While daring-impulsive (DI) traits have been deemed an important concept in subtyping youth with conduct disorder (CD) as part of a multispecifier model, no work has examined whether DI traits add to the existing practice of designating youth with CD beyond co-occurring attention-deficit/hyperactivity disorder (ADHD). This study examined the utility of DI traits (versus ADHD features) in a sample of 322 justice-involved adolescent boys (ages 16-17 years). In addition to a diagnostic interview to determine severity of CD, adolescents completed measures of DI, ADHD, as well as other relevant characteristics. Findings revealed differential associations between DI and ADHD in relation to indices of CD, externalizing psychopathology (i.e. reactive aggression, proactive aggression, substance use), internalizing psychopathology (i.e. anxiety, depression), and domains of impulsivity (i.e. positive urgency, negative urgency, sensation seeking, premeditation, perseverance). Additionally, over and above ADHD, DI contributed incremental information in explaining CD, externalizing psychopathology, positive urgency, sensation seeking, and lack of premeditation, but not internalizing psychopathology nor negative urgency and lack of perseverance. Of the 286 adolescents with CD, 114 (39.9%) were in the DI group and only 81 (28.3%) were in the ADHD group. Finally, differential correlates emerged between adolescents exhibiting CD alone, high CD and high DI traits, and high CD and high ADHD features. Findings tentatively suggest DI traits and ADHD features are empirically distinct from each other in relation to CD and relevant characteristics and, therefore, improved clinical care for adolescents with CD will likely require differential consideration of DI and ADHD.
Chronic knee joint pain affects millions worldwide, with radiofrequency ablation (RFA) of genicular nerves emerging as a potential treatment in the last 15 years. Despite its growing popularity, with studies demonstrating its efficacy in pain reduction for up to 12 months, recent randomized controlled trials have questioned the efficacy of RFA. Discrepancies in study results may partially be explained by the heterogeneity of patient selection and technical protocols.This daring discourse aims to explore and critically analyze the ongoing debates surrounding RFA of the genicular nerves, addressing key controversies, namely: (1) Is there a role for performing prognostic blocks prior to RFA?; (2) What are the optimal target sites for final cannulae placement for the classical targets?; (3) Which and how many nerves should be targeted in RFA procedures?; (4) What are the comparative benefits of using ultrasound versus fluoroscopy guidance, and whether a combined technique may be advantageous?; (5) Is there a potential role for pulsed radiofrequency of the genicular nerves?; (6) Should genicular nerve RFA be performed after total knee arthroplasty?Through this in-depth discussion, we aim to guide pain medicine clinicians in informed decision-making and encourage further research in this field.
There is limited data regarding provision of information and managing risk of premature mortality in Dravet Syndrome (DS). We aimed to investigate the perspectives of caregivers and neurologists on receiving and providing information and managing risk in relation to premature mortality in DS. Semi-structured interviews were undertaken with caregivers of children (n = 12) and adults (n = 4) with DS and neurologists (n = 9). Caregiver interviews focused on perceptions of risk of premature mortality, views on information received and managing risk. Neurologist interviews focused on how to inform caregivers about the risk and on how to support caregivers in living with the risk. Data was analyzed via thematic analysis. Caregiver themes regarding perception of risk and information received included: Limited information from healthcare providers, SUDEP is scary, Navigating Uncertainty, Delivery is Important and Optimal timing varies. Neurologist themes regarding informing included: Inform early, Verbal is best, An individualized approach, Emotional issues to consider and Inform along with other risks. Caregiver themes regarding management of risk included: Use of surveillance methods, Need for better seizure control, Managing anxiety related to the risk, and Need for both emotional and practical support to manage risk. Neurologist themes included: Focus on practical steps such as use of surveillance while avoiding overprotectiveness and Need for psychological support for caregivers. Caregivers want to be informed about the risk of premature mortality in DS in a physical meeting, even though it is 'scary'. When the neurologist fails to inform, information is found via other sources. Neurologists may prefer to give verbal information to facilitate adapting to the individual context, but complementary written information is important for caregivers. The multidisciplinary team is crucial for providing support for the caregivers to manage and live with the risk of premature mortality.
