搜索结果：Creation

Alzheimer's disease poses not only clinical but also profound emotional and relational challenges, requiring healthcare professionals to develop empathetic and communicative competences alongside technical skills. In vocational healthcare education, arts-based approaches may contribute to a more humanised understanding of the disease. This study explores the potential of photographic artistic creation as a tool for raising awareness and fostering reflective learning about Alzheimer's disease during the initial training of auxiliary nursing care professionals. A qualitative collective case study was conducted using an arts-informed research approach. Participants were 30 students enrolled in an Intermediate Vocational Training Programme in Auxiliary Nursing Care in southern Spain. Students engaged in a guided creative process involving photographic artworks reflecting different aspects of Alzheimer's disease. Data sources included the photographs, written reflective reports, participant observation, and an open-ended questionnaire. Visual and thematic analyses were undertaken. The photographic artworks revealed that students were able to visually represent key cognitive, emotional, and social dimensions of Alzheimer's disease, including memory loss, disorientation, dependence, and affective suffering. The images also demonstrated sensitivity towards the lived experience of people with the disease. Most participants reported a positive perception of photography and art as resources for enhancing communication and empathy with patients. The findings highlight the pedagogical and humanising value of photography within vocational healthcare education. Photographic artistic creation emerges as an effective reflective tool for developing professional competences related to empathy, communication, and holistic care in future auxiliary nursing care professionals working with people with Alzheimer's disease.

 Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease limited to the colonic mucosa, with rising incidence and prevalence in many regions of the world, including Latin America. A subset of patients requires colectomy for medically refractory disease, acute severe colitis, dysplasia, or malignancy, for whom restorative proctocolectomy with ileal pouch-anal anastomosis (RPC-IPAA) is the preferred restorative procedure. Pouch-related complications -- including pouchitis, chronic antibiotic-refractory pouchitis (CARP), pouch failure, and diagnostic reclassification to Crohn's disease -- represent major clinical challenges; however, published institutional data on RPC-IPAA outcomes from hospital centers in Mexico and Latin America remain exceptionally scarce. This descriptive single-center study aimed to describe the demographic profile, operative characteristics, and predefined pouch-related complications in patients with UC who underwent RPC-IPAA at a tertiary referral center in Mexico. A retrospective observational study was conducted at the Inflammatory Bowel Disease Clinic of the Coloproctology Service, Hospital General de México "Dr. Eduardo Liceaga," reviewing medical records of UC patients who underwent RPC-IPAA between 2010 and 2022. Demographic and clinical variables were analyzed using IBM SPSS Statistics, version 29 (IBM Corp., Armonk, NY). Quantitative variables were summarized as mean ± SD and categorical variables as frequencies and percentages. Pouchitis was diagnosed using the Pouchitis Disease Activity Index (PDAI ≥7). CARP was defined as active pouchitis (PDAI ≥7) persisting despite at least four consecutive weeks of antibiotic therapy and failure of at least two sequential antibiotic regimens. Postoperative follow-up was calculated from the date of pouch creation to the last clinical encounter.  Fourteen patients were included; 8 (57.1%) were women. Mean age was 34.86 ± 7.94 years. All patients had Montreal E3 pancolitis. The mean interval between UC diagnosis and pouch creation was 3.86 ± 1.81 years. The median postoperative follow-up was 6.2 years (IQR: 3.4-9.1 years; range: 0.5-12.0 years). J-pouch construction was performed in 13 (92.9%) patients and D-pouch in 1 (7.1%). One (7.1%) patient experienced pouch failure and underwent W-pouch reconstruction. One (7.1%) patient originally diagnosed with UC E3 was subsequently reclassified as Crohn's disease (Montreal A2L4B2) and is currently receiving anti-interleukin-12/23 therapy (ustekinumab). Pouchitis occurred in 4 (28.6%) patients; all developed CARP and are currently being treated with anti-integrin therapy (vedolizumab).  In this descriptive single-center study, RPC-IPAA was predominantly performed with J-pouch construction, achieving durable pouch preservation over a median follow-up of 6.2 years. Pouch-related complications -- including CARP, pouch failure, and diagnostic reclassification to Crohn's disease -- emerged as important sources of morbidity requiring escalation to advanced biologic therapy and, in selected cases, surgical reintervention. These findings underscore that successful pouch surgery depends on structured individualized surveillance, dedicated multidisciplinary care, and timely access to biologic therapies throughout the postoperative course.

