Search Results (1,463)

Achieving sustainable land restoration in southern Chinese ionic rare earth mining areas remains a significant challenge due to the extended duration and low efficiency of conventional remediation approaches. Although the hyperaccumulator Dicranopteris pedata possesses a remarkable capacity for rare earth element (REE) enrichment, a significant knowledge gap exists regarding how to effectively combine exogenous organic acids with agronomic practices like clipping to enhance its remediation efficiency in an environmentally sustainable manner. Crucially, the potential environmental risks associated with such synergistic strategies have not been systematically evaluated, hindering their practical application. To address this, our study focused on Dicranopteris pedata and employed integrated pot and soil column leaching experiments to systematically analyze the effects of different concentrations of citric acid and tartaric acid on REE migration and transformation within the soil–plant system. The results demonstrated that exogenous organic acids significantly reduced soil pH and promoted the conversion of REEs from the residual to the exchangeable fraction. Specifically, the 20 mmol·kg⁻¹ citric acid treatment increased the proportion of exchangeable REEs by 43.46%. Furthermore, organic acid treatments significantly altered the REE uptake patterns in Dicranopteris pedata, inhibiting the translocation and accumulation of REEs in the aboveground tissues. Soil column leaching experiments revealed that citric acid drove the migration of REEs to deeper soil layers, with the concentration peaking at 288.33 mg·kg⁻¹ at a depth of 6–8 cm; concomitantly, the REE content in the leachate reached its maximum on the 5th day. This study demonstrates that the combined application of 20 mmol·kg⁻¹ citric acid and 100% clipping management increased the annual REE accumulation in Dicranopteris pedata to 4.85 g·m⁻², thereby significantly shortening the theoretical remediation period from 25.0 years in the control to 12.1 years. Soil column leaching experiments indicated no significant secondary pollution risk associated with this strategy. These findings provide a feasible, low-risk, and sustainable technical strategy for the synergistically enhanced remediation of REE-contaminated soils, offering a promising path for ecological restoration and sustainable land management in degraded mining ecosystems. Full article

Background/Objectives: The COVID-19 pandemic exposed global weaknesses in healthcare preparedness and highlighted the pivotal role of the World Health Organization (WHO) in coordinating responses and issuing technical guidance. Among these, the document “Rational use of personal protective equipment (PPE) for COVID-19 and considerations during severe shortages” (December 2020) aimed to standardize PPE use amid global scarcity. This study assessed the awareness, implementation, and perceived usefulness of this WHO guidance among Polish healthcare personnel and evaluated discrepancies between the WHO expectations and workplace realities. Methods: A cross-sectional, anonymous online survey was conducted between July and September 2025 among employees of 243 randomly selected healthcare facilities in Poland (constituting 20% of all hospitals). The original 24-item questionnaire covered the demographics, awareness and implementation of the WHO PPE guidelines, and perceptions of their effectiveness during and after the pandemic. Data were analyzed descriptively. Results: A total of 542 healthcare workers participated, predominantly nurses (56.8%) and physicians (12.2%), with 86.8% being female and 59.3% having over 20 years of experience. Most respondents (76.5%) reported familiarity with the WHO PPE document, and 63.1% confirmed its implementation in their institutions. Over two-thirds (68.0%) reported that the guidelines improved their sense of safety at work. The main barriers to implementation included staff shortages (52.9%) and insufficient local guidance (20.6%). In 2025, 52.3% continue to apply the WHO recommendations, and 70.8% believe they remain relevant in current practice. However, 80.2% indicated that the WHO guidance should be more closely adapted to local conditions. Conclusions: The WHO PPE guidance was widely recognized and reported as implemented by respondents from participating healthcare facilities, contributing to improved preparedness. Nonetheless, limited institutional support and inadequate local adaptation reduced implementation effectiveness. Future WHO recommendations should better align with national healthcare contexts to enhance preparedness for future crises. Full article

