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Autistic individuals report high levels of interest in pursuing and maintaining romantic relationships but indicate fewer and less satisfying relationships when compared with non-autistic populations. In this mixed-methods study, we investigated the self-identified factors that contribute to successful romantic relationships for autistic adults with the additional goal of understanding if and how their partners' neurotypes may influence relationship satisfaction. We compared levels of relationship satisfaction among 106 autistic individuals by categorizing each participant into one of three groups based on the specific neurotype of their partner: (1) autistic/autistic (A/A) dyads; (2) autistic/neurotypical (A/NT) dyads; and (3) autistic/non-autistic but neurodivergent (A/ND) dyads. All participants completed a series of online surveys to gather information about their autistic traits, overall relationship satisfaction, reciprocal communication and support, and perceived impact of autism on relationships. Across the three dyads, participants reported similar levels of relationship satisfaction, and we found no statistically significant differences when comparing the mean satisfaction of each sample group. Participants indicated a wide variety of positive and negative relational aspects, with a few themes changing in frequency based on partner neurotype. Participants with autistic partners tended to focus on an inherent and deep sense of understanding when discussing the positive aspects of their relationships, while those with non-autistic partners were more likely to discuss the presence of mutual support and accommodation. In addition to some differences in reported themes, participants tended to report that their autistic traits positively impacted satisfaction in A/A dyads, while those in A/NT and A/ND dyads tended to report that their autistic traits posed challenges in their relationships. The results of this study indicate that the neurotype of an autistic individual's partner may influence some of the reported positive and challenging aspects of their relationships. However, survey results indicate that autistic populations generally find comparable levels of satisfaction in romantic relationships irrespective of neurotype, which suggests that while partner neurotype may shape the enabling and barring factors for relationship success, it does not directly affect the overall health of a relationship. Finally, how an autistic individual perceives the impact of autism on their relationship may be affected by the neurotype of their partner. Why is this an important issue?: Many autistic folks seek out and thrive in romantic relationships, but studies report that autistic people experience lower relationship satisfaction than non-autistic people. Despite this, the autism research field has made little progress toward understanding (a) why this is the case and (b) how we can better support autistic individuals who are navigating romantic relationships. To best understand what autistic people seek in relationships, we created a space where autistic participants could share their experiences without comparison with those of non-autistic people.What was the purpose of this study?: We contributed to the current body of literature by learning more about what autistic people seek in relationships. We also wanted to see what they may struggle with and if these factors are influenced by whether their partner is neurotypical (referring to someone whose brain works in a way that is socially "typical"), neurodivergent (broadly referring to someone whose brain works differently from what is considered "typical"), and/or autistic. In doing this, we hope to help develop more effective ways of supporting autistic individuals who seek romantic connections.What did the researchers do?: The lead researcher, J.K., developed the project based on her experiences navigating romantic relationships as an autistic person. She recruited 106 autistic participants to complete a series of surveys regarding relationship satisfaction. Then, participants completed free-response questions about the most positive and negative parts of those relationships. She asked how they felt autism affected their relationships and gathered these components to identify what increased and decreased relationship satisfaction.What were the results of the study?: We found that autistic people are similarly satisfied in their relationships regardless of whether their partners are autistic or not. Despite this, participants consistently identified different positive and challenging factors within their relationships that tended to align with the neurotype of their partners. We found an interesting link between how autistic people view positive and negative factors in successful romantic relationships and their partners' neurotypes.What do these findings add to what was already known?: We added to a broad body of knowledge about relationship satisfaction by including a greater, more detailed consideration of autistic adults. Instead of comparing survey responses between autistic and non-autistic participants, we compared how autistic people viewed relationship satisfaction based on if their partners were autistic, non-autistic but still neurodivergent, or neurotypical.What are potential weaknesses in the study?: Potential limitations include the following: (1) we recruited a low number of male-identified participants, (2) we did not collect co-occurring diagnoses and conditions from the autistic participants, and (3) we did not verify partner neurotype.How will these findings help autistic adults now or in the future?: Through this project, we were able to highlight positive communication and interpersonal skills among autistic adults. We hope that the results of this study will help autistic people and their partners find some peace and community by reading about others with similar relationship experiences. We also hope to help them further understand what factors might serve as potential strengths and weaknesses in their relationships.

