This research investigated the potential improvement of IVR on procedural practical knowledge in maritime safety education in a lifeboat case study. Participants were divided into three groups: a VR, control and VR+ group. A practical test exam with a real lifeboat was conducted to evaluate the differences in number of students passed/failed and overall performances in the execution of lifeboat launching procedures between groups. There was no evidence that the VR students had a higher success rate than students in the control group in correctly and safely performing a lifeboat drill. However, VR students’ overall performances on procedural correctness were significantly better than those of the control group, despite that the VR students never practiced with a physical lifeboat. Given the importance of safety in the maritime industry, it is worthwhile to further investigate to what extent IVR can provide a solution to the current limitations in maritime safety education.

Human-centric uncertainty remains one of the most persistent yet least quantified sources of risk in aviation maintenance. Although established safety frameworks such as SMS (safety management system), STAMP (Systems-Theoretic Accident Model and Processes), and FRAM (Functional Resonance Analysis Method) have advanced systemic oversight, they fall short in capturing the dynamic, context-dependent variability of human performance in real time. This study introduces the uncertainty quantification in aircraft maintenance (UQAM) framework – a novel, predictive safety tool designed to measure and manage operational uncertainty at the task level. The integrated uncertainty equation (IUE) is central to the model, a mathematical formulation that synthesises eight empirically derived uncertainty factors into a single, actionable score. Using a mixed-methods design, the research draws on thematic analysis of 49 semi-structured interviews with licensed maintenance engineers, followed by a 12-month field validation across four distinct maintenance tasks. Results demonstrate that the IUE effectively distinguishes between low, moderate and high-risk scenarios while remaining sensitive to procedural anomalies, diagnostic ambiguity and environmental complexity. Heatmap visualisations further enable supervisory teams to identify dominant uncertainty drivers and implement targeted interventions. UQAM enhances predictive governance, supports real-time decision-making and advances the evolution of next-generation safety systems in high-reliability aviation environments by embedding quantitative uncertainty metrics into existing safety architectures.

G protein-coupled receptors (GPCRs) are involved in many physiological and pathophysiological processes. Conventional pharmacological models categorize the typology of pharmacologic ligands as agonists or antagonists. Biased agonism is a relatively newer pharmacodynamic characteristic that has potential to optimize therapeutic efficacy while minimizing adverse effects in psychiatric and neurological treatments. We conducted a narrative literature review of articles obtained from PubMed, Embase, and MEDLINE from inception to April 2025, focusing on pharmacologic antagonism (i.e., competitive, noncompetitive, uncompetitive) and agonism (i.e., full, partial, inverse, superagonism, biased). Primary and secondary articles defining these concepts were included, provided they addressed pharmacologic (rather than chemical) antagonism and agonism. Distinct mechanisms of antagonism and agonism were identified, each contributing nuanced receptor modulation beyond the conventional models. Notably, biased agonism facilitates targeted intracellular signaling (e.g., G protein- versus β-arrestin–mediated). Use cases demonstrate relatively greater efficacy (e.g., incretin receptor agonist, tirzepatide) and improved safety (e.g., serotonergic psychedelics, opioids). Biased agonism provides a potential avenue for future drug development, with emerging preclinical evidence suggesting potential to differentially activate intracellular pathways and thereby improve efficacy and safety profiles of psychopharmacologic agents—pending clinical validation. Future research vistas should aim to rigorously assess the long-term outcomes of biased agonism, explicitly addressing individual variability in receptor signaling and therapeutic response.

Iron deficiency has been associated with heart failure severity and mortality in children and adults. Intravenous iron therapy has been associated with improved outcomes for adults with heart failure. However, little is known about its impact and safety in children. We performed a single-centre review of all intravenous iron sucrose infusions prescribed to hospitalised patients ≤ 21 years of age with a primary cardiac diagnosis from 2020 to 2022. Ninety-one children (median age 6 years, weight 18 kg) received 339 iron sucrose infusions with a median dose of 6.5 mg/kg [5.1 mg/kg, 7.0 mg/kg]. At initial infusion, the majority (n = 63, 69%) had CHD, 70 patients (77%) were being managed by the advanced cardiac therapy team for heart failure, 13 (14%) were listed for heart transplant, 32 (35%) were on at least one vasoactive infusion, and 5 (6%) were supported with a ventricular assist device. Twenty infusions (6%) were associated with 27 possible infusion-related adverse events in 15 patients. There were no episodes of anaphylaxis or life-threatening adverse events. The most common adverse events were hypotension (n = 12), fever (n = 5), tachycardia (n = 3), and nausea/vomiting (n = 3). Eight of 20 infusion-related adverse events required intervention, and two infusions were associated with escalation in a patient’s level of care. Following intravenous iron repletion, patients’ serum iron, serum ferritin, transferrin saturation, and haemoglobin increased (p < 0.05 for all). In children hospitalised with cardiac disease, intravenous iron sucrose repletion is safe and may improve haemoglobin and iron parameters, including transferrin saturation and ferritin levels.