Background/Objective: Infectious bursal disease (IBD) is an acute and highly contagious immunosuppressive disease in chickens caused by infectious bursal disease virus (IBDV). In recent years, a novel variant IBDV (nVarIBDV) has emerged and spread widely, inducing severe immunosuppression and posing a substantial threat to the poultry industry. More importantly, owing to antigenic variations, nVarIBDV can escape the immune protection of the existing vaccines. Therefore, it is imperative to develop a new vaccine that is antigenically matched to nVarIBDV. Methods: The major protective antigen gene VP2 of the representative nVarIBDV strain SHG19 was inserted into the eukaryotic expression plasmid pCAGGS to construct the recombinant plasmid pCASHGVP2. Subsequently, pCASHGVP2 was encapsulated in lipid nanoparticles (LNPs) to form pCASHGVP2-LNP nanoparticles. Finally, using the SPF chicken model, the immune efficacy of pCASHGVP2-LNP was preliminarily assessed by administering two vaccine doses (10 and 20 μg) and two immunization regimens (single or double immunization). Results: Efficient VP2 protein expression from pCASHGVP2 was confirmed by in vitro transfection experiments. The prepared pCASHGVP2-LNP nanoparticles exhibited an optimal particle size distribution and acceptable polydispersity index, indicating a homogeneous formulation. Furthermore, animal experiments showed that the candidate DNA vaccine elicited specific neutralizing antibodies after double immunization and protected immunized chickens from disease induced by nVarIBDV challenge. Conclusions: This study reports the first development of an LNP-encapsulated VP2 DNA vaccine (pCASHGVP2-LNP) against nVarIBDV, highlighting its potential application for the prevention of nVarIBDV. Full article

Background and Objectives: Academic point-of-care (POC) manufacturing enables the in-hospital design and production of patient-specific medical devices within certified environments, integrating clinical practice, engineering, and translational research. This model represents a new academic ecosystem that accelerates innovation while maintaining compliance with medical device regulations. Gregorio Marañón University Hospital has established one of the first ISO 13485-certified academic manufacturing facilities in Spain, providing on-site production of anatomical models, surgical guides, and custom implants for oral and maxillofacial surgery. This study presents a retrospective review of all devices produced between April 2017 and September 2025, analyzing their typology, materials, production parameters, and clinical applications. Materials and Methods: A descriptive, retrospective study was conducted on 442 3D-printed medical devices fabricated for oral and maxillofacial surgical cases. Recorded variables included device classification, indication, printing technology, material type, sterilization method, working and printing times, and clinical utility. Image segmentation and design were performed using 3D Slicer and Meshmixer. Manufacturing used fused deposition modeling (FDM) and stereolithography (SLA) technologies with PLA and biocompatible resin (Biomed Clear V1). Data were analyzed descriptively. Results: During the eight-year period, 442 devices were manufactured. Biomodels constituted the majority (approximately 68%), followed by surgical guides (20%) and patient-specific implants (7%). Trauma and oncology were the leading clinical indications, representing 45% and 33% of all devices, respectively. The orbital region was the most frequent anatomical site. FDM accounted for 63% of the printing technologies used, and PLA was the predominant material. The mean working time per device was 3.4 h and mean printing time 12.6 h. Most devices were applied to preoperative planning (59%) or intraoperative use (35%). Conclusions: Academic POC manufacturing offers a sustainable, clinically integrated model for translating digital workflows and additive manufacturing into daily surgical practice. The eight-year experience of Gregorio Marañón University Hospital demonstrates how academic production units can enhance surgical precision, accelerate innovation, and ensure regulatory compliance while promoting education and translational research in healthcare. Full article

Visual search behavior, influenced by expertise, prior knowledge, training, and visual fatigue, is crucial in ophthalmic diagnostics. This study investigates differences in eye-tracking strategies between novice and experienced eye care practitioners during fundus image interpretation. Forty-seven participants, including 37 novices (first- to fourth-year optometry students) and 10 experienced optometrists (≥2 years of experience), viewed 20 fundus images (10 normal, 10 abnormal) while their eye movements were recorded using an Eyelink1000 Plus gaze tracker (2000 Hz). Diagnostic and laterality accuracy were assessed, and statistical analyses were conducted using Sigma Plot 12.0. Results showed that experienced practitioners had significantly higher diagnostic accuracy (83 ± 6.3%) than novices (70 ± 12.9%, p < 0.005). Significant differences in oculomotor behavior were observed, including median latency (p < 0.001), while no significant differences were found in median peak velocity (p = 0.11) or laterality accuracy (p = 0.97). Diagnostic accuracy correlated with fixation count in novices (r = 0.54, p < 0.001), while laterality accuracy correlated with total dwelling time (r = −0.62, p < 0.005). The experienced practitioners demonstrated systematic and focused visual search patterns, whereas the novices exhibited unorganized scan paths. Enhancing training with visual feedback could improve fundus image analysis accuracy in novice clinicians. Full article

