ in plant physiology and genetics, and its interplay with external factors, serving as a cornerstone for those keen on harnessing its potential for horticultural excellence.Magnesium (Mg Its importance stretches across a broad spectrum of plant physiology, governing photosynthesis, nutrient metabolism, cell membrane stability, enzyme activation, and, notably, its resilience against various environmental stresses  and nicotinamide adenine dinucleotide phosphate (NADPH) , which catalyzes the fixation of carbon dioxide (CO2) and the subsequent formation of carbohydrates  . This el (NADPH) . Furtherhydrates . As an eolecules . Conclusynthesis . Through2+ serves as a multifunctional catalyst in plant physiology, playing a critical role in various aspects of enzyme activation and metabolism  to pyruvate during glycolysis (2+ affects the activity of enzymes in the tricarboxylic acid (TCA) cycle, such as isocitrate dehydrogenase and α-ketoglutarate dehydrogenase (2+ is indispensable for protein synthesis in plants as it contributes to the structure and function of ribosomes (2+ adds stability and aids in binding messenger RNA (mRNA) and transfer RNA (tRNA), ensuring the accurate translation of genetic information into functional proteins . Acting as a cofactor for ATP synthase, ATP synthesis is observed during oxidative phosphorylation in mitochondria  and transfer RNA (tRNA), thereby ensuring accurate translation of genetic information into proteins . Its involvement in pre-mRNA splicing is vital for the formation of mature and functional mRNA molecules , iron (Fe2+), and zinc (Zn2+). The interactions of Mg2+ with other nutrients are summarized in 2+ can lead to inadequate uptake and utilization of Fe2+ and Zn2+, resulting in micronutrient imbalances that can hinder plant growth and development , calcium (Ca2+), and other cations, across membranes , or via membrane surface charges and phospholipids , prolonging shelf life up to 24 days, offering a sustainable, biodegradable alternative to traditional synthetic packaging materials like low density polyethylene and polypropylene. A study by 2+ has consistently emerged as a pivotal element in determining nutrient content across a diverse range of crops, signifying its vital role in agricultural practices. Citrus sinensis seedlings, where it was discovered that Mg2+ application considerably augmented the nutrient content of the leaf blades. Specifically, while Mg2 + deficiency resulted in a decrease in the concentrations of N, P, and Mg2+, it influenced the levels of other nutrients such as K, Ca, Mn, Fe, Cu, and Zn in different ways depending on the leaf’s position and age. This emphasizes the complex yet crucial interplay between Mg2+ and other nutrients in plant growth. Highlighting the broad influence of Mg2+, 2+ and Mg2+ significantly boosted the plant’s bioactive compounds, notably acemannan and total phenolic content in Aloe vera. This not only underscores the role of Mg2+ in nutrient enhancement but also hints at its potential influence on the therapeutic properties of medicinal plants. 2+ treatments distinctly impacted soluble protein, sugar, and ascorbic acid contents. This further supports the idea that the role of Mg2+ in nutrient enhancement is not limited to fruits or medicinal plants but extends across the vegetable spectrum. In a recent study on tomatoes, 2+. A dose of 12 kg·ha−1 Mg2+ yielded not only the most abundant tomatoes but also tomatoes of superior nutritional quality, enriched with vitamin C, β-carotene, and protein. Collectively, these studies underscore Mg2+ pivotal role in enriching the nutrient profile of various crops, ranging from fruits to vegetables and medicinal plants, highlighting its significant impact on agriculture.The effects of Mg3.22+ is a fundamental macronutrient pivotal to various physiological and metabolic processes in horticultural crops, profoundly influencing the yield and quality of fruits, vegetables, and root crops. For instance, 2+ supplementation in ‘Red Fuji’ apple trees bolstered nitrogen utilization, enhanced photosynthesis, and encouraged anthocyanin biosynthesis, thereby elevating fruit size, weight, and yield. 2+ application. Specifically, 12 kg·ha−1 of Mg2+ notably improved photosynthetic efficiency, carbohydrate translocation, and overall yield, resulting in heavier, more nutritious fruits. Similarly, 3) amplified crop yield by 20% and enhanced berry biochemical properties, suggesting its role in strengthening plant defense mechanisms and optimizing grape growth and yield. Root crops such as potatoes also benefit from Mg2+ supplementation. A two-season study by 4 combined with calcium chloride foliar application optimized growth characteristics, leading to significant improvements in tuber yield, dry matter, and starch content. The combined treatment resulted in yield spikes of approximately 42%. Leafy vegetables such as spinach and lettuce are also responsive to Mg2+. 