Robust, reproducible, and meaningful research requires suitable murine preclinical models that effectively mimic the disease and possess a functional immune system. In the context of metastatic castration-resistant prostate cancer (mCRPC) studies and with all the opportunities offered by theranostics, particularly prostate-specific membrane antigen (PSMA)-targeted therapies, the development of PSMA-positive murine models is essential for evaluating and further exploring these therapies in immunocompetent animals. However, strategies based on the transfection of murine cell lines with the human version of PSMA have led to immune rejection by the host. To preserve an intact immune system, which is indispensable, we focused on a strategy involving the expression of the murine version of PSMA. The core objective of this strategy was to evaluate radiotracer efficacy, using imaging and therapeutic response as complementary endpoints. While the imaging results using [68Ga]-Ga-PSMA-11 were satisfactory, we did not observe any therapeutic response to the radioligand therapy (RLT) using PSMA-617. A deeper analysis of the differences between murine PSMA (mPSMA) and human PSMA (hPSMA), as well as between the ligands PSMA-11 and PSMA-617, revealed significantly lower internalization and overall weaker radiotracer total binding in the mPSMA context, especially pronounced with PSMA-617. We identified a key motif in the amino acid sequence of hPSMA that is involved in internalization but is absent in that of mPSMA. Introducing a single amino acid substitution into the mPSMA sequence was sufficient to restore the internalization motif. We then investigated whether this point-generated mutation in murine cell lines was tolerated by the host immune system and improved sensitivity to RLT through restored internalization. This single-point mutation successfully led to an internalization rate comparable to that of the hPSMA; nonetheless, using PSMA-617 RLT, no therapeutic efficacy was observed. This study highlights the lack of equivalence between PSMA-11 and PSMA-617 ligands. The inability to use the PET imaging ligand (PSMA-11) for therapy prediction and model development hindered progress and complicated the creation of immune-tolerant mPSMA models. Comparative analyses of hPSMA versus mPSMA and PSMA-11 versus PSMA-617 revealed substantial differences in internalization, externalization, and radiotracer behavior despite preserved binding affinityeffects most pronounced with PSMA-617. Molecular docking further suggested that species-specific structural differences in the PSMA binding pocket, particularly steric hindrance introduced by Ser550 in murine PSMA, may limit optimal ligand positioning, independent of chelator chemistry. These findings indicate that both the receptor trafficking and structural features of the PSMA binding pocket may contribute to the observed differences and should be considered when developing translationally relevant murine models. Nevertheless, this study represents a valuable first step toward the development of syngeneic, PSMA-expressing murine models for preclinical theranostic studies.

Agroforestry provides essential ecosystem services while enhancing climate resilience and biodiversity in rural landscapes. Despite a growing body of research on farmers' adoption of agroforestry, much less is known about citizens' attitudes and priorities. Citizen disapproval of agroforestry practices or policies may undermine the legitimacy of these initiatives and impede their long-term implementation. This risk is particularly relevant in countries where agroforestry is being promoted as a national policy priority, such as the UK. We surveyed 1509 UK citizens to examine their attitudes toward agroforestry, explore factors influencing these attitudes, and study how these factors operate across distinct segments of the sample. Overall, participants expressed neutral to positive attitudes toward agroforestry. Benefits associated with climate resilience (wildlife habitat creation, greenhouse gas capture, and flood control) were rated most highly. Negative socio-economic consequences (delayed benefit realization, higher input requirements, and potential stakeholder conflicts) were identified as representing the greatest risks. Structural equation modeling validated a novel hybrid model explaining participants' attitudes toward agroforestry, highlighting three primary drivers: evoked affect, perceived benefits, and the perceived importance of environmental conservation in farming. Latent class analysis identified three distinct citizen groups. The negative impact of perceived risk associated with agroforestry on attitudes was greatest among cautious conservation-oriented citizens. The positive impact of perceived threat to the rural environment exceeded the influence of perceived importance of environmental conservation in farming among citizens sensitive to threats to the rural environment. Among countryside-engaged eco-productive citizens, perceived importance of both environmental conservation and food productivity as well as attachment to the countryside emerged as strong positive predictors of acceptance. Our results provide evidence for adopting a holistic approach that accounts for diverse citizen preferences when promoting agroforestry across UK regions, and highlight the importance of addressing multiple ecosystem services at the landscape level in agroforestry policies. The online version contains supplementary material available at 10.1007/s13593-026-01130-w.