Background: Kaposi sarcoma (KS) is a multifocal, angioproliferative neoplasm strongly associated with human herpesvirus-8 infection. Radiotherapy(RT) is a well established treatment due to the intrinsic radiosensitivity of KS lesions. High-dose-rate contact brachytherapy allows precise dose delivery with optimal sparing of surrounding tissues; however, its application in KS remains poorly documented. Methods: We conducted a retrospective analysis of 10 patients with histologically confirmed KS treated with c-HDR-BRT between June 2010 and June 2023. A total of 40 cutaneous lesions were treated using Leipzig applicators with hypofractionated regimens: 10 Gy in 1 fraction, 20 Gy in 2 fractions, or 30 Gy in 3 fractions. Treatment parameters were individualized based on lesion size and location. Local control (LC), overall survival (OS), disease-specific survival (DSS), and toxicity (graded by the RTOG criteria) were evaluated. Follow-up assessments were performed every four months during the first year and annually thereafter. Results: At a median follow-up of 10.3 years, the 2-year LC, OS, and DSS rates were 100%. Complete response was achieved in 62.5% of lesions, with a partial response observed in 37.5%. Grade 1–2 acute skin toxicities were recorded in 55% of treated lesions, while grade 3 toxicity occurred in a single case (2.5%) and was managed conservatively. The hypofractionated schedule significantly improved patient compliance, particularly in those with multiple lesions requiring sequential irradiation. Conclusions: Our long-term institutional experience supports c-HDR-BRT as a feasible and well tolerated local treatment option for the management of KS, providing favorable long-term local outcomes. These results support the inclusion of c-HDR-BRT in the multidisciplinary treatment of KS, warranting further prospective evaluation. Full article

Objective: The impact of underweight or low-BMI donors on heart transplantation (HTx) outcomes remains poorly understood. This study aims to investigate the effect of underweight donors on post-transplant outcomes. Methods: We retrospectively analyzed 574 patients divided into 2 groups based on donor BMI: underweight donors (BMI < 20 kg/m², n = 101, 17.6%) and normal-weight donors (BMI 20–25 kg/m², n = 473, 82.4%). Baseline variables and postoperative outcomes were compared using the Student’s t-test for continuous variables and the chi-squared test for categorical variables. Propensity score matching (PSM) was performed to balance baseline differences and control for confounders. Survival analysis was performed using the Kaplan–Meier method. Results: The matched cohort included 71 patients per group, with balanced baseline characteristics. Compared to the normal-weight group, recipients of underweight donors had significantly higher rates of respiratory complications (64.8% vs. 47.9%, p = 0.042), neurological complications (15.9% vs. 4.2%, p = 0.021), renal complications (17.4% vs. 5.6%, p = 0.029), and longer postoperative hospital stay (37.2 vs. 28.4 days, p < 0.001). No significant difference was observed in hospital mortality (2.8 vs. 4.2%, p = 0.649). The overall follow-up time was 72.2 ± 1.9 months (range 68.5 to 75.8). The 1-, 3-, and 5-year survival rates for the underweight and normal-weight donor BMI groups were 83.1% vs. 85.9% (p = 0.624), 75.6% vs. 80.2% (p = 0.527), and 72.0% vs. 77.3% (p = 0.468), respectively. Conclusions: Patients receiving hearts from underweight donors demonstrate comparable long-term survival to those from normal-weight donors but have a higher risk of postoperative complications. These findings suggest that underweight donors could be cautiously utilized to expand the donor pool, offering lifesaving opportunities to recipients who might otherwise experience adverse outcomes due to donor scarcity, albeit with an increased risk of postoperative complications. Full article

Background/Objectives: Many elementary school-aged children (i.e., 5 to 12 years old) experience sleep difficulties that negatively impact their daytime functioning. Despite this high prevalence, sleep education is rarely included in school curricula and evidence-based interventions are limited. To better understand this gap, a needs assessment was conducted to inform the development of a sleep education program. Method: Semi-structured virtual interviews were conducted with 14 elementary school teachers in Nova Scotia, Canada. Participants were asked 20 questions about their students’ sleep and its impact, teachers’ needs and practices in sleep education, what a sleep education program would look like, and how it could be delivered. During the interview, participants watched the online ABCs of SLEEPING storybook as a potential foundation for developing a sleep education program, and interview themes were analyzed using deductive thematic analysis. Results: All teachers identified poor sleep as an issue impacting students’ behavior and learning, and reported that they had a lack of resources to teach sleep education. Teachers believed the storybook could be used with their students and integrated into the curriculum. Recommended modifications include making the storybook available for families, adding interactive activities and student discussions, providing teacher resources, and tailoring the content to be suitable for both lower and upper elementary school-aged students. Most teachers indicated that the storybook could be adapted for upper elementary students with more age-appropriate vocabulary and visuals. Conclusions: The findings from this needs assessment will inform the development of an elementary school sleep education program using the ABCs of SLEEPING storybook as the foundation of the program, while noting limitations such as sample diversity. Full article