Good quality information helps adolescents with their menstrual health. It supports them in realising their human rights. Many adolescents find information on menstrual health online through websites, social media, or health apps. Online information is increasingly important. But we know little about how adolescents access and use it for menstrual health. We conducted a qualitative study in junior high schools in two districts of Bali, Indonesia. 24 school girls aged 13-15 took part. We wanted to understand how they accessed online information and what they learnt from this about menstruation. We carried out five group discussions in each of four junior high schools. We also did five in-depth interviews, a solicited diary activity and participant observation. Our study confirmed that online sources were important for menstrual health information. Participants shared that they looked for menstrual health information through search engines. They also came across it via social media, especially the video platform TikTok. Many participants saw online information as positive. They felt it offered personalised, private, entertaining and convenient information. But there were also risks. Excessive information caused them to worry and misinformation reinforced menstrual myths. Our findings highlight the need for menstrual health programming and policy to take into account the role of online information. It would also commit to understanding the lived experiences of adolescents. Critical health and digital literacy could be part of puberty and health education. This would be very helpful in countries like Indonesia with growing digital engagement. Informasi berkualitas memberikan remaja akses terhadap kesehatan menstruasi sekaligus mendukung kesadaran mereka akan hak asasi manusia. Mayoritas remaja mengakses informasi kesehatan menstruasi secara daring melalui situs web, media sosial, atau aplikasi kesehatan. Meskipun informasi daring semakin relevan, pemahaman kita tentang bagaimana remaja mengakses dan menggunakan informasi daring untuk kesehatan menstruasi sangat jauh dari kata cukup. Penelitian ini dilakukan dengan kajian kualitatif pada 24 remaja putri berusia 13-15 tahun di sekolah menengah pertama di dua kabupaten di Bali, Indonesia (Kabupaten Gianyar dan Kota Denpasar). Penelitian ini bertujuan untuk memahami bagaimana remaja mengakses informasi daring dan apa yang mereka pahami dari informasi tersebut terkait menstruasi. Sebanyak lima kegiatan diskusi kelompok dilakukan di setiap empat sekolah menengah pertama. Selanjutnya, dilakukan lima wawancara mendalam, aktivitas buku harian singkat, dan observasi partisipan. Hasil dari penelitian ini menegaskan bahwa sumber daring berperan penting untuk informasi kesehatan menstruasi. Partisipan menyatakan bahwa mereka secara aktif mencari informasi kesehatan menstruasi melalui mesin pencari (Google) dan/atau menemukannya secara tidak sengaja melalui media sosial, khususnya platform video pendek TikTok. Sebagian besar partisipan berpendapat bahwa informasi daring membawa dampak positif. Selain itu, mereka menyatakan bahwa platform daring menawarkan informasi yang bersifat pribadi, rahasia, menghibur, dan praktis. Namun, terdapat risiko dari informasi daring tersebut. Terkadang terdapat informasi yang berlebihan yang membuat mereka cemas atau informasi yang salah yang memperkuat mitos tentang menstruasi. Dari penelitian ini dapat disimpulkan bahwa pentingnya program dan kebijakan kesehatan menstruasi untuk lebih memperhitungkan peran informasi daring dan berkomitmen untuk memahami pengalaman hidup remaja. Program atau kebijakan lebih lanjut dapat mengintegrasikan literasi kritis tentang kesehatan dan digital ke dalam pendidikan kesehatan dan pubertas, khususnya di negara-negara yang mengalami perkembangan digital yang pesat, seperti Indonesia. Des informations suffisantes et exactes sont indispensables pour la santé menstruelle et aident les adolescentes à réaliser leurs droits humains. À mesure que la connectivité mobile augmente dans le monde, de nombreux jeunes peuvent rechercher ou trouver des informations sur la santé menstruelle en ligne via des plateformes internet, des réseaux sociaux ou des applications de santé. Malgré la pertinence des informations en ligne, la recherche et les programmes en matière de santé menstruelle se sont concentrés sur l’apprentissage formel et scolaire. Utilisant une approche participative et ethnographique sur sept mois, de novembre 2022 à juin 2023, cette étude qualitative examine comment les adolescentes âgées de 13 à 15 ans scolarisées dans des établissements secondaires du premier cycle dans deux districts de Bali, en Indonésie, obtiennent et utilisent des informations en ligne pour en savoir plus sur la santé menstruelle. Les résultats proviennent de 20 discussions de groupe; des séances ont eu lieu cinq fois avec chaque groupe dans quatre écoles. Quatorze participantes ont aussi complété des journaux personnels (solicited diaries) et cinq ont participé à des entretiens. Les données sont également tirées de l’observation des participantes dans les écoles et les espaces communautaires. Nous