The creation of person-centred cultures in health care settings is understood as a pre requisite to the provision of person-centred practice. Such cultures need systematic facilitation by health care leaders. While there are few empirically informed theoretical models for person-centred leadership and many organisations internationally, educate leaders in how to transform cultures to become more person-centred, there is lack of consensus on how person-centred leadership can be developed and no high quality, multi-centre evaluations of their effectiveness or impact. Before such evaluations can be undertaken an agreed curriculum is necessary. Only by having this can the fidelity of a leadership programme, subject to evaluation, be maintained. This study sought to gain international expert consensus on a curriculum for person-centred leadership using a modified Delphi method. Delphi studies employ anonymous and confidential survey methods to ensure expert consensus can be achieved without the interference of influential voices or group coalitions. They typically include two or more rounds with controlled feedback between rounds. We developed curriculum components by undertaking a literature review to identify programmes and theoretical models for person-centred leadership alongside a mapping of current person-centred leadership programmes being delivered by members of an international community of practice committed to the development of person-centred practice. We recruited experts using snowball recruitment. In round 1 we focused on seeking consensus on 16 curriculum components and 6 pedagogical delivery principles and offered the opportunity to comment on the phrasing or clarity of any components or propose additional components. Round 1 resulted in consensus of ≥70% for all components. All bar one had consensus of ≥80%. In round 2 consensus was achieved for all components (≥80% and a mode of 5). Using a modified Delphi study approach we have developed an internationally critiqued curriculum framework for person- centred leadership programmes, specific enough to ensure the fidelity of future programme delivery whilst providing sufficient flexibility for appropriate cultural modification within any complex intervention evaluation study. Research is now needed to evaluate the impact of engagement with this curriculum on healthcare leaders' self-views; enacted leadership behaviours and practices; health care cultures and other relevant patient and staff outcomes.

Across Europe, oral health is increasingly recognized as a public health priority. Still, structural, financial, and social barriers disproportionately affect people in vulnerable circumstances. Within the EU-funded DELIVER project, this study aimed to (1) identify which barriers to oral healthcare manifest across urban contexts, and (2) explore how community networks including citizens, healthcare professionals, social workers, policy makers, and other local stakeholders can contribute to developing local solutions related to improving quality of oral healthcare for citizens in vulnerable circumstances. A participatory action research design, guided by the Community Health Improvement Process, was used. Participants included citizens with lived experience of poverty or social exclusion, oral healthcare professionals, social workers, and policymakers. Data collection methods included semi-structured interviews, focus groups, co-creation meetings, and creative workshops. Data were analyzed using inductive thematic analysis. A total of 64 participants contributed to 21 interviews, 7 focus groups, and 4 co-creation meetings. Seven key barriers were identified: high treatment costs, limited insurance coverage, low oral health literacy, emotional and psychological factors (e.g., shame and fear), competing life priorities, limited support from professional organizations, and poor communication between social and oral healthcare services. Proposed solutions included walk-in consultations in community settings, buddy systems, improved support for navigating insurance, stronger integration of dental and social care, and oral health promotion through trusted local networks. Community-network approaches can substantially reduce inequalities in access to oral healthcare. Engaging citizens as co-creators enables inclusive and needs-based solutions and improvements. This study offers a promising model for improving oral healthcare accessibility by systematically identifying barriers and addressing them through community-based collaboration.