2+ deficiency in spinach reduces CO2 assimilation. 2+ fertilizers, predominantly MgO, outperform their fast-release counterparts in boosting soybean and pomelo yields in acidic soils. In studies on peppers and cucumbers, researchers observed that while Mg2+ supplementation significantly improved yields, its influence on nutrient composition and interactions with factors like irrigation and nitrogen was equally critical. A study by 2+ and other nutrients in horticultural crops. Findings by 2+, 2+ in 73% of them, prompting the recommendation to curtail NPK usage and elevate Mg2+ supplementation to further sustainable agriculture. The interrelationship between Mg2+ and other nutrients underscores the importance of a holistic nutrient management strategy.Mg3.32+ homeostasis in plants, including Mg2+ deficiency and toxicity, high temperature, drought, high light irradiance, low or high pH, and antagonistic ions  displayed increased resilience to elevated irradiance and air temperature commonly associated with heatwaves. The trees maintained optimal photosynthetic and transpiration rates and Mg2+ enhanced the activity of the antioxidant enzyme system, thereby decreasing oxidative stress. Similarly, 2+ nutrition in mitigating the adverse effects of heat stress in coffee seedlings. Adequate Mg2+ nutrition is essential for maintaining lower hydrogen peroxide production and preventing lipid peroxidation and protein degradation under heat stress, emphasizing its indispensable role in preserving cellular integrity and enhancing antioxidant responses during temperature extremes.Many environmental and intracellular factors affect Mgtic ions . Howevertoxicity . Underst climate . Droughtt stress . In a stNicotiana tabacum L.) demonstrated that under cold stress conditions, Mg2+ supplementation led to notable improvements in plant morphology, nutrient uptake, and photosynthetic attributes. Notably, tobacco plants treated with Mg2+ under cold stress exhibited significant increases in biomass, nutrient uptake, photosynthetic activity, and chlorophyll content. Furthermore, Mg2+ application positively influenced tobacco quality, including increased starch and sucrose content. These findings highlight that Mg2+ application can mitigate the adverse effects of cold stress and promote better growth and quality of tobacco plants. Mg2+ supplementation has been identified as a vital factor for improving the resilience of pepper plants to salinity stress. 2+ doses on pepper plants under salt-induced stress and discovered that higher Mg2+ doses led to increased plant growth, as demonstrated by greater total plant weights, especially in the exogenous application of Mg2+ @98.56 ppm + salt treatments. Additionally, elevated Mg2+ levels resulted in augmented chlorophyll content and heightened antioxidant enzyme activities, which play a role in combating oxidative stress. Simultaneously, there was a reduction in malondialdehyde (MDA) levels, an indicator of cellular damage. These findings suggest that increasing Mg2+ doses can mitigate the detrimental effects of salinity stress on pepper plants, thereby enhancing their growth and physiological health.Cold stress, particularly in temperate regions, can severely affect the yield of horticultural crops. A study by 2 the potential role in alleviating these toxic effects in horticultural crops. 2+ on field-grown Chinese cabbage and discovered that it significantly enhanced the cabbage’s nutritional profile, with noticeable increases in vitamin C and water-soluble protein content. Most notably, Mg2+ reduced the uptake and accumulation of heavy metals, such as cadmium and nickel, in plant tissues, thereby minimizing their adverse health effects. Cr uptake increased, but the health risks posed by Cr were substantially lower than those posed by Cd and Ni. Therefore, soil-applied Mg2+, particularly in the range of 22.5–45 kg ha−1, can notably enhance the nutritional qualities of Chinese cabbage, while alleviating the potential health risks from heavy metal consumption. 