avons constaté que les informations informelles en ligne constituent une source importante d’apprentissage sur la santé menstruelle et qu’elles sont accessibles par des recherches actives et des rencontres fortuites. Les motivations pour avoir accès aux informations en ligne et pour les utiliser étaient spécifiques aux besoins des participantes en matière de santé menstruelle. Nous avons remarqué que l’information en ligne présentait des occasions d’apprentissage personnalisé et pratique. Néanmoins, elle comportait aussi des risques associés à une information excessive et inadaptée qui suscite des inquiétudes et renforce les mythes autour des menstruations. Nos résultats mettent en évidence la nécessité de tenir compte des informations informelles en ligne dans les recherches et programmes futurs sur la santé menstruelle, en particulier dans les contextes présentant un niveau élevé de connectivité mobile chez les jeunes. La información suficiente y veraz es un requisito para la salud menstrual y apoya a las adolescentes en ejercer sus derechos humanos. A medida que la conectividad móvil aumenta a nivel mundial, muchas personas jóvenes posiblemente busquen o encuentren información digital sobre salud menstrual por medio de plataformas en internet, redes sociales o aplicaciones sobre salud. A pesar de la relevancia de la información digital, las investigaciones y los programas de salud menstrual se han centrado en el aprendizaje formal y escolar. Utilizando un enfoque participativo y etnográfico durante siete meses, desde noviembre de 2022 hasta junio de 2023, este estudio cualitativo explora cómo las adolescentes entre 13 y 15 años, en escuelas secundarias en dos distritos de Bali, Indonesia, obtienen y utilizan información digital para aprender sobre salud menstrual. Los hallazgos provienen de 20 discusiones en grupos; se llevaron a cabo sesiones cinco veces con cada grupo en cuatro escuelas. Catorce participantes también llevaron diarios solicitados y cinco participaron en entrevistas. Además, se obtuvieron datos por medio de la observación participante en escuelas y espacios comunitarios. Encontramos que la información informal digital es una fuente significativa del aprendizaje sobre salud menstrual y es obtenida por medio de búsquedas activas y encuentros incidentales. Las motivaciones para obtener y utilizar información digital estaban relacionadas específicamente con las necesidades de salud menstrual de las participantes. Encontramos que la información digital presentaba oportunidades para el aprendizaje personalizado y conveniente. Sin embargo, también presentaba riesgos asociados con información excesiva e inadecuada que causaba preocupación y reforzaba los mitos menstruales. Nuestros hallazgos destacan la necesidad de considerar la información digital informal en futuras investigaciones y programas sobre salud menstrual, en particular en contextos con alto nivel de conectividad móvil entre jóvenes. Informasi berkualitas memberikan remaja akses terhadap kesehatan menstruasi sekaligus mendukung kesadaran mereka akan hak asasi manusia. Mayoritas remaja mengakses informasi kesehatan menstruasi secara daring melalui situs web, media sosial, atau aplikasi kesehatan. Meskipun informasi daring semakin relevan, pemahaman kita tentang bagaimana remaja mengakses dan menggunakan informasi daring untuk kesehatan menstruasi sangat jauh dari kata cukup. Penelitian ini dilakukan dengan kajian kualitatif pada 24 remaja putri berusia 13-15 tahun di sekolah menengah pertama di dua kabupaten di Bali, Indonesia (Kabupaten Gianyar dan Kota Denpasar). Penelitian ini bertujuan untuk memahami bagaimana remaja mengakses informasi daring dan apa yang mereka pahami dari informasi tersebut terkait menstruasi. Sebanyak lima kegiatan diskusi kelompok dilakukan di setiap empat sekolah menengah pertama. Selanjutnya, dilakukan lima wawancara mendalam, aktivitas buku harian singkat, dan observasi partisipan. Hasil dari penelitian ini menegaskan bahwa sumber daring berperan penting untuk informasi kesehatan menstruasi. Partisipan menyatakan bahwa mereka secara aktif mencari informasi kesehatan menstruasi melalui mesin pencari (Google) dan/atau menemukannya secara tidak sengaja melalui media sosial, khususnya platform video pendek TikTok. Sebagian besar partisipan berpendapat bahwa informasi daring membawa dampak positif. Selain itu, mereka menyatakan bahwa platform daring menawarkan informasi yang bersifat pribadi, rahasia, menghibur, dan praktis. Namun, terdapat risiko dari informasi daring tersebut. Terkadang terdapat informasi yang berlebihan yang membuat mereka cemas atau informasi yang salah yang memperkuat mitos tentang menstruasi. Dari penelitian ini dapat disimpulkan bahwa pentingnya program dan kebijakan kesehatan menstruasi untuk lebih memperhitungkan peran informasi daring dan berkomitmen untuk memahami pengalaman hidup remaja. Program atau kebijakan lebih lanjut dapat mengintegrasikan literasi kritis tentang kesehatan dan digital ke dalam pendidikan kesehatan dan pubertas, khususnya di negara-negara yang mengalami perkembangan digital yang pesat, seperti Indonesia.