Technological developments and affordable price structures have increased the usage of unmanned aerial vehicles (UAVs) across almost all sectors, hence increasing demand. Since UAVs can fly and perform various tasks without requiring a human operator, the most dangerous and time-consuming tasks previously performed by humans in many sectors are now accomplished by using UAVs. The increased use of UAVs has also introduced critical safety and security risks, including airspace congestion, collisions and malicious use, and therefore, identifying and assessing the risks associated with UAVs and finding ways to mitigate them is of great importance. This qualitative study investigates the safety and security risks posed by the increased use of UAVs and discusses ways to mitigate these risks. Semi-structured interviews with aviation professionals, including pilots, air traffic controllers and academicians, were conducted, and the collected data were analysed by using MAXQDA 24 qualitative analysis software. The results indicate that 86% of participants emphasised air traffic density as a major safety concern, while 71% underlined the need for dedicated air corridors and robust legal frameworks to reduce collision risks. These insights suggest that the safe integration of UAVs into current aviation systems demands a multifaceted strategy involving regulatory interventions, such as clearly defined UAV flight zones and essential technological enhancements. Overall, the study underscores the urgent need for coordinated efforts–legal, technological, and inter-institutional–to ensure the secure incorporation of UAVs into national airspace.

Over the past two decades, digital mental health interventions (DMHIs) have seen a surge in studies with people experiencing mental ill-health, whether this be via web-based platforms, smartphone applications, text messages or other digital devices. Although DMHIs already demonstrate evidence of their acceptability and some of their effectiveness among different populations, the information about their safety is less clear. This Editorial reflects on a Delphi study by Taher and colleagues that explored the regulation of DMHIs and generated ten safety recommendations. We discuss these recommendations in the context of existing relevant literature and provide suggestions for further steps to advance research and policy on DMHIs in the UK and globally. Further dialog is needed, including the views and experiences of all key stakeholders, and particularly of people with lived experience, to ensure DMHIs are not only an acceptable and potentially effective treatment approach, but also safe for those that use them.

Safety accounts of knowledge intend to explain why certain true and intuitively justified beliefs fail to be knowledge in terms of such beliefs falling prey to a modal veritic type of luck. In particular, they explain why true and intuitively justified beliefs in “lottery propositions” (highly likely propositions reporting that a particular statistical outcome obtains) are not knowledge. In this paper, I argue that there is a type of case involving lottery propositions that inevitably lies beyond the scope of any reasonable safety account of epistemic luck. I offer counterexamples to accounts of epistemic luck in terms of safety conditions that involve both “locally” and “globally” reliable ways of forming beliefs in nearby worlds. All such counterexamples present a lottery case illustrating the next possibility: the process of selecting the lottery winner might be such that any world in which it delivers a different outcome is extremely far away from the actual world. In addition to being a case of safe ignorance, this type of lottery case shows that, ultimately, either veritic epistemic luck is not unsafe true belief or beliefs in lottery propositions are not epistemically luckily true.

It is a well-worn platitude that knowledge excludes luck. According to anti-luck virtue epistemology, making good on the anti-luck platitude requires an explicit anti-luck condition along the lines of safety: S knows that p only if S’s true belief that p could not have easily been mistaken. This paper offers an independent, virtue epistemological argument against the claim that safety is a necessary condition of knowledge, one that adequately captures the anti-luck platitude. The argument proceeds by way of analogy. I focus on two paradigmatic kinds of normative achievements that also exclude luck: (i) – having a doxastically justified belief and (ii) – performing a morally worthy action. I then show that while (i) and (ii) exclude luck, they are nevertheless susceptible to what I call “modal luck.” I then move on to show that knowledge, or at least some instance of knowledge, is a normative achievement, which I claim provides strong reasons to expect that knowledge is also susceptible to modal luck. Since safety entails that knowledge is incompatible with modal luck, the argument provides strong reasons to reject safety as a necessary condition of knowledge.