In this work, we introduce ShinyDataMatcher, a user-friendly R Shiny application designed to support the integration of survey data through statistical matching. The tool enables practitioners to import, explore and process survey data, harmonize variables, select appropriate matching variables, and apply a wide range of macro- and micro-level matching methods without writing any code. The application guides the user through the full workflow of a matching exercise, from data preparation to the creation of a synthetic matched dataset, and includes diagnostic tools for assessing matching quality. To illustrate its capabilities, we present an application based on the Italian Household Budget Survey (HBS) and the Survey on Household Income and Wealth (SHIW), where the goal is to fuse income and expenditure information and to construct a Social Accounting Matrix (SAM). The example also highlights how repeated random hot-deck imputations can be used to account for the additional uncertainty induced by statistical matching. Overall, ShinyDataMatcher provides a transparent and accessible environment for exploring, prototyping, and implementing statistical matching procedures, lowering the technical barriers that often limit their use in applied and official-statistics contexts.

Financial pressure on the German healthcare system is rising, and physicians face high pressure in balancing patient care and research. Into this environment comes an ethics approval process for retrospective studies that is becoming more complex and requires a greater volume of documentation. The objective of this study was to first describe and calculate the costs incurred by the ethics approval process. Using ChatGPT and Gemini, the required times for preparation, creation, and submission, as well as the time required for the ethics committee to process and vote on ethics approval, were estimated. Costs were calculated based on the newest version of the collective agreement for physicians at German university hospitals (Tarifvertrag für Ärzte an Universitätskliniken). Time required for submitting adds up to approximately 4-10 hours, and 4.5-8.5 hours for submission control and voting, respectively. Summing up, this amounts to 161.7-388.1 € for submission and 241.6-456.3 € for the ethics committee, respectively. In total, 8.5-18.5 hours are required for ethics approval for a retrospective study, resulting in a total of 403.3-844.4 €. Ethics approval is of major relevance to ensure good ethical practice and shall therefore not be omitted. Nevertheless, processes can be tightened to facilitate clinical research, free up resources, and save costs. Der finanzielle Druck auf das deutsche Gesundheitssystem nimmt zu, während Ärztinnen und Ärzte zunehmend gefordert sind, klinische Versorgung und Forschung miteinander zu vereinbaren. Gleichzeitig wird das Ethikgenehmigungsverfahren für retrospektive Studien zunehmend komplexer und erfordert einen steigenden Dokumentationsaufwand. Ziel dieser Studie war es, den zeitlichen und finanziellen Aufwand des Ethikgenehmigungsverfahrens zu beschreiben und zu quantifizieren. Unter Verwendung von ChatGPT und Gemini wurden die benötigten Zeiten für Vorbereitung, Erstellung und Einreichung der Unterlagen sowie die Bearbeitungsdauer durch die Ethikkommission einschließlich Prüfung und Beschlussfassung abgeschätzt. Die Kostenberechnung erfolgte auf Grundlage der aktuellen Fassung des Tarifvertrags für Ärztinnen und Ärzte an Universitätskliniken (TV-Ärzte). Der Zeitaufwand für die Antragstellung beträgt etwa 4–10 Stunden, für Antragsprüfung und Votierung durch die Ethikkommission 4,5–8,5 Stunden. Daraus ergeben sich Kosten von 161,7–388,1 € für die Antragstellung sowie 241,6–456,3 € für die Antragsbearbeitung und -prüfung. Insgesamt werden für das Ethikgenehmigungsverfahren einer retrospektiven Studie 8,5–18,5 Stunden benötigt, was Gesamtkosten von 403,3–844,4 € entspricht. Die Ethikgenehmigung ist von zentraler Bedeutung zur Sicherstellung guter wissenschaftlicher Praxis und darf daher nicht entfallen. Dennoch sollten bestehende Prozesse optimiert werden, um klinische Forschung zu erleichtern, Ressourcen freizusetzen und Kosten zu reduzieren.