To report a case of retinoschisis associated with retinal detachment, documented with ultra-widefield optical coherence tomography (OCT), and to highlight subtle vitreoretinal interface changes not previously described. A patient with retinoschisis was evaluated using multimodal imaging, including ultra-widefield OCT. Serial OCT scans were reviewed to assess structural alterations of the outer and inner retinal layers, vitreoretinal interface, and hyaloid status. Ultra-widefield OCT demonstrated the development of a retinal detachment secondary to an isolated outer retinal hole within the region of retinoschisis, occurring in the context of traction from a thickened inner retinoschisis leaf, without evidence of communication with an inner retinal hole. Additionally, undulations on the inner surface of the outer leaf of the retinoschisis cavity were observed possibly representing residua of a tractional separation between the outer and inner leaf of the retinoschisis cavity. These subtle features were only appreciable through the extended coverage of ultra-widefield OCT imaging. Ultra-widefield OCT provided critical structural insights into the progression from retinoschisis to a retinal detachment. It revealed the development of an isolated outer retinal hole with associated inner leaf traction and undulations on the inner surface of the outer leaf of the retinoschisis cavity without detectable inner leaf holes, underscoring OCT's value in detecting and better understanding subtle vitreoretinal changes in this condition.

Evidence-based nutrition guidance for female athletes remains limited relative to that available for males; in part, this has contributed to widespread reliance on social media for dietary information. Whilst social media can enhance health communication, it also facilitates the rapid dissemination of unverified, commercially driven nutrition claims. This narrative review critically synthesises the current scientific literature underpinning four prevalent claims targeting nutrition close to exercise for active females; (1) fasted training is harmful for all females, (2) menstrual cycle-related hormonal fluctuations require sex-specific hydration strategies, (3) carbohydrate differences by sex and menstrual cycle phase, and (4) precise protein timing is essential for optimal adaptation in females. Despite social media and 'influencer' claims of no evidence in humans for many of the claims, there is some, albeit limited, evidence. This review evaluates the available research and the evidence supporting these claims to provide practical advice for active females. Collectively, this review demonstrates that many widely circulated nutrition claims directed at active females lack robust scientific support. The findings emphasise the importance of individual context, including training load, energy availability, environmental conditions and total dietary intake, over rigid, sex-specific nutrition rules. Improved translation of female-specific sports nutrition research into accurate, accessible public messaging is urgently needed to counter persistent misinformation in digital media.

The use of generative artificial intelligence tools such as ChatGPT has transformed various academic practices in higher education, generating interest in understanding its perceived impact on the development of students' communicative and analytical skills. This study aimed to validate the Student Perception of ChatGPT instrument. A non-experimental quantitative design with an instrumental and comparative approach was applied to a sample of 2,579 students with prior experience using ChatGPT, from Ecuador, Mexico, Chile, Brazil, Colombia, and Guatemala. The questionnaire included 18 items organized into two key dimensions, communicative skills and analytical skills, measured on a five-point Likert scale. Internal consistency analyses (α = 0.943; ω = 0.944), as well as exploratory and confirmatory factor analyses, were conducted. The results confirmed high reliability and a coherent two-factor structure, with consistent groupings among items related to academic writing, digital communication, critical thinking, and problem-solving. These findings provide empirical evidence of the instrument's validity to measure students' perceptions of ChatGPT's contribution to the development of such skills. It is recommended to conduct longitudinal, mixed-method, and performance-based studies to more precisely examine its actual effect on university learning.

Multiple sclerosis (MS) is a chronic autoimmune disorder of CNS with demyelination, neurodegeneration and compartmentalized inflammatory disorder. Excessive T-helper cell (CD4+) activation and unregulated cytokine signaling play a key role in its onset and progression. These changes impair communication between peripheral immune cells and CNS resident microglia, astrocytes and oligodendrocytes. This review provides an overview on the contribution of specific subsets of T-helper cells to MS pathology/immunity. Th1 cells release interferon-γ and lymphotoxin, that stimulate activation of myeloid cells/antigen presentation. Activated by IL-23, the Th17 cells produce IL-17A/F that lowers the blood-brain barrier (BBB) integrity, recruit neutrophils and monocytes, and enhance microglial killing. Activation of CD4+ T cells leads to activation of B cells via T follicular helper cells which couple these processes through the production of IL-21 and CXCR5. This leads to the development of tissue-like aggregates and intrathecal antibody production. T-cell plasticity adds to epitope spreading as well as chronic inflammation, IL-22, IL-9, IL-1β, IL-6, and TGF-β (these are additional mediators involved in the regulation of effector phenotypes). In MS, the regulation of dendritic cell co-stimulation and of glial activation often does not work. This is due to the lack of control of dendritic-cells co-stimulation and the lack of regulation of glial activation by regulatory pathways such as FOXP3+ regulatory T cells and Tr1 cells that secrete IL-10 and TGF-Beta. The review also explores the cytokine network biomarkers, CSF and serum signatures and single-cell immune states, as well as existing and new drugs. These include migration blockade, targeting of S1P-receptors, anti-CD20 therapy, targeting of Th17/GM-CSF and JAK-STAT pathways, low-dose IL-2, approaches of targeting antigens and engineered Tregs. Investigating the areas of stage and compartment-specific CD4+ T-cell circuits can help to advance targeted immunomodulation in progressive MS and neuro-repair.