This study, adopting a person-centered approach and using network analysis, explores latent subtypes of Junzi personality among college students and their links to Receptiveness to Opposing Views, offering empirical backing for the ancient Chinese idea of "Junzi harmonize yet remain distinct." Traditional variable-centered methods often fail to fully expose the underlying typological structure due to the possible heterogeneous combinations in Junzi personality dimensions. Thus, a person-centered latent profile analysis (LPA) was used to pinpoint typical personality trait patterns. With 1116 college students as participants, the study employed the Junzi Personality Questionnaire Based on Confucian Thought and the Receptiveness to Opposing Views Scale. LPA identified three personality types: The Moderate Type (50%), The Daring-Aggressive Type (15%), and The Virtuously-Accomplished Type (35%). Regression analysis showed significant correlations between gender, age, and personality type, with The Virtuously-Accomplished Type scoring notably higher in Receptiveness to Opposing Views. Network analysis further revealed distinct differences in the network structures of Receptiveness to Opposing Views among the three types: The Moderate Type centered on "derogation of opponents," "refraining from what should not be done," and "respectfulness and propriety"; The Daring-Aggressive Type focused on "conversancy with righteousness and cherishment of benign rule," "derogation of opponents," and "respectfulness and propriety"; while The Virtuously-Accomplished Type highlighted "negative emotions" and "wisdom, benevolence, and courage," with "taboo issues" at the periphery in all datasets. The findings uncover the heterogeneity of Junzi personality and its varied associations with Receptiveness to Opposing Views, providing insights for understanding harmonious interactions in diverse settings.
Queer identities in Indian cinema are frequently subject to erasure, sanitization, or sensationalism. Pine Cone, directed by Onir, presents a daring and meditative intervention. Drawing on his own life, Onir crafts a semi-autobiographical narrative that forgoes linear storytelling in favor of a fragmented structure spanning three decades of queer love, longing, and loss. The film follows Sid Mehra, a gay filmmaker, as he navigates different phases of his life and intimate relationships, making visible not only the inner life of a queer man but also the shifting social contours of LGBTQ+ identity in urban India. Rather than offering a singular coming-out narrative or an assimilationist love story, the film interrogates the emotional debris of queer living: conditional acceptance, failed intimacies, temporal displacement, and the politics of visibility.
In Regenerative Medicine, the quest to harness the body's own healing potential is as much a philosophical journey as it is a clinical challenge. Promising interventions-from platelet-rich plasma injections to stem cell therapies-often differ in subtle yet critical ways, leading to variable outcomes. One method might modestly enrich bioactive components, while another yields a preparation bursting with regenerative signals. This variability compels us to ask: should we focus on merely categorizing these diverse approaches, or instead strive to define the fundamental nature of the therapeutic agents we deploy?This Daring Discourse explores the tension between the intricate diversity of human biology and our need for consistency and reproducibility in treatment. Drawing on the parable of the blind men and the elephant, it illustrates how isolated perspectives reveal only fragments of the truth; only by integrating these views can we grasp the full regenerative potential. It further cautions against the rise of "spin wizards"-clinicians who, relying solely on centrifugation without understanding underlying biological determinants, claim a universal cure for degenerative conditions.This narrative advocates for a unified framework that marries innovative techniques with rigorous standardization. Such an approach promises to transform Regenerative Medicine from a field of hopeful experiments into one where treatments are reliably safe and effective, ultimately fulfilling its transformative potential.