2+ treatment also transformed the soil Cd into less bioavailable forms, reducing the exchangeable Cd content and increasing other bound Cd forms. This means that magnesium hydroxide, particularly in its nanometer form, can act as an effective agent in reducing harmful Cd concentrations in crops grown in contaminated soils, offering a potential avenue for mitigating heavy metal stress in agricultural settings. In a separate investigation by 2+ supplementation could reduce the uptake and accumulation of these heavy metals, thus protecting plants from oxidative damage and preserving their growth and productivity. These findings underscore the crucial role of Mg2+ in bolstering the resilience of horticultural crops to various abiotic stresses and maintaining their productivity and quality. Nonetheless, further research is necessary to elucidate the precise mechanisms of Mg2+-mediated stress tolerance and to develop tailored Mg2+-based strategies for mitigating different types of abiotic stress in horticulture. In order to provide a comprehensive overview of the effects of magnesium supplementation on the tolerance of crops to environmental stresses, we have summarized recent research findings in The growing concern over heavy metal toxicity in soils has sparked research into Mg3.42+ on plant physiology is its role in photosynthesis. Their integral position in chlorophyll molecules resonates with the vitality of plants and their combined resistance to biotic threats , which is a cornerstone of plant defense. In its nanoparticle form, Mg2+ amplifies the function of phenylalanine ammonia-lyase (PAL), a significant driver of SA production , soil organic matter, soil texture and structure, moisture and drainage, presence of other nutrients, and ambient temperature (2+ in the soil is significantly influenced by the pH level. When the soil is acidic (pH < 6.0), the solubility of Mg2+ decreases because it binds more readily to the soil particles, leading to less accessibility for plant uptake. Conversely, in alkaline soils (pH > 7.0), Mg2+ can become limited owing to the excessive precipitation of Ca and Mg carbonates  proteins, whose functionalities are garnering increasing research attention. It meticulously orchestrates the absorption, transportation, and storage of Mg2+ within plant cells, ensuring optimal growth and stress responses  for its uptake and transportation across plant tissues. Recent research on MGTs in horticultural crops is summarized in + uptake . The mor+ uptake . Howevernutrient . The tead uptake . Similar species . The subortation . When fa prowess . Moreovedynamics . In conc5.32+ is transported via the xylem from the roots to the shoots and is particularly mobile within the phloem. This mobility facilitates the redistribution from mature to younger tissues, ensuring that newer tissues receive adequate Mg2+ levels , display unique patterns. In Dimocarpus longan, MGT genes like DlMGT4.2 are expressed across various organs, suggesting a universal role in Mg2+ management  have indicated distinct transport capacities among different transporters  family stands out as a linchpin in maintaining Mg2+ homeostasis, thereby underpinning the plant’s growth and developmental trajectories  in chlorophyll biosynthesis. Disruptions in this process, as observed in the strawberry species Fragaria pentaphylla, manifest as phenotypic changes, such as yellow-green leaves, underlining the importance of Mg2+ in plant health  sheds light on four key MGT genes: CsMGT1, CsMGT2, CsMGT2.1, and CsMGT3. These genes were expressed across roots, stems, leaves, and flowers, with varying responses to Mg2+ levels. Intriguingly, while CsMGT1 and CsMGT2 have evident Mg2+ transport functionality . SlMGT1-1, for instance, was more dynamically expressed in stems, leaves, and flowers, while genes like SlMGT3-1 and SlMGT5-1 showed minuscule transcript levels in stems and flowers. Such variations hint at the unique roles that each transporter plays in plant growth and physiological metabolism. Viticulture is another arena in which Mg2+ plays a vital role. Recent observations have highlighted increasing Mg2+ deficiencies in vineyards in southern China, which have adverse consequences for grape growth and fruit quality , the VvMGT9 gene is notably upregulated under waterlogging, suggesting a key role in waterlogging resistance , where two NIPA genes were found to be responsive to drought stress (Cucumis sativus). Here, NIPA and MSR2 genes exhibited upregulated expression when exposed to NaCl stress  family under Mg-deficient conditions. Notably, the ACS11 gene becomes active in both roots and leaves, whereas ACS2, ACS7, and ACS8 are primarily expressed in leaves, underscoring the profound role of ethylene in the Mg2+ starvation response  in banana seedlings, have revealed an essential role in root hair development under MD conditions. MYB108’s function appears multifaceted, as it is also implicated in processes such as wound healing, and potentially in the regulation of genes linked to chlorophyll catabolism , liming with materials such as dolomitic lime can help increase pH and Mg2+ availability. In alkaline soils, pH must be reduced using acidifiers to increase Mg2+ availability. Furthermore, chelated Mg can be used effectively in alkaline soils, as it is more soluble and available to plants than inorganic sources at higher pH levels  or magnesium oxide, into a balanced fertilization program can help provide Mg2+ to