Digital behavioral interventions are promising to support patients' pursuit of live donor kidney transplantation (LDKT). This study examined the effectiveness of a patient-led digital intervention (KidneyTIME) versus active control on facilitating LDKT. An individually randomized (1:1) parallel-group trial was conducted at a safety-net hospital transplant program with adult kidney transplant candidates in referral, evaluation, or listed phases who were English-speaking and had email or text access. KidneyTIME participants received animated video LDKT education and outreach enablement via video sharing. The primary outcome was &#x2265;1 live donor inquiry within 12 months in the intent-to-treat population. Secondary outcomes included LDKT knowledge, attitudes, behaviors toward listing and donor outreach, extent of video sharing, and intervention acceptability assessed by survey at 4 timepoints post-exposure. Between 4/22 and 7/23, 422 candidates (mean age 54 years; 57% male, 45% income < $30,000) were randomized to KidneyTIME (n = 212) or active control (n = 210). Between-group differences in donor outreach behaviors and receipt of a donor inquiry were not detected. KidneyTIME participants had higher LDKT knowledge (p = 0.002), new listing behaviors (IRR:1.62, p = 0.005), and extent of video sharing (p = 0.016). In planned as-treated analysis, intervention participants who viewed at least one optional video had significantly higher cumulative donor inquiry probability than those who did not (viewer 22.9%; non-viewer 9.8%, p = 0.029). Intervention acceptability scores were high. A digital intervention self-administered by patients did not increase donor inquiries. Preliminary dose effect findings suggest the need to consider how to encourage people to engage more with the intervention.

Social self-efficacy (SSE) is a key cognitive-motivational construct predicting social adjustment and mental health. However, existing SSE scales were developed in Western individualistic cultures, neglecting collectivistic characteristics (e.g., relational harmony, emotional restraint) and online social contexts. This study developed and validated a culturally adapted multidimensional College Students 'Social Self-Efficacy Questionnaire (CSSEQ) for Chinese students. A mixed-method, multi-phase design was used. Phase 1 involved semi-structured interviews (n&#x202f;=&#x202f;13) and open-ended surveys (n&#x202f;=&#x202f;266) to explore the indigenous structure. Phase 2 included item generation, expert review, content validity, item analysis, and exploratory factor analysis (EFA; n&#x202f;=&#x202f;572). Phase 3 performed confirmatory factor analysis (CFA; n&#x202f;=&#x202f;1,011), reliability, validity, and common method bias tests. The final 24-item CSSEQ exhibited a three-factor correlated model: Social Interaction Competence Confidence, Emotional Regulation Confidence, and Interpersonal Awareness Confidence. CFA showed excellent fit: &#x3c7; 2 /df&#x202f;=&#x202f;2.59, RMSEA&#x202f;=&#x202f;0.04, CFI&#x202f;=&#x202f;0.96, TLI&#x202f;=&#x202f;0.95, SRMR&#x202f;=&#x202f;0.03. A higher-order model also fit acceptably. Reliability was excellent (Cronbach's &#x3b1;&#x202f;=&#x202f;0.96, composite reliability&#x202f;=&#x202f;0.95, test-retest&#x202f;=&#x202f;0.96). Convergent validity (AVE&#x202f;>&#x202f;0.50), discriminant validity (HTMT < 0.85), criterion validity (r&#x202f;=&#x202f;0.88 with PSSE; r&#x202f;=&#x202f;0.72 with social self-esteem), and incremental validity (&#x394;R 2&#x202f;=&#x202f;0.124) were all supported. Content validity was excellent (I-CVI&#x202f;>&#x202f;0.78). Common method bias was not substantial (Harman's single-factor: 28.6%). Measurement invariance across gender, grade, and major was supported (&#x394;CFI &#x2264; 0.01, &#x394;RMSEA &#x2264; 0.015). The CSSEQ is a psychometrically rigorous, culturally grounded, and structurally robust instrument for assessing social self-efficacy among Chinese college students. Compared to the Western Perceived Social Self-Efficacy Scale (PSSE), the CSSEQ demonstrated significant incremental validity (&#x394;R 2&#x202f;=&#x202f;0.124) and a correlation of r&#x202f;=&#x202f;0.88 (below the redundancy threshold of 0.90), indicating that it captures culturally specific components not covered by existing Western measures. It captures culturally specific components missing from Western scales and integrates modern social contexts, making it suitable for cross-cultural research, mental health screening, intervention design, and educational assessment.