Abdominal radiography is commonly used as an initial diagnostic tool in dogs and cats with gastrointestinal (GI) signs. Historically, abdominal radiographs were considered unreliable for detecting GI masses, with detection rates below 50%. The purpose of this retrospective, case–control study was to determine the accuracy of abdominal radiographs in identifying the presence and location of GI masses and to assess the influence of the reviewer experience. Radiographs from 114 dogs and 111 cats were reviewed by two board-certified radiologists, one first year radiology resident, and one rotating intern. Patients were categorized into three groups: animals with a GI mass greater than 2 cm (dogs n = 44; cats n = 41), animals with a normal abdomen (both n = 50), and animals with abdominal disease but no GI mass (both n = 20). Reviewers demonstrated high specificity but low sensitivity for both detection and localization of GI masses. Sensitivity for detecting a mass ranged from 34 to 64% in dogs and 36 to 71% in cats; specificity exceeded 87% in dogs and 92% in cats. Sensitivity for location identification ranged from 9 to 58% in dogs and 21 to 68% in cats; specificity exceeded 76% in dogs and 81% in cats. No statistically significant differences in detection rates were found among reviewers. The accuracy of plain digital radiography for the detection of gastrointestinal masses in dogs (75%) and cats (81%) is better than previously reported film radiography but remains inferior to other imaging modalities. However, its high specificity supports its clinical utility in ruling out gastrointestinal masses. Full article

Background: Chronic Obstructive Pulmonary Disease (COPD) affects over 400 million people worldwide. Ireland reports the highest COPD-related mortality and hospitalizations in Europe. Dysphagia impacts approximately 50% of people with COPD (PwCOPD) and contributes to COPD exacerbations, hospitalizations, and mortality. Expiratory Muscle Strength Training (EMST) improves respiration and swallowing for PwCOPD; however, little is known about its clinical use by Speech-Language Pathologists (SLPs). Methods: A cross-sectional online survey, developed in accordance with CHERRIES and CROSS guidelines, aimed to explore SLPs awareness, assessment approaches, treatment protocols, training, and confidence in EMST delivery. It was distributed to SLPs working with adults with dysphagia in Ireland. Purposive and snowball sampling were used, with a target sample size of n = 258. Results: The response rate was 36% (n = 92). Awareness of EMST was high (99%, n = 91). 53% (n = 49) reported using EMST. Among EMST users, 20% employed objective assessments of maximal expiratory pressure (MEP), while most calibrated devices to 75% of MEP and followed the “rule of fives” treatment protocol. 29% had formal training in EMST. SLPs with ≤10 years’ clinical experience and those working in acute hospitals used EMST most often. Confidence was influenced by training, experience, access to specialized respiratory equipment, and interdisciplinary team members. Conclusions: SLPs EMST awareness is high, but implementation practices remains variable, with low uptake of formal training and limited use of objective MEP assessment. Findings highlight the need for structured training and population-specific protocols to support consistent and confident EMST delivery for PwCOPD. Full article