Interventional nephrology has progressively emerged as a discipline aimed at integrating clinical management with procedural expertise in the care of patients with kidney disease. Historically, Italy has represented one of the leading international models in the management of dialysis access and ultrasound-guided procedures, largely due to the direct procedural involvement of nephrologists. This narrative review examines the historical evolution, status, and future perspectives of interventional nephrology in Italy. Early national surveys and data from the Dialysis Outcomes and Practice Patterns Study documented exceptionally high rates of native arteriovenous fistula use and minimal reliance on central venous catheters, outcomes closely associated with the active procedural role of nephrologists. However, more recent national surveys and international registry data indicate a gradual decline in nephrologists' direct procedural involvement, paralleled by increasing catheter use and greater reliance on other specialties for dialysis access creation and related procedures. Several factors appear to contribute to this transition, including healthcare system reorganization, workforce reductions affecting training and mentorship, epidemiological changes in the dialysis population, increasing use of pre-emptive kidney transplantation, and evolving medico-legal considerations. Despite these challenges, Italian nephrology retains significant technical expertise and organizational potential. Strengthening structured training pathways, establishing coordinated educational initiatives, such as a proposed Academy of Interventional Nephrology and implementing collaborative hub-and-spoke networks could support the revitalization of procedural competencies within the specialty. Reintegrating procedural skills into nephrology practice may not only improve the quality and timeliness of dialysis access care and ultrasound-guided procedures but also help redefine the professional identity and future attractiveness of the discipline.

Despite advantages in survival and quality of life with kidney transplantation (KT) compared to other treatments for kidney failure requiring dialysis, many patients do not receive sufficient information about KT or have concerns about it. New artificial intelligence capabilities enable the creation of virtual agents to supplement human efforts to engage patients about treatment options. Single arm, open label trial with the primary outcome assessed pre- and post-intervention. Adults (&#x2265;18 and <75 years) with eGFR <25 mL/min/1.73 m2 in a large health system. Our group developed the virtual transplant nephrologist - an interactive, video-based platform to provide personalized education about KT. Meetings could occur anytime from a smartphone with a weblink. Participants first selected the demographic profile of their virtual nephrologist. Participants then self-tailored the encounter, choosing among 11 topics, pausing, changing the topic, and requesting more information. The primary outcome was the difference in participants' intentions to speak to their human doctor about KT, before versus after the intervention, assessed on a 5-point Likert-like scale. Participants had a median age of 66 years; 59% were female and 50% were Black. Female and Black participants demonstrated preferences to select a gender (p<0.001) or race (p<0.001) concordant virtual nephrologist, respectively. Participants spent a median 12.6 minutes reviewing a median of 11 topics in the encounter. The primary outcome of intention to speak to a human clinician about KT increased significantly after the virtual encounter (mean increase 0.30; p<0.001). The clinical significance of the outcome is uncertain. Virtual clinicians offer a promising path to education and engagement about complex treatments such as KT. This customizable approach to providing high quality information about KT using a virtual clinician warrants more definitive testing in a randomized trial.

Modern 3D-software enables the creation of detailed virtual models of a patient's anatomy, allowing more precise visualisation of deformities and simulation of surgical strategies in a risk-free environment. Once an optimal plan is defined, patient-specific guides can be 3D-printed to transfer the virtual plan directly to the operating theatre, reducing reliance on freehand techniques. 3D-guided procedures are often faster, more predictable, and require less imaging. The technology also helps identify conditions not visible on conventional imaging. We describe some benefits of 3D technology and illustrate its clinical value with a case of corrective osteotomy for a malunited forearm fracture.