Cell membranes are not mere platforms for signalling proteins; they can shape how receptor inputs are assembled into local responses. In membrane-rich microdomains, receptor identification and pathway mapping do not reveal the logic of a measured effect. That effect may arise from independent receptor activity, pairwise crosstalk or higher-order integration governed by membrane state. The membrane-encoded chemosensory system (MECS) is introduced as a conceptual framework for addressing the inferential gap between receptor co-expression mapping and mechanistic crosstalk claims in territories with cannabinoid GPCRs, ectopic olfactory GPCRs and TRP channels. Its operational method, MECS baseline-edit-rescue (MECS-BER), fixes one membrane prior, one locked proximal outcome and one three-arm candidate assembly. Eligibility gates test arm engagement and outcome competence. Combinatorial responses are analysed with &#x3ba;, the third-order interaction under a pairwise-only null within a complete three-factor perturbation design, to distinguish lower-order explanation from higher-order interpretation and test edit-rescue reversibility. Deterministic matrices and simulations establish classification logic and tolerance handling; biological adjudication awaits fully compliant MECS-BER datasets. The workflow provides a prespecified and formalized methodological route, not biological proof of any specific receptor triad. It keeps nomination separate from adjudication and requires co-localization, distal phenotypes, shared downstream signals and nonlinear mixtures to be tested against a locked proximal outcome before biological interpretation. Renal micro-niches specify prospective deployment across renin, transport, barrier and flow-sensitive calcium control without claiming validated cannabinoid-olfactory-TRP assemblies. Membrane lipids may shape both the signalling vocabulary of individual receptors and the local language through which receptors communicate.

The nuclear receptor Nurr1 (NR4A2) is a transcriptional regulator of inflammatory homeostasis, but its systemic effects on orchestrating inter-organ communications are largely unknown. Here we show that Nurr1 haplo-insufficiency results in a lethal coupled disorder across the liver-gut axis. Using a CRISPR-Cas9 generated murine model, we find that metabolically-activated heterozygous deficiency of Nurr1 results in profound hepatocellular necrosis and marked hepatic activation of inflammatory and pro-fibrotic genes coupled with dysregulation of the intestinal barrier, and severe small-intestinal dysbiosis. Multi-omics integration reveals a highly penetrant transcriptional signature of this herein termed liver-gut disorder, achieving up to 0.950 accuracy (SVM-RBF, 10-fold cross-validation) in classifying genotypes from integrated multi-omics features. Notably, we also demonstrate that these gene level perturbations in Nurr1 haplo-insufficiency can be thought of as learnable tissue 'morphologies' detectable by AI. Next, we created deep convolutional neural networks that accurately classify genotype from routine histopathology. Our algorithm achieves 99.50% accuracy in classifying hepatic fibrosis (Sirius Red), 99.20% in liver inflammation (H&E) and 92.31% in intestine (H&E). We provide the first multi-omics phenotype of Nurr1 deficiency, revealing its pivotal regulatory role in coordinating liver-gut homeostasis, and establishing a histopathological AI-driven framework. Grad-CAM saliency analysis confirms biological interpretability. Translational relevance is supported by human transcriptomic data (E-GEOD-61260) showing concordant upregulation of COL1A1 (log2FC= + 0.725, p <&#xa0;0.01), TGFB1 (+ 0.429, p <&#xa0;0.05), and MMP9 (+ 0.969, p&#xa0;<&#xa0;0.01) alongside reduced NR4A2/NURR1 in human liver disease.