Background/Objectives: Advances in the genetic understanding of pheochromocytoma–paraganglioma (PPGL) have considerably refined personalized approaches to diagnosis and management. This study aims to present our institutional experience on the diagnostic characteristics, clinical course, and genetic background of patients with PPGL, in the context of the current literature. Methods: This retrospective analysis included 35 patients diagnosed with PPGL between years 2020 and 2024, all of whom underwent surgical resection and next-generation sequencing for germline mutations in major PPGL susceptibility genes. Clinical presentation, biochemical profile, pathological findings, and follow-up outcomes were compared between mutation-positive and mutation-negative cases. Results: Of the 35 patients with PPGL, germline mutations were identified in 6 patients (17%): 2 in Cluster 1A genes (SDHA, SDHB), 2 in Cluster 1B (VHL), and 2 in Cluster 2 (NF1). Consistent with existing literature, pathogenic germline variants—particularly SDHB and VHL—were identified in our cohort exclusively in patients younger than 30 years (ages 17, 20, and 25). Mutation-positive patients more frequently exhibited noradrenergic or non-secretory profiles (p = 0.01). Among the three non-secretory tumors in the cohort, two harbored genetic mutations (SDHA, NF1). Interestingly, both NF1-positive patients were normotensive—one (c.3496G > A) with a non-secretory tumor and the other (c.2329T > A) presenting at an unusually late age (63 years)—a strikingly atypical spectrum that underscores the phenotypic variability of NF1-associated PPGL. Bilateral disease was observed exclusively in VHL carriers (p = 0.03). Importantly, we identified a rare VHL c.369delG frameshift variant, not previously reported in association with PPGLs, in a patient with PPGL. No significant difference was observed between SDHB loss (p = 0.1) and proliferative indices (mitotic count, Ki-67) (p = 0.07, p = 0.6) between the two groups. During a median follow-up of 24 months (IQR: 18–36), one SDHB-positive patient had a recurrence, while no distant metastases were detected in the remaining mutation carriers. Conclusions: These findings support characteristic clinical patterns among mutation-positive PPGL and underscore the importance of systematic germline testing in all cases—irrespective of age, family history, or biochemical profile—to guide individualized management and enable cascade screening. The identification of a rare VHL c.369delG variant, previously unreported in association with PPGL, within a characteristic VHL-related clinical phenotype highlights the importance of this association. Similarly, atypical NF1 cases emphasize phenotypic variability and reinforce the importance of germline testing even in clinically silent presentations. Full article

Background: Lung carcinoids—typical and atypical—are rare neuroendocrine tumors (NETs) representing 1–2% of lung cancers. Despite clinicopathological differences, their clinical management often mirrors lung cancer protocols rather than NET-specific recommendations. Objectives: Portray a 12-year real-world experience with lung carcinoids at a Comprehensive Cancer Center, identifying gaps in diagnostic work-up, treatment decision-making, and follow-up. Methods: Retrospective observational cohort study of adult patients with histologically confirmed lung carcinoids diagnosed at IPO Porto between January 2013 and December 2024. Demographic, clinical, imaging, and treatment data were collected from electronic patient records. Analyses were descriptive. Results: Among 179 identified cases, 129 met eligibility criteria. Median age was 62 years (range 18–84); 53.6% were women and 53.5% were non-smokers; 84.5% had ECOG-PS 0–1. The most frequent presentation was respiratory symptoms (34.1%), followed by incidental findings (43.4%, of which ~20% were during staging or surveillance of other cancers). Typical carcinoids accounted for 49.6% and atypical for 43.4%. FDG-PET/CT was requested in 70.9% of cases, including many with typical carcinoid, and SSTR-PET/CT in 64.6% (dual PET in 38.8%). Most patients (65.1%) presented with stage I disease; 17.1% were stage IV. Mean time-to-first treatment was 83 days (range 1–259). Surgery was the first treatment option for 78.3% of patients. Conclusions: This real-world series highlights heterogeneity in diagnostic pathways, excessive FDG-PET use in typical carcinoids, and non-standardized follow-up. Dedicated multidisciplinary lung-NET boards and national reference centers are needed to homogenize and streamline patient management. Full article