plants. While Epsom salt is highly soluble and provides an immediate source of Mg2+, magnesium oxide is a slow-release fertilizer that provides Mg2+ over an extended period  have garnered significant attention. Their biodegradability and non-toxicity coupled with their diverse applications make them indispensable. At the crossroads of food security and sustainable agriculture, nanotechnology has become an innovative solution. The application of Mgallenges . Althoug82+ in horticulture, certain knowledge gaps and areas require further exploration. Addressing these gaps could guide future research and enhance our understanding of the role of Mg2+ in crop production. Some potential research directions and needs include the following.Although significant progress has been made in understanding the role of Mg2+-responsive genes and transcription factors in horticultural plants. Better knowledge of the genetic regulation of Mg2+ uptake, transport, and utilization can pave the way for targeted breeding programs and genetic engineering strategies. Employing omics approaches such as metabolomics and proteomics to decipher the metabolic and biochemical pathways influenced by Mg2+ deficiency or excess (2+ stress. Extensive research into the molecular mechanisms of Mg2+ transport in plants, from root uptake to distribution in various tissues and organs, is required to understand the role of transporters, channels, and regulatory factors involved in Mg2+ uptake, long-distance transport, and compartmentalization, which will further enhance our understanding of Mg2+ homeostasis in plants. Investigating the interactions between Mg2+ and other vital nutrients, such as calcium, potassium, and phosphorus, is essential to comprehend their synergistic and antagonistic effects on plant growth and development. Developing precise nutrient management strategies that affect spatial and temporal variations in Mg2+ availability and crop nutrient requirements (2+ application to ensure that a precise nutrient supply meets crop needs. Probing the genetic regulation of Mg2+ homeostasis in horticultural crops is critical for the evolution of plant varieties with improved Mg2+ utilization (2+ recognition, transport, and distribution. Studying Mg2+ dynamics in different soil types, including their interactions with soil pH, organic matter, and nutrient availability, is crucial for effective nutrient management (2+ availability, mobility, and transformation in diverse soil environments under various management practices. Designing sustainable Mg2+ management strategies that balance nutrient availability with minimal environmental impacts is crucial (2+-efficient plant genotypes, and optimizing fertilization techniques to enhance Mg2+ utilization and minimize nutrient losses. Examining the role of rhizosphere microbiome in regulating Mg2+ availability and uptake by plants is a promising research direction (2+ cycle can provide insights into potential microbial strategies to improve Mg2+ uptake and nutrient acquisition. Furthermore, studies focusing on Mg2+ management under specific growing conditions, such as hydroponics, greenhouse cultivation, or controlled environments, would help optimize nutrient supply and crop performance. Integrating Mg2+ management practices with other sustainable cropping strategies, such as conservation agriculture, organic farming, and cover cropping, could provide holistic solutions (2+ availability, soil health, and crop performance should be evaluated to develop comprehensive approaches for improving nutrient use efficiency and sustainability. By addressing these research needs, we aim to refine our understanding of the role of Mg2+ in horticultural crops, improve Mg2+ management practices, develop nutrient-efficient crop varieties, and promote sustainable and resilient agriculture. This could fuel innovation in crop management, breeding programs, and nutrient optimization strategies, ultimately enhancing the efficiency, sustainability, and nutritional value of horticultural production.Comprehensive genomic and transcriptomic studies to identify Mgr excess . By moniirements . Remote lization . Furthernagement . Further crucial . Future irection . Understolutions . The com92+ in the production and quality of horticultural crops. As a vital macronutrient, it is implicated in several physiological functions such as chlorophyll synthesis, enzyme activation, nutrient uptake, protein synthesis, and gene expression. Ensuring appropriate levels of Mg2+ contributes to higher quality plants by enhancing chlorophyll production, leading to vibrant leaf coloration and more efficient photosynthesis. Beyond mere aesthetics, Mg2+ also affects the nutrient content, flavor, texture, and shelf life of horticultural produce, increasing their consumer appeal. Conversely, Mg2+ deficiency can restrict plant growth, impair reproductive development, and lead to yield losses, underlining the importance of nutrients in crop yield potential. Another crucial aspect of Mg2+ is its role in bolstering stress tolerance, disease resistance, and pest defence mechanisms in plants. These factors can significantly affect the resilience and overall health of horticultural crops, thereby affecting their productivity and profitability. Interactions among Mg2+, plants, and soil microbiomes also require mention. The role of MGTs from various cellular levels to different organ levels and compartmentalization, and their role in Mg2+ homeostasis are also highlighted. Mg2+ availability can influence the rhizosphere microbiome composition, which in turn can affect plant health and nutrient acquisition. Microbial activities in the rhizosphere can also affect Mg2+ availability and form, which can affect plant uptake and utilization. Efficient Mg2+ management strategies, including soil testing, balanced fertilization, and precise nutrient management, are integral to ensuring optimal Mg2+ availability and utilization in horticultural cropping systems. Emphasizing the importance of Mg2+ and implementing effective management practices can enhance crop quality, yield, stress tolerance, and disease resistance. Ultimately, this can optimize horticultural productivity and profitability, underscoring the need for continued research and innovation in Mg2+ management in horticulture.In summary, this study emphasized the significant role of MgNA: Conceptualization, Formal Analysis, Investigation, Methodology, Software, Visualization, Writing – original draft, Writing – review & editing. BZ: Funding acquisition, Supervision, Writing – review & editing. BB: Investigation, Writing – review & editing. SC: Investigation, Visualization, Writing – review & editing. MR: Investigation, Writing – review & editing. JL: Conceptualization, Writing – review & editing. YL: Project administration, Writing – review & editing. FH: Methodology, Writing – review & editing. ZC: Formal Analysis, Writing – review & editing. PT: Funding acquisition, Project administration, Resources, Supervision, Writing – review & editing.


O-linked arabinogalactan (AG) glycans. Additional posttranslational modifications on FLAs include N-linked glycans in the FAS1 domains, a cleaved signal peptide at the N terminus, and often a glycosylphosphatidylinositol (GPI) anchor signal sequence at the C terminus. The roles of glycosylation, the GPI anchor, and FAS1 domain functions in the polysaccharide-rich extracellular matrix of plants remain unclear, as do the relationships between them. In this study, we examined sequence–structure–function relationships of Arabidopsis  FLA11, demonstrated to have roles in secondary cell wall (SCW) development, by introducing domain mutations and functional specialization through domain swaps with FLA3 and FLA12. We identified FAS1 domains as essential for FLA function, differentiating FLA11/FLA12, with roles in SCW development, from FLA3, specific to flowers and involved in pollen development. The GPI anchor and AG glycosylation co-regulate the cell surface location and release of FLAs into cell walls. The AG glycomotif sequence closest to the GPI anchor (AG2) is a major feature differentiating FLA11 from FLA12. The results of our study show that the multidomain structure of different FLAs influences their subcellular location and biological functions during plant development.The role of glycoproteins as key cell surface molecules during development and stress is well established; yet, the relationship between their structural features and functional mechanisms is poorly defined. FASCICLIN-LIKE ARABINOGALACTAN PROTEINs (FLAs), which impact plant growth and development, are an excellent example of a glycoprotein family with a complex multidomain structure. FLAs combine globular fasciclin-like (FAS1) domains with regions that are intrinsically disordered and contain glycomotifs for directing the addition of  Differences in subcellular location and biological functions of fasciclin-like arabinogalactan proteins rely on variations in their complex multidomain glycoprotein structure. The properties of the polysaccharide-rich extracellular matrix  define cellular morphology, tissue, and plant architecture and are essential for growth. The composition of walls varies depending on the plant species, cell type, tissue, developmental stage, and history of responses to abiotic and biotic stresses, each factor with the potential to modify the type and distribution of constituent polysaccharides within individual cells. Crucial to the wall's role as a cell surface sensor are proteins and glycoproteins that transduce and respond to external and internal cues .O-linked AG glycans  that include proline-rich regions with glycomotifs that direct the addition of  glycans , 2017b.  glycans . AGPs ha glycans . Despite glycans . Recentl glycans . The FAS glycans .