Brain-computer interface (BCI) technology has emerged as a crucial interdisciplinary advancement in the field of neuropsychiatric disease treatment. With the global rise in the prevalence of neurological and psychiatric disorders, which impose a substantial burden on society, BCI offers a novel approach. Since the discovery of bioelectric phenomena in the 19th century, various classification frameworks have been developed based on signal paradigms, invasiveness, and feedback mechanisms. BCI applications span multiple disease areas. In movement disorders, it aids in restoring motor function through prosthetic control, functional electrical stimulation, and brain stimulation-based therapies. For patients with communication barriers, it enables alternative communication methods and speech-related neural signal decoding. In psychiatric conditions, BCI shows growing potential in both diagnosis and treatment, particularly in conditions like autism and depression. Despite significant progress, BCI faces challenges. The long-term biocompatibility of electrodes and the resolution of neural signals remain to be improved. To address these limitations, research on new electrode materials, such as carbon nanomaterials and composites, is ongoing. Emerging BCI technologies, including endovascular BCI and optogenetics BCI, present new possibilities. The integration of multimodal technologies and artificial intelligence in BCI systems is expected to enhance performance and enable more personalized treatment. Overall, BCI technology holds great promise for improving the quality of life of patients with neuropsychiatric disorders and driving innovation in the medical and neuroscience fields.

Fetal-type posterior communicating artery (PcomA) aneurysms remain a difficult subgroup in the flow-diverter era. In these lesions, the PcomA supplies a substantial portion of the posterior cerebral artery territory because the ipsilateral P1 segment is absent, hypoplastic, or functionally insufficient. The branch therefore functions as a major outflow channel, and persistent distal demand may maintain circulation through the aneurysm-neck complex after flow diversion. This review summarizes the anatomical basis of fetal-type PcomA aneurysms and the current evidence for clipping, coiling, intrasaccular devices, and flow diversion. Among PcomA aneurysms treated with flow diverters, non-fetal lesions generally show better angiographic outcomes than fetal-type lesions. In a recent meta-analysis, complete occlusion at final follow-up was 77% in non-fetal aneurysms versus 42% in fetal-type aneurysms. A multicenter comparative cohort similarly reported complete occlusion in 81.8% versus 43.7%, with a markedly shorter median time to occlusion in non-fetal lesions (6 vs. 51 months). Earlier fetal-type series often showed persistent aneurysm filling and low complete occlusion rates, whereas more recent selected cohorts have reported complete or near-complete occlusion in 60%-80% of cases, suggesting that flow diversion can still be effective in carefully selected anatomies and with tailored strategies. Overall, clipping and coiling remain important branch-preserving options, and intrasaccular treatment may be reasonable in selected lesions with favorable geometry. Flow diversion should be considered selectively, particularly for large, recurrent, broad-necked, or morphologically complex aneurysms, while recognizing that robust fetal circulation may delay or limit aneurysm occlusion. Current evidence remains constrained by small retrospective series, inconsistent definitions of fetal anatomy, and heterogeneous device strategies.

The possible effects of Tai Chi exercise on neural coordination during walking in older adults remain unclear. This study aimed to compare cortical functional connectivity (FC) and corticomuscular coupling (CMC) during walking among older Tai Chi practitioners, older brisk walkers, and non-exercise controls. A total of 62 participants were recruited in this study, including older Tai Chi practitioners (n=20), older brisk walkers (n=22), and non-exercise controls (n=20). Participants performed a walking test during which data were collected. The FC was measured using cortical oxygenated hemoglobin (HbO2) concentration via a functional near-infrared spectroscopy device, and CMC was calculated between HbO2 signals and surface electromyography signals. The Tai Chi practitioners showed greater FC in right primary motor cortex-left supplementary motor area (rM1-lSMA, p=0.006, d=1.081), right primary motor cortex-right supplementary motor area (rM1-rSMA, p=0.003, d=1.318), right primary motor cortex-left primary somatosensory cortex (rM1-lS1, p=0.002, d=1.150), and rM1-rS1 (p=0.011, d=1.015) compared with the non-exercise controls, and greater FC in rM1-rS1 (p=0.015, d=0.856) compared with the brisk walkers. In addition, the Tai Chi practitioners demonstrated greater CMC in the left tibialis anterior-right supplementary motor area (lTA-rSMA, p=0.015, d=0.991), lTA-rS1 (p=0.006, d=1.096), lMG-rSMA (p=0.002, d=1.118), right medial gastrocnemius-right supplementary motor area (rMG-rSMA, p=0.015, d=0.962), and rMG-rS1 (p=0.017, d=0.939) compared to the non-exercise controls. Older Tai Chi practitioners exhibited greater functional connectivity and corticomuscular coupling, which may contribute to improved postural control and reduced fall risk in older adults.