Cold case investigations involve revisiting case circumstances and prior evidentiary material. Novel or improved methods better suited to minute, mixed or degraded samples may provide new leads or higher evidential values. Here, we describe a reinvestigation started in 2016 of a 2004 murder case in which the body parts of a young woman were found in five double-bagged rubbish bags in the city of Amsterdam. Resampling and autosomal DNA-profiling of one of the rubbish bags knot areas resulted in a low LR for a man who had had sexual contact just before the victim went missing. This man became therefore suspect in this case. Detailed trace examination of stored upholstering of the backseat of the car of the 2004 victim revealed blood-stained sand particles and small botanical material. DNA profiling presented a match to a young woman who was found naked and brutally murdered on an embankment in Amsterdam in 2003. Both women worked as prostitutes but did not know each other. Moreover, the suspect in the 2004 case was found to have had sexual contact with the 2003 victim shortly before she deceased. A crucial DNA link between the two cases was provided through mitochondrial DNA (mtDNA) analysis of samplings of the rubbish bag knots. Because the 2004 DNA extracts contained insufficient material for autosomal analysis, massively parallel sequencing (MPS)-based mtDNA profiling was performed[1]. At that time, our laboratory had just validated and implemented MPS, allowing detection of minor mtDNA contributions as low as 3 % in mixtures. Remarkably, one sample yielded a match with both the 2004 victim and the suspect, while another matched the 2004 and the 2003 victim. A scenario could be that the suspect used the car of the 2004 victim to dispose not only of her body parts but also of an artefact from the 2003 case. A 2021 court of appeal decision convicted the suspect for both these, and a third, homicide also involving a young prostitute. Looking back, several aspects contributed to resolving the cold case: saving evidentiary items so that these can be reanalysed in later years when methods have advanced, scrutinous trace examination detecting blood-stained sand and botanical particles, furthering (mt)DNA analyses to deal better with low-level mixtures, improved DNA profile interpretation presenting higher evidentiary values by applying a continuous probabilistic genotyping model, and daring to apply these novel techniques in cases and report to the court.
The application of stem cells, mesenchymal stem cells (MSCs), and exosomes/extracellular vesicles (EVs) derived from these stem cells has shown potential advancement in solving several major medical complications. Recent studies on MSC-EVs have gained focus on tissue repair, inflammation, apoptosis, fibrosis, and regenerative medicine. MSC-EVs modulate and play potential therapeutic roles in the treatment of various diseases such as cancer, neurological disorders, and viral infections. In the current study, we provide evidence that human telomerase reverse transcriptase (hTERT)-immortalized MSC-EVs possess a neuroprotective role in Zika virus (ZIKV)-infected murine cortical neurons. The American Type Culture Collection (ATCC) 2022 challenge award (call for proposals to use the product "ATCC SCRC-4000-EXM," hTERT-immortalized MSC-EVs in new, interesting, or daring applications) afforded us the opportunity to test these hTERT-MSC-EV in ZIKV-infected neurons. We found that hTERT-MSC-EV treatment increased the cell viability of ZIKV-infected neurons and decreased the expression of apoptotic markers (Bax, caspases 3/9, and Bcl-2). In addition, hTERT-MSC-EV treatment reduced ZIKV loads in cortical neurons that correlated with increased interferon-beta and decreased TNF-alpha transcripts. Poly I:C (polyinosinic:polycytidylic acid) stimulation and treatment of uninfected cortical neurons with hTERT-MSC-EV showed an increased trend in IFN-alpha levels, but IFN-beta transcript levels were reduced. Furthermore, hTERT-MSC-EV treatment continued to reduce viral loads, even upon Poly I:C stimulation and ZIKV infection. GW4869 inhibition followed by hTERT-MSC-EV treatment revealed that exosome-mediated viral transmission is also affected in ZIKV-infected cortical neurons. Overall, this study suggests a potential therapeutic effect of hTERT-MSC-EV in ZIKV-induced neuronal death and perhaps in controlling exosome biogenesis during viral infections. This study opens new thoughts on how hTERT-MSC-EV could be proposed as a therapeutic potential in ZIKV-mediated microcephaly by enhancing cell viability of ZIKV-infected cortical neurons, inhibiting apoptosis, and reducing viral infection and exosome-mediated transmission in fetal and newborn brains. Zika virus (ZIKV), a mosquito-borne flavivirus that vertically transmits from pregnant women to her fetus, causes microcephaly, a birth defect where newborns show smaller head circumference and brain size compared to normal healthy babies. Microcephalic newborns exhibit several developmental delays and neurological complications. There is no cure or potential therapeutics available to treat ZIKV-caused microcephaly. Human telomerase reverse transcriptase (hTERT)-immortalized mesenchymal stem cell (MSC)-derived extracellular vesicles (MSC-EVs) have been recently proposed as potential therapeutics in the treatment of various diseases, including cancer, neurological disorders, and viral infections. We hypothesized an important role of hTERT MSC-EVs in providing neuroprotective effects upon ZIKV infection in murine cortical neurons. Our study opens new thoughts on how hTERT-MSC-EV could be proposed as potential therapeutics in ZIKV-caused microcephaly, where they enhance cell viability, inhibit apoptosis, and reduce viral infection and exosome-mediated transmission/dissemination of ZIKV-infected murine cortical neurons in embryonic brains.