β-induced protein IG-H3 (βIG-H3), and stabilin-1 contain tandem repeat FAS1 domains are the most extensively studied mammalian FAS1 proteins . The contribution of different FLA domains to biological function has only been investigated for FLA4, involved in root salt tolerance. Domain deletion studies showed that only 1 of the 2 FAS1 domains in FLA4, the C-terminal (Type A) FAS1, was necessary for its biological functions in response to salt stress  of action at a molecular level . Our preN-glycosylation motifs, 2 Pro-rich regions containing AG glycan motifs that direct O-glycosylation, and a GPI anchor , the C-terminal AG region (mutAG2), or both regions (mutAG1 + 2) and variants with the GPI anchor signal sequence removed (mutGPI). In addition, mutations within the FAS1 domain included mutation of 2 predicted surface regions (mutSurfA and mutSurfB), mutation of 3 predicted N-glycosylation motifs within the FAS1 domain by replacing NXS/T with AXA  and replacing NXS/T with QXS/T  (A suite of mutated variants of the OE-FLA11 constructs were generated . These ing site) ; Fig. 1AFLA11 transcript levels in stems were analyzed by RT-qPCR and showed that all transgenic plants had 3- to 9-fold higher expression of FLA11 than WT  to a smaller size, indicating that FLA11 is likely N-glycosylated  resulted in plants with reduced stem length and weaker stems compared to WT  and IFs compared to WT and OE-FLA11. Unlike OE-FLA11, the introduction of proFLA11::HIS-YFP-FLA12 into WT (pFLA11::FLA12) did not result in plant growth phenotypes  with the FAS1 domain of FLA12  and FLA3  see . Protein amounts . SmearedA11-FAS3 . Phenotym length ; Table 2m length , reducedm length , increases to WT ; Table 2FLA11 transcripts by RT-qPCR showed that pFLA11::FLA11-FLA12GPI, pFLA11::FLA11-FLA12linker + GPI, pFLA11::FLA11-FLA12AG2 + linker + GPI, and pFLA11::FLA11-FLA3AG + GPI plants all had 3- to 6-fold increased FLA11 transcript levels in stems compared to WT  were experimentally investigated by swapping FLA11 AG2 motif, GPI anchor signal sequence, and disordered linker region with the equivalent region from either FLA12 or FLA3 see . Analysied to WT . Proteined to WT . As expe11::FLA3 . Consistan FLA11 , minimalkDa band .pFLA11::FLA11-FLA12GPI, pFLA11::FLA11-FLA12linker + GPI, and pFLA11::FLA11-FLA3AG + GPI plants showed reduced stem length  (Col-0), fla11 mutant (SALK_046976), and OE-FLA11/FLA12/FLA3 domain mutation/deletion/swap variants plants were grown under long day (16 h light/8 h dark) conditions at 22/18 °C in controlled environment rooms.Arabidopsis . At least 3 plants from 3 independent transgenic lines were imaged with 1 representative image shown.Sd.A 2-mm region at the base of stems at growth 6.9 were chemically fixed, dehydrated, and embedded in LR white according to the method outlined in Sd. Student’s t-test was used for significance analysis with P < 0.05.To measure stem fiber length, Arabidopsis base stems (2 cm length of stem from the base) were incubated with glacial acetic acid and hydrogen peroxide (v/v 1:1) for 12 h at 80 °C . Fibers Sd. Student’s t-test was used for significance analysis with P < 0.05.For the measurement of IF wall thickness, TEM images were used. Primary IF cell layers closest to the pith were used for quantification with 2 biological samples from 2 independent transformed lines. At least 10 cells were used for quantification. Data represent mean ± Sd. Student’s t-test was used for significance analysis with P < 0.05.Arabidopsis stems were harvested and alcohol-insoluble residue (AIR) was prepared . The UpdFLA11 using a relative quantitative method . Complementary DNA was synthesized using SuperScript IV Reverse Transcriptase (Invitrogen). RT-qPCR was conducted to measure the transcript levels of e method , with 2 n-Dodecyl-β-D-maltoside (DDM). Denatured proteins were used for SDS-PAGE and protein blots analysis and detected with anti-GFP . Two biological replicates from 2 independent transformed lines were performed.Arabidopsis seedlings (10 d old) were harvested for total protein preparation and GFP-trap enrichment. Total proteins were extracted using extraction buffer containing 100 mM Tris-HCl at pH 8.8, 150 mM NaCl, 1 mM EDTA, 10% (v/v) glycerol, and 1 × cOmplete protease inhibitor cocktail . Total proteins were enriched using a GFP-trap  according to the manufacturer's instructions at 4 °C for 1 h with 1% (w/v) FLA11 (AT5G03170), FLA12 (AT5G60490), FLA3 (AT2G24450), and ACT2 (AT3G18780).Sequence data from this article can be found in the GenBank/EMBL data libraries under accession numbers: kiad097_Supplementary_DataClick here for additional data file.