Breastfeeding and Nutrition Counselling (NC) plays an important role in paediatric and adolescent medicine for the prevention of nutrition-related diseases. The necessary fundamentals should already be taught during undergraduate medical education. The objectives of this paper were 1. to analyse the National Competence-Based Catalogue of Learning Objectives 2.0 (NKLM) with regard to nutrition-related competencies, 2. to identify possible discrepancies, and 3. to formulate recommendations. With the help of a structured literature research, the competency goals which are necessary for primary preventive NC were identified and summarised in a theoretical catalogue of criteria. The NKLM 2.0 was subsequently checked for its content using the qualitative content analysis according to Mayring. The final code system consisted of 82 codes. All 1,426 coded segments were distributed across the code categories as follows: "Preventive nutritional knowledge": 532 (37.31%), "Communication competencies": 442 (31%), "NC competencies": 216 (15.15%), "Nutritional medicine": 236 (16.55%). No teaching content was identified for 5 codes. Teaching formats and time frames were not specified. NKLM 2.0 covers most of the competencies required for adequate preventive medical NC. There are gaps in nutritional knowledge (nutrition of breastfeeding mothers, cooking and kitchen techniques, eating behaviour) and in nutrition counselling competencies (nudging, sensitive communication about body weight, systemic counselling). These topics can be taught in a targeted manner in communication courses or as part of culinary medicine programs. Mandatory advanced training in paediatrics and adolescent medicine, as well as clear guidelines regarding teaching formats and time requirements, appear to be sensible measures to ensure lasting learning success and effective prevention. F&#xfc;r die Pr&#xe4;vention ern&#xe4;hrungsassoziierter Erkrankungen spielen Still- und Ern&#xe4;hrungsberatungen (EB) in der Kinder- und Jugendmedizin eine wichtige Rolle. Daf&#xfc;r ben&#xf6;tigte Grundlagen sollten bereits im Medizinstudium vermittelt werden. Ziele dieser Arbeit waren 1. Analyse des Nationalen Kompetenzbasierten Lernzielkatalogs Medizin 2.0 (NKLM) bez&#xfc;glich ern&#xe4;hrungsbezogener Kompetenzen, 2. Aufdecken m&#xf6;glicher Diskrepanzen und 3. Formulieren von Empfehlungen. Mithilfe einer strukturierten Literaturrecherche wurden die f&#xfc;r eine prim&#xe4;rpr&#xe4;ventive EB notwendigen Kompetenzziele ermittelt und in einem theoretischen Kriterienkatalog zusammengefasst. Der NKLM 2.0 wurde anschlie&#xdf;end mittels qualitativer Inhaltsanalyse nach Mayring auf deren Beinhaltung gepr&#xfc;ft. Das finale Codesystem umfasste 82 Codes. Alle 1,426 codierten Segmente verteilten sich wie folgt auf die Codekategorien: &#x201e;Ern&#xe4;hrungswissen pr&#xe4;ventiv&#x201c;: 532 (37,31%), &#x201e;Kompetenzen Kommunikation&#x201c;: 442 (31%), &#x201e;Kompetenzen EB&#x201c;: 216 (15,15%), &#x201e;Ern&#xe4;hrungsmedizin&#x201c;: 236 (16,55%). Zu 5 Codes wurden keine Lehrinhalte identifiziert. Lehrformate und Zeitumf&#xe4;nge waren nicht angegeben. Der NKLM 2.0 umfasst den Gro&#xdf;teil der f&#xfc;r eine ad&#xe4;quate &#xe4;rztliche pr&#xe4;ventive EB erforderlichen Kompetenzen. Defizite bestehen im Ern&#xe4;hrungswissen (Ern&#xe4;hrung der Mutter in der Stillzeit, Koch- und K&#xfc;chentechniken, Essverhalten) sowie in Beratungsstrategien (Nudging, sensibler Umgang mit K&#xf6;rpergewicht, systemische Beratung). Diese Inhalte k&#xf6;nnen gezielt in Gespr&#xe4;chsf&#xfc;hrungskursen oder im Rahmen von Culinary-Medicine-Angeboten vermittelt werden. Eine verpflichtende Vertiefung in der Fach&#xe4;rzt:innenweiterbildung Kinder- und Jugendmedizin sowie klare Vorgaben zu Lehrformaten und Zeitumf&#xe4;ngen erscheinen zur Sicherung nachhaltiger Lernerfolge und effektiven Pr&#xe4;vention sinnvoll.