Sub-Saharan African countries remain adversely affected by the burden of liver cirrhosis, recording the highest age-standardized death rates in the world. Hospital admission represents a measurable proxy of the burden of cirrhosis, driving up healthcare costs and imposing a burden on patients and caretakers. This study was set out to fill a local gap in knowledge of the rate and predictors of readmission among patients with decompensated cirrhosis which is crucial in order to reduce it. We conducted a hospital-based prospective cohort study in the Gastroenterology unit of the Muhimbili National Hospital in Tanzania. Applying consecutive sampling, we recruited 110 consenting patients with decompensated liver cirrhosis 18 years and older admitted between August and November 2023 and followed them up for 90 days after hospital discharge. Patients who underwent transplant, died during the index admission and those discharged against medical advice were excluded. Socio-demographic, clinical and laboratory data were recorded using a structured questionnaire. Follow up post-discharge was done through phone calls. Data analysis was done using STATA version 15.1 (StataCorp, Texas, USA). Continuous variables were summarized as medians with interquartile ranges and categorical variables as counts with percentages. Comparison was done using the Kruskal–Wallis test for continuous variables and Chi-squared test and Fisher exact test for categorical variables. The Robust Poisson regression model was used to analyze for predictors of readmission at 1 and 3 months. A p-value of 0.05 was used to denote statistical significance. Of 110 patients, 71.8% were male. Median age was 44.5. Leading etiology of cirrhosis was alcohol (38.2%), leading decompensating event responsible for index hospitalization was ascites (68.2%). One-month and three-month readmission rates were 20.9% and 30.9% respectively. Predictors of readmission at 1 month were Model for End-stage Liver Disease- Sodium (MELD-Na) score (p = 0.029) and at 3 months were MELD-Na score (p = 0.006) and thrombocytopenia (p = 0.023). We found a high readmission rate among patients with decompensated cirrhosis, similar to literature from other countries. The identification of the MELD-Na score and platelet count as independent predictors of readmission provides valuable insight into risk factors for poor outcomes among patients with cirrhosis.
Anti-inflammatory peptides (AIPs), a class of biologically active molecules with high specificity and low toxicity, demonstrate outstanding potential in replacing traditional anti-inflammatory drugs. In this review, the multiple natural sources of AIPs (including marine organisms, terrestrial plants and animals, and microorganisms) are comprehensively reviewed, and their core molecular mechanisms to inhibit inflammatory responses through the synergistic regulation of key signaling pathways such as NF-κB, MAPK, PI3K/Akt, JAK/STAT, and Keap1-Nrf2 are examined. To address the bioavailability bottlenecks of AIPs' oral delivery, such as gastrointestinal degradation and low intestinal permeability, this review systematically analyzes the mechanisms of action of enhancement strategies, including nanocarrier technologies and chemical modification methods. Finally, we propose cutting-edge future directions such as artificial intelligence-guided design and innovative combination therapies to accelerate their clinical translation. This work provides not only a solid theoretical foundation but also practical insights for the development of AIPs as next-generation anti-inflammatory ingredients.