Background and Objectives: Patients with Sjögren’s disease (SjD) do not experience any improvement in gastroesophageal reflux disease (GERD) symptoms after SjD treatment, and in some patients, reflux even worsens. It is important to note that GERD manifests itself through typical and atypical symptoms, the latter of which may include eye damage, as evidenced by a growing body of research. When SjD patients were prescribed medication to treat GERD, their condition improved at the same time. Therefore, we aim to investigate whether there is a link between ocular dryness and gastroesophageal reflux disease (GERD) in patients with Sjögren’s disease (SjD). Materials and Methods: Our study included 27 patients with SjD according to the 2016 American College of Rheumatology and the European League Against Rheumatism (ACR/EULAR) Sjögren’s syndrome Classification Criteria, and 28 patients with non-autoimmune sicca syndrome due to GERD (nonautoimmSicca). Results: The study involved 55 participants, 48 (87.3%) women and 7 (12.7%) men. The median age was 54 years (IQR 49–64). A total of 41 subjects (74.5%) had GERD, and 20 subjects (36.4%) tested positive for Helicobacter pylori: 13 (48.1%) and 1 (3.7%) in the SjD group, and 28 (100.0%) and 19 (67.9%) in the nonautoimmSicca group, respectively. A significant difference in asymmetric tear secretion (p < 0.001) was found between the nonautoimmSicca and SjD patients, with values of 5 (3–10) mm/5 min and 1 (0–2) mm/5 min, respectively. A low correlation was detected between sialometry results and tear secretion asymmetry (r = 0.48, p < 0.001). An increase of 1 mm/5 min in the tear secretion asymmetry between the eyes was associated with a 2.04-fold increase in the odds ratio for having GERD (95% CI 1.25–3.32, p = 0.004), and was associated with a 1.9-fold increase in the odds ratio for having GERD (95% CI 1.04–3.49, p = 0.038) in patients with SjD. The presence of Helicobacter pylori is associated with asymmetric tear secretion [95% CI 1.22 (1.05–1.41, p = 0.010)]. Conclusions: Asymmetric tear secretion between the eyes is associated with the odds of having GERD. Patients with non-autoimmune sicca syndrome due to GERD have significantly greater asymmetry in tear secretion compared to those diagnosed with Sjögren’s disease. Full article

A two-year (2024–2025) field experiment was conducted in southern Xinjiang to alleviate soil compaction and severe salinization in saline–alkali soils and to evaluate the combined effects of tillage depth and subsurface drain spacing on soil improvement. Six treatments were established with three deep tillage depths, 70 cm (W1), 50 cm (W2), and 30 cm (W3), and two subsurface drain spacings, 20 m (S1) and 40 m (S2). Treatment effects on soil water–salt dynamics, soil physical properties and structure, ionic composition, and subsurface drainage and salt removal were analyzed. This study provides mechanistic and practical evidence that coupling deep tillage with subsurface drainage creates a more effective leaching–drainage pathway than either measure alone and enables robust optimization of design parameters (drain spacing × tillage depth) for saline–alkali land improvement in arid regions. Deep tillage in combination with subsurface drainage significantly increased soil profile water content, total porosity, and cumulative subsurface drainage and salt export, all of which reached their maxima under S1W1; it also significantly reduced bulk density, total salinity, and the concentrations of Na⁺, K⁺, Mg²⁺, Ca²⁺, Cl⁻, and SO₄²⁻, which reached their minima under S1W1. After two spring irrigation–leaching events (in 2024 and 2025), surface salt accumulation in the soil profile was markedly alleviated, and the mean salinity in the 0–20 cm layer decreased by 45.68% across treatments. The S1W1 treatment achieved the best desalinization performance in both leaching events, with reductions of 41.36% and 44.68%, respectively. Pearson correlation analysis indicated that the desalinization effect was significantly negatively correlated with porosity and significantly positively correlated with bulk density and ionic concentrations. Overall, coupling deep tillage with subsurface drainage effectively reduced soil salinity and harmful ions, improved soil structure, and enhanced drainage-mediated salt removal, with the 70 cm tillage depth combined with a 20 cm drain spacing delivering the best performance. Full article

Climate change is intensifying drought frequency and severity, posing increasing challenges for tropical forest species whose growth and survival depend on water availability. Ochroma pyramidale (Cav. ex Lam.) Urb. (balsa) is a fast-growing pioneer tree that plays important ecological roles, and it is valued for its lightweight timber, yet little is known about its drought tolerance or intraspecific variation among populations. This study evaluated the morphophysiological responses of O. pyramidale seedlings from three provenances spanning a rainfall gradient (850–6275 mm year⁻¹) under controlled soil moisture levels. The experiment followed a completely randomized factorial design with two factors, provenance (high-, medium-, and low-rainfall origins) and soil moisture (100%, 50%, and 20% field capacity), with six replications per treatment (n = 54 total plants). Drought significantly affected growth, water status, and physiological variables. Seedlings maintained high relative water content and photosynthetic pigment concentration under moderate stress (50% field capacity) but showed marked declines at 20% field capacity. Soluble sugar accumulation increased with drought intensity, suggesting osmotic adjustment, while root proliferation was enhanced under moderate stress (50% FC), evidenced by significantly higher Total Root Length (TRL) and Number of Branch Points (NBP). Provenance effects were weak, with only the number of leaves differing significantly among provenances. These results demonstrate that O. pyramidale tolerates moderate drought through physiological adjustment and root plasticity, supporting its use in reforestation and restoration initiatives in water-limited tropical environments. Full article