Mechanical ventilation (MV) is a frequently used lifesaving treatment in intensive care units (ICUs); yet, earlier research suggests that it may expose patients to unpleasant physiological and psychological stressors. While international literature characterises MV as distressing, limited research has explored these experiences within the specific sociocultural context of Maltese and Mediterranean ICUs. To explore the lived experience of adults who received MV during an ICU stay and how they made sense of this unique experience. A qualitative approach was adopted utilising Interpretative Phenomenological Analysis (IPA). Purposive, homogeneous sampling was used to recruit adults (n&#x2009;=&#x2009;7) who were invasively ventilated for at least 4&#x2009;days in a general ICU at a public hospital in Malta. Data collection took place in 2023 through semi-structured interviews and continued until sufficient idiographic depth was achieved. Data analysis was guided by the stages of IPA to identify shared patterns across participants while adhering to idiographic principles. Four Group Experiential Themes emerged: (1) delivered into the hands of others, representing the transition to a state of profound vulnerability, voicelessness and dependence; (2) living in a disconnected world, involving a psychological detachment from reality characterised by vivid hallucinations and terrifying nightmares; (3) an agonising experience, encompassing both physical pain and a long-term emotional burden after discharge; and (4) Supportive encounters, highlighting the role of healthcare worker dedication, family networks and spirituality as vital mediators of suffering. Patients may perceive MV as a disorienting journey defined by a loss of autonomy and identity. The psychological impact of delusions often lingers long after discharge, which underscores the necessity of humanising critical care and providing compassionate interventions. The findings highlight the need for tailored communication strategies and the integration of spiritual care as a core component of the care for mechanically ventilated patients. Environmental adjustments, ICU diaries, flexible visiting hours and non-pharmacological interventions like music therapy should be prioritised to facilitate holistic recovery and reduce the risk of post-intensive care syndrome.

The integration of clinical skills and humanistic literacy is a paramount objective in modern medical education. This study evaluates a novel tutorial-based model designed to promote early clinical-humanities integration for first-year medical students. A cross-sectional study was conducted at Zhejiang University School of Medicine. A self-reported questionnaire was administered to first-year medical students enrolled in the "Whole Life Cycle Health I" course (N&#x202f;=&#x202f;275). The questionnaire assessed their adaptation to this model, learning interest, perceived promotion of clinical-humanities integration, module effectiveness, and self-rated competency improvement. Most students reported good adaptation (90.9%) and increased learning interest (88.0%). Although adaptation levels were comparable between genders, male students expressed significantly stronger agreement regarding enhanced interest and the model's effectiveness in fostering integration (p&#x202f;<&#x202f;0.05). Key practical modules-including "Simulated Outpatient Role-Playing," "AI-Powered Science Video Production," and "Postpartum Home Visits"-were rated as highly effective. Students reported substantial improvement in patient communication (87.3%) and teamwork (85.1%), despite challenges like time constraints and task integration difficulties. The tutorial-based model is perceived by students as a feasible, promising, and well-received strategy for early clinical-humanities integration, demonstrating significant potential for broader implementation in medical education reform.

Adverse childhood experiences (ACEs) have shown impacts on prenatal depression. Most studies examined the cumulative risk of ACE scores, though impacts of different ACE types can vary. And less is known about the psychosocial mechanisms underlying the impacts. Supportive communication within a family formed through marriage may serve as a psychosocial resource for pregnant women. To differentiate the associations of ACE scores and types with prenatal depression. The mediation effect of family communication was further investigated. A cross-sectional study in 873 Chinese pregnant women (mean age 30.89 [SD 3.93] years). ACEs, family communication, and prenatal depression were measured using the ACE International Questionnaire (ACE-IQ), Family Communication Scale (FCS), and Edinburgh Postnatal Depression Scale (EPDS), respectively. Specifically, 13 types of ACEs included physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect, domestic violence, parental death or separation, family substance use, family mental illness, family incarceration, bullying, collective violence, and community violence. Multivariable linear regression examined the associations of ACE scores and types with prenatal depression, adjusting for demographic, lifestyle, and pregnancy-related covariates. Causal mediation analysis investigated the mediation effect of family communication. Childhood abuse (physical, emotional, and sexual), neglect (physical and emotional), domestic violence, collective violence, and bullying showed associations with prenatal depression (adjusted b range 1.34-3.28, all ps <0.05). ACE scores were associated with prenatal depression (adjusted b&#x2009;=&#x2009;0.55, 95% confidence interval [CI] 0.38, 0.72). Family communication mediated the associations of ACE scores (proportion of total effect [TE] mediated&#x2009;=&#x2009;22%), physical (26%) and emotional abuse (15%), physical (57%) and emotional neglect (31%), and domestic violence (22%) with prenatal depression. Associations with prenatal depression were observed with ACE scores and were various across ACE types, which were medicated through family communication. Pregnant women with high ACE scores and specific ACE types can be vulnerable groups for prenatal depression, and interventions for promoting family communication are needed.