To investigate reflections on wishes and needs of adults living with the life-threatening disease Duchenne muscular dystrophy (DMD) to target future rehabilitation. Adults with DMD have a short life expectancy with a mean age of death at 26.8 years. Despite this, palliative rehabilitation is sparsely mentioned in standards of care. Relatives and healthcare professionals seem to find it difficult to talk about the future and future care with people living with a life-threatening disease. The design of the study was qualitative using the Interpretive Description Methodology and the salutogenic theory of Sense of Coherence (SOC) as the theoretical framework. The method was individual semi-structured interviews with 13 adult men with DMD. The interviews were conducted from February to March 2025. Navigating life with DMD was considered a condition of life, and being able to accept and adapt to uncertainties were effective coping mechanisms affecting the participants' overall SOC. Furthermore, living with a life-threatening disease was managed by living one day at a time, finding solutions, taking life as it comes, and getting the best out of it. Also, having dreams like everybody else, despite the uncertain future, was important. Finally, talking about future care felt strange to the participants, but it was easier if someone dared to ask directly. Timing and addressing individual needs were essential. Adults living with DMD appreciated the opportunity to talk about their wishes and needs for the future. Healthcare professionals are recommended to initiate conversations about biopsychosocial and existential issues, and palliative rehabilitation is recommended throughout the DMD lifespan with attention to individual needs, timing, and state of the disease. Wishes and needs of adults living with Duchenne Muscular Dystrophy This study investigated how adults living with Duchenne Muscular dystrophy (DMD) in Denmark reflected on their wishes and needs for the future. Although life expectancy with DMD is short, palliative rehabilitation is sparesly mentioned in care programs and rarely talked about with health care professionals. The design of the study was qualitative, and 13 adults were interviewed from February to March 2025. The study emphasized that adults living with DMD were good at coping with their disease and adapting to uncertainties. They took one day at a time, found solutions, took life as it came and got the best out of it. They had dreams about the future like everybody else even though it was uncertain. They were unfamiliar with talking about future care but found it easy when asked directly. The participants in this study appreciated the opportunity to talk about future wishes and needs. We recommend that healthcare professionals start conversations about thoughts, wishes and needs for future care with patients who live with a life-threatening disease. We recommend that people with DMD receive palliative rehabilitation throughout their lifespan which is adjusted to individual needs, timing, and state of the disease.
Cross-border migration presents increasing challenges to healthcare systems globally. Ensuring equitable healthcare access for immigrant populations, particularly in Southeast Asia, requires a thorough understanding of the barriers to effective service delivery. This scoping review aimed to synthesize the existing literature on the challenges related to the delivery of healthcare services to immigrant communities from Southeast Asia. While previous studies (e.g., Brandenberger et al., 2019) applied the 3C framework to migrants and refugees globally, this review generates new insights by focusing specifically on Southeast Asia, a region underrepresented in the literature. By applying the 3C model in this context, our review identifies region-specific challenges, such as immigration policies, financial barriers, and COVID-19 impacts, that extend beyond the findings of earlier global reviews. A comprehensive search was conducted in ProQuest, PubMed, ScienceDirect, and Scopus databases on October 13, 2024, for studies published between January 1, 2011, and October 13, 2024. The search strategy used tailored keywords, including "challenges," "healthcare services," "immigrants," and "Asia." Inclusion criteria focused on peer-reviewed, English-language articles reporting on challenges in healthcare service delivery among immigrant populations in Southeast Asia. Data extraction and synthesis were guided by the 3C model: communication, continuation of care, and confidence in the healthcare system. The search identified 656 records, of which 7 studies met the inclusion criteria after a multi-stage screening process. Key challenges identified across the included studies were: Communication barriers, including language differences, cultural misunderstandings, and limited health literacy; Issues with continuation of care, such as poor health literacy, difficulties navigating healthcare systems, barriers to accessing services (e.g., due to legal status or financial constraints), and lack of coordination between healthcare and social services; and Lack of confidence in the healthcare system, stemming from distrust, lack of understanding, and negative experiences, including perceived discrimination. This review highlights the complex challenges in delivering healthcare services to immigrants from Southeast Asia. These challenges, encompassing communication, continuation of care, and confidence, necessitate targeted and multifaceted interventions. Addressing these issues through culturally competent care, enhanced communication strategies, and policy reforms that promote equitable access is crucial for improving the health and well-being of immigrant populations and fostering more inclusive healthcare systems within the region.