The global prevalence of Staphylococcus aureus (S. aureus) in clinical settings represents a critical hazard to global public health security, highlighting the pressing demand for highly effective antibacterial compounds with novel molecular scaffolds and unique action mechanisms. Herein, we describe the first creation and synthesis of a series of piperazine-bridged sulfonamide indole oxime derivatives, aiming to overcome the drug resistance bottleneck of existing antibiotics. Biological evaluation demonstrated that these derivatives exhibited remarkable antibacterial potential against the tested strains. Notably, the propyl-substituted analog 8b displayed remarkable suppression of S. aureus growth, achieving a MIC value of 2&#xa0;&#x3bc;M, representing a 6.5-fold improvement compared to the positive control norfloxacin (MIC&#xa0;=&#xa0;13&#xa0;&#x3bc;M). The hybrid 8b showed a significantly lower tendency to induce bacterial resistance, outperforming the control drug. Druggability assessment revealed that compound 8b possessed excellent biocompatibility with L929 fibroblasts (negligible cytotoxicity) and could specifically upregulate TGF-&#x3b2; secretion at low concentrations to promote fibroblast proliferation, highlighting its potential synergistic value in tissue repair. Molecular docking simulations confirmed that the potent compound 8b could demonstrat stable interactions with the binding sites of DNA hexamer duplexes and hCAII through an extensive network of hydrogen bonds, suggesting a multi-targeting profile. Preliminary mechanistic studies uncovered that oxime 8b exerted antibacterial effects through a dual-action mode: inducing bacterial cell membrane disruption and mediating bacterial genomic DNA cleavage, which impaired genetic material integrity and blocked key replication-transcription pathways. This work offers an essential structural model and experimental foundation for designing next-generation multi-target sulfonamide-indole oxime antibacterial agents.

Cataracts continue to be the leading cause of preventable blindness worldwide and represent a significant public health challenge, particularly in rural and underserved regions where access to ophthalmology specialists and diagnostic infrastructure is limited. Early detection plays a crucial role in preventing visual impairment and improving treatment outcomes; however, large-scale screening programs are often constrained by the availability of trained professionals and specialized equipment. The purpose of this research was to develop and evaluate an automated cataract detection system based on deep learning using retinal fundus images in order to support early screening and improve accessibility to ophthalmological diagnosis. The proposed methodology followed an experimental quantitative approach that included dataset preparation, image preprocessing, model training, and performance evaluation. A labeled subset of 2,658 retinal fundus images extracted from the ODIR-5K dataset was used as the primary data source. The images underwent preprocessing procedures including normalization and noise reduction, followed by data augmentation techniques such as random rotations (&#xb1;10&#xb0;), scaling (90%-110%), and brightness and contrast adjustments. These transformations allowed the creation of a balanced dataset of 4,840 images, enhancing model generalization and reducing overfitting. Six deep neural network architectures were trained and evaluated: ResNet152, EfficientNet-v2S, Inception v3, MobileNet v3, DenseNet201, and Vision Transformer (ViT). Transfer learning with ImageNet pre-trained weights was applied together with selective fine-tuning of deeper layers and optimization using the Adam algorithm combined with a Cosine Annealing learning rate scheduler. The results obtained indicate that ResNet152 is the bestperforming architecture with an accuracy of 99.10%, precision of 99.72%, sensitivity of 98.46%, and F1 score of 99.08%. It is concluded that deep convolutional neural network architectures, particularly ResNet152, provide highly effective performance for automated cataract detection from retinal fundus images. The proposed system demonstrates strong potential as a clinical decision-support tool for large-scale screening programs, especially in resource-limited settings, as it can facilitate early diagnosis, improve access to ophthalmological care, and reduce the diagnostic workload of specialized medical personnel.