Extracellular vesicles (EVs), lipid bilayer nanoparticles released by virtually all cells, serve as essential messengers for intercellular communication. Due to their involvement in several pathophysiological processes, EVs have recently gained considerable attention as potentially diagnostic and prognostic biomarkers for various illnesses. The widespread distribution of EVs across all biofluids positions them as ideal, minimally invasive biomarkers for disease progression using a liquid biopsy approach. Among biofluids, saliva is uniquely accessible and has a low soluble protein content, making its EV population a highly promising source of diagnostic biomarkers.&#xa0;Salivary EVs have been investigated for their promising potential for diagnosing local and systemic diseases, including cancers, autoimmune diseases and neuropsychiatric disorders. In this review, we present a synopsis of the current landscape related to salivary EVs, highlighting the unique characteristics and potential of these vesicles, the technical challenges related to their application, and their future prospects for clinical translation as powerful diagnostic tools.

Appropriate antibiotic use can save life in sepsis while reducing the risk of bacterial resistance. Biomarkers, such as procalcitonin (PCT), can inform the timing of the clinical decision to stop a course of antibiotics. The recently reported multicentre ADAPT-Sepsis trial showed that a daily PCT-guided protocol can safely reduce the duration of antibiotic use in people with suspected sepsis. This linked study aimed to identify potential barriers and facilitators to implementation of PCT testing. This process evaluation collected qualitative and quantitative data from clinical teams involved in the delivery of adapt-sepsis. Trial site staff were invited to complete a questionnaire and to participate in a semistructured interview. Responses were thematically analysed and compared with constructs from the Consolidated Framework for Implementation Research (CFIR v2.0). A total of 69 staff from 26 critical care units responded to the online questionnaire (n&#x2009;=&#x2009;55); the interview invitation (n&#x2009;=&#x2009;3); or both (n&#x2009;=&#x2009;11). Interviewees included critical care consultants, junior doctors, and research nurses. At least 60% of ADAPT-Sepsis trial staff respondents supported the continuation of PCT testing, even before trial results were publicised. Several of the implementation facilitators related to factors evident at the level of the site/organisation, such as microbiology involvement and increasing access to knowledge and information about evidence supporting the tests. Cost was raised as a potential barrier. Adoption of biomarker tests such as PCT may be facilitated by communicating high-quality evidence, supported by staff focussed on antimicrobial stewardship. Cost implications have been considered in a related economic analysis. This study was prospectively registered online. The unique identifying number at researchregistry.com is researchregistry4244.

This research investigates the criminalization of fake news under the 2023 Jordanian Cybercrime Law, evaluating its implementation within the broader global canon of fake news law analyses. Adopting a qualitative research design that integrates doctrinal content analysis with comparative legal assessment, the study examines how Jordan's regulatory framework navigates the tension between international human rights standards, specifically Article 19 of the ICCPR and domestic security logics. The analysis identifies a shift toward the securitization of digital speech, characterized by: (i) the use of imprecise legal definitions that allow for the criminalization of political criticism; (ii) the imposition of penalties that prioritize state security over individual expression; and (iii) a state-centric interpretation of digital sovereignty. Through analyzing judicial precedents such as Court of Cassation Decision No. 6280/2022, the paper demonstrates how hybrid regimes utilize legalistic justifications to manage digital dissent. The paper concludes by positioning Jordan's legislative evolution as a case of Coordinated Digital Governance, offering a nuanced understanding of how Global South legal systems negotiate international norms against the backdrop of regional political pressures.