Recent national surveys show that anaemia affects approximately 30-40% of school-aged children and up to 50% of adolescents in Tanzania, with prevalence exceeding 50% in some regions, underscoring the urgent need for nutrient-dense, school-appropriate food solutions. This study developed snack bars from biofortified crops and compared partially germinated and non-germinated formulations to improve the diets of school-aged children and adolescents. Germination significantly (P ≤ 0.05) increased carbohydrate, fat, fibre, and provitamin A content. Zinc content was slightly higher in the germinated bars, whereas iron content was slightly lower compared to the non-germinated formulation. Both formulations supplied 50-70% of the Recommended Dietary Allowances for carbohydrate, protein, fibre, iron and zinc iron aligning with Tanzania's School Feeding Policy targets. Sensory testing showed higher acceptance of germinated ingredient's snack bars for texture, colour, aroma and overall acceptability, while non-germinated bars were preferred for appearance and taste. These results demonstrate that both germinated and non-germinated biofortified snack bars can provide substantial amounts of essential nutrients in a child-friendly form. To our knowledge, this is the first study in Tanzania to develop germinated biofortified crop-based snack bars, offering a scalable, culturally acceptable approach to reducing micronutrient deficiencies among school-aged children.
Artificial photosynthesis (APS) is using light for uphill chemical reactions that converts light energy into chemical energy. It follows the example of natural photosynthesis, but offers a broader choice of materials and components, which can enhance its performance it terms of application conditions, stability, efficiency, and uphill reactions to be carried out. This work presents here first the status of the field, just to focus afterward on the current problems seen at the forefront of the field, as well as discussing some general misunderstandings, which are often repeated in the primary literature. Finally, this perspective article is daring to define some grand challenges, which have to be tackled for the translation of APS into society.
The utilization of robots in the food industry, including restaurants and cafés, has increased in recent years. This study investigated participants' responses to robots in the serving and cooking domains, which require varying degrees of consumer interactions. This study examined expected liking and willingness to try food prepared or served by robots at three levels of anthropomorphism, along with associated emotional responses. Participants were divided into a group that received positive information about robot (n = 845) and a control group (n = 870). Compared to the control group, the informed group showed significantly higher ratings for the expected liking (p < 0.05) and willingness to try (p < 0.05) food from cooking robots. For serving robots, only willingness to try (p < 0.05) was higher in the informed group. The informed group also demonstrated more positive emotions (adventurous, secure, curious, daring, interested, and trusting) and fewer negative emotions (disgusted, disagreeable, and bad) than those of the control group. For the varying levels of cooking and serving robots, the ratings of consumers' expected liking and willingness to try food were significantly decreased (p < 0.05) as robots are became more human-like. In the emotional change, the lower the level of anthropomorphism, the stronger the positive emotions and the weaker. Considering the current labor shortages and rising costs in food service sector, appropriate designed robots can effectively enhance consumer acceptance of robot-prepared or robot-served food.
Parkour is a modern sport known for daring jumps and moves in urban environments that require exceptional motor skills and various sports-specific techniques. Although it is increasingly popular among children and adolescents, training routines in youth Parkour are still rather driven by personal beliefs and experience of coaches than by evidence. This study aims to analyze basic motor skills and physical fitness of youth Parkour athletes compared to team sports athletes. Cross-sectional study with matched-pair analysis. Seventeen youth Parkour (12.50 ± 1.80 years) and seventeen team sports athletes (11.90 ± 1.70 years), matched for height and weight, participated in this study. Tests included static (single-leg postural sway = PS) and dynamic balance (Y-Balance test = YBT), jumping (countermovement jump = CMJ, drop jump = DJ, side-hop = SH), muscle strength (planks, pull-ups = PU) and basic gymnastics skills (bridging = BG, handstand = HS, cartwheel = CW). The Parkour group performed significantly better in the CMJ ( p  = 0.014), the anterior direction of the YBT ( p  < 0.001), cartwheel performance ( p  = 0.019), and pull-ups ( p  = 0.029) when compared to the team-sports group. Moderate but non-significant differences were observed in PS for the dominant (p = 0.12) and non-dominant leg (p = 0.14) as well as in SH (p = 0.06). No further significant differences were observed. Children practicing Parkour demonstrated superior performances in certain parameters of motor skills and physical fitness compared to team sports athletes. The findings suggest that Parkour may contribute positively to children's overall physical development. However, more intervention studies with a prospective study design are needed for further recommendations.