Postoperative wound complications remain a major cause of morbidity, prolonged hospitalization, increased healthcare costs, and reduced quality of life. While traditional wound dressings functioned primarily as passive barriers against contamination and exudate, advances in wound biology have transformed surgical wound management. Tissue repair is now recognized as a dynamic immunometabolic process involving coordinated interactions among immune cells, stromal populations, extracellular matrix remodeling, mechanotransduction, mitochondrial function, redox balance, microbial ecology, and bioelectrical signaling. Consequently, modern wound dressings are increasingly designed as bioactive systems capable of actively modulating the wound microenvironment. Recent developments in biomaterials science, immunoengineering, nanotechnology, extracellular vesicle biology, bioelectronics, and artificial intelligence have enabled the creation of advanced wound platforms, including stimuli-responsive hydrogels, immunomodulatory biomaterials, nanozyme-based dressings, conductive scaffolds, oxygen-generating matrices, extracellular vesicle-loaded systems, and biosensor-integrated interfaces. Therapeutic strategies are progressively shifting from antimicrobial-focused approaches toward immune-regenerative modulation targeting chronic inflammation, mitochondrial dysfunction, ferroptosis, cellular senescence, and impaired mechanobiological signaling. This review examines emerging surgical wound dressings from mechanistic, translational, and biomaterial perspectives, highlighting current innovations, translational challenges, and future directions. Collectively, these technologies may enable intelligent therapeutic systems capable of sensing and directing tissue regeneration in real time.

Of individuals with mild-to-moderate multiple sclerosis (MS), 56% report falling at least once during a 3-month period. Several fall risk factors have been identified, but the issue is complex, with interactions between triggering factors and preceding activities and events. There is a lack of studies explicitly evaluating fall prevention strategies given as counselling over time. The project includes (1) a two-armed randomised controlled internal pilot study with a nested qualitative study on participants' experiences and (2) a randomised controlled trial (RCT). The pilot study will evaluate feasibility in terms of recruitment, dropout, adverse events and battery of tests and will constitute a basis for recalculating the preliminary estimated sample size for a full-scale study. The RCT study will evaluate whether fall prevention strategies based on individual fall risk evaluation reduce fall frequency compared with general fall prevention information. Participants in the intervention group will have an extensive discussion with a physiotherapist regarding the impact of specific MS symptoms, environmental and personal factors, triggering factors and activities and/or circumstances that they perceive to precede fall situations; these discussions will then lead to the creation of individual strategies. In case of falling during follow-up, further discussions on strategies will be held by phone contact. The control group will receive general fall risk prevention recommendations. After completion of the study, the control group will be offered individual strategies based on reported falls. Participants in the pilot study allocated to the intervention group will after follow-up be invited to individual interviews focusing on experiences of taking part in the intervention and the study.Adults diagnosed with MS, fall history and remaining walking ability will be recruited by physiotherapists from six sites in Sweden. The primary outcome will be self-reported falls for 6 months and secondary outcomes will be self-rating scales covering concern about falling, confidence in remaining balance during activities, walking limitations and ability to avoid falls. Descriptive measures of disease impact will be used. The study was approved by the Swedish Ethical Review Authority, Stockholm Dept. 4 (ID: 2025-04486-1, date: 2025-08-12). All participants will provide written informed consent. Findings will be disseminated through peer-reviewed journals, conference presentations and relevant patient organisations. NCT07378566.

Mental diseases have been rising at an unprecedented rate across all age groups worldwide and are predicted to be one of the biggest health challenges of thus century. Despite significant advances, lot remains to be understood in modern sciences. In this scenario, Ayurveda along with the sankhya, yoga and vedanta darshanas constitute an invaluable treasure house of understanding regarding various aspects of human mind. These sources discuss mind extensively, including its creation, anatomy, location, functioning based on the three maha gunas of satva, rajas and tamas; role of prana, role of tridoshas of vata, pitta kapha;organization into different types of satvas or personality types, its functional states, various modifications it can undergo through the process of yoga; its relationship with body, brain and senses; its perfected state through yoga and its final release. The sources also teach us invaluable information regarding a normal mind, different ways and disciplines needed to keep it healthy and the benefits of following these disciplines. Finally, the different types of diseases that are possible are explored with a brief review of various treatment modalities and principals involved. Ayurveda and Darshanas provide extremely useful information to the exploring scientist, inquisitive physician or a traditional seeker; to understand, manage or unravel the human mind.