This study examines how individuals "do gender" in their help-seeking for psychotherapy, focusing on the facilitators that support entry into treatment and the ways these are articulated by women and men. A qualitative study design was adopted, guided by the theoretical framework of doing gender and complemented by a mixed-methods component. Narratives from 43 psychotherapy patients who identified as female or male were analysed using qualitative content analysis. This was supplemented by a word count analysis. Women often relied on female social and professional networks, valued empathy and emotional sensitivity, and described their treatment choices in a more assertive way. Men more frequently adopted structured, problem-focused reasoning, at times linking therapy to the restoration of social and professional functioning and invested more effort in selecting a therapeutic approach. Findings highlight the importance of gender-responsive communication strategies in mental health care: relational and empathetic aspects may resonate more strongly with women, whereas practical, goal-oriented benefits may be particularly effective for men. At the same time, approaches must remain flexible to account for diversity and fluidity in gender identities. Future research should include younger, non-binary and gender-diverse groups.
Global increases in armed conflict, forced displacement, pandemics and economic instability have contributed to rising levels of psychological distress worldwide, placing relevant segments of the population at increased risk of developing mental health conditions. This burden is particularly pronounced in humanitarian and low-resource settings where access to specialist mental health services is limited. Scalable, low-intensity, evidence-based psychological interventions are therefore urgently needed. In response, the WHO has developed transdiagnostic programmes, including Self-Help Plus (SH+) and Doing What Matters in Times of Stress (DWMS). Although these interventions are increasingly implemented across humanitarian and public health contexts, evidence for their effectiveness and implementation has not yet been systematically synthesised. This preregistered systematic review and meta-analysis will be conducted in accordance with Cochrane Collaboration standards and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We will include randomised controlled trials evaluating the effectiveness of SH+ or DWMS, alongside qualitative and mixed-methods studies examining their implementation among stressor-exposed individuals of any age. Outcomes will include symptoms of depression and anxiety, general distress and post-traumatic stress symptoms. Moreover, we will examine effects on well-being, psychosocial functioning, adverse events and implementation outcomes (eg, acceptability, feasibility, fidelity). We will search Cochrane CENTRAL, APA PsycNet, Web of Science Core Collection, Embase and Scopus for records published from 2016 onwards. Searches will be supplemented by hand-searching preprint repositories and citation tracking. Risk of bias will be assessed using the Revised Cochrane Risk of Bias Tool and a customised appraisal tool for studies on implementation. Quantitative data will be synthesised using random-effects multilevel meta-analyses, with meta-regression models applied to examine moderators. Bayesian meta-analyses will be conducted where appropriate as sensitivity analyses to assess the robustness of the findings. Certainty of evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Ethical approval is not required. Findings will be disseminated through an open-access peer-reviewed publication, a plain-language summary, and the Open Science Framework, where all materials will be made publicly available. CRD420251168521.
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Orb web construction behavior offers unusual advantages for understanding the mental processes of an arthropod, because an orb weaver's intentions, perceptions, and decisions can be deduced in some contexts by observing the movements of her legs, just as one can make similar deductions from observing how a blind man moves his cane. This study shows that when spiders of two species were experimentally interrupted during orb construction, they remembered for up to several minutes the portion of the web in which they had been working, the type of activity in which they had been engaged, the direction in which they had been moving (left vs right, clockwise vs. counterclockwise), and the location of the hub. Biases in the searching behavior of legs in other contexts revealed apparent expectations regarding the sites and angles of the lines for which the spider was searching. These observations, combined with previous demonstrations of the ability to remember the distance travelled along a radial line, indicate that orb weavers possess the information necessary to form mental representations of their webs. The behavioral phenomena demonstrated here fit Merker's triangular dependency model of animal awareness.
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Difficult facemask ventilation is an entity that lacks a robust definition, leading to inconsistent identification in clinical practice and research. The aim of this study was to develop and validate an objective classification and numeric score for difficult facemask ventilation. Four hundred patients who required tracheal intubation for ear, nose and throat or maxillofacial surgery participated in this prospective single centre study. After induction of anaesthesia, facemask ventilation was attempted using pressure-controlled mechanical ventilation. The primary outcome was difficult facemask ventilation documented as an alert in the patient health records. An independent observer assessed for potential indicators of difficult facemask ventilation: two-handed grip; oral airway use; jaw thrust; senior consultant anaesthetist taking over; conversion to manual rescue ventilation; peripheral oxygen saturation drop; tidal volume; and leak fraction. Difficult facemask ventilation occurred in 43 (10.8%) patients. Five eligible indicators were selected by cross-validated least absolute shrinkage selector operator regression and used to develop a multivariable logistic regression model (MASCAN model) and score (MASCAN score). These indicators were: two-handed grip; oral airway use; jaw thrust; tidal volume ≤ 2 ml.kg-1; and peripheral oxygen saturation drop ≥ 10%. The area under the receiver operating characteristic curve was 0.96 (95%CI 0.93-0.98) for the MASCAN model and 0.94 (95%CI 0.91-0.98) for the MASCAN score. The MASCAN score is an objective, data-driven classification for difficult facemask ventilation with clearly defined thresholds that may improve airway documentation and inform future airway management. Researchers studied 400 patients having head and neck surgery. After the patients were given an anaesthetic, doctors used a facemask to ventilate them. The researchers looked for signs that facemask ventilation was difficult, such as using two hands to hold the mask, using an oral airway tool, doing a jaw thrust, low airflow into the lungs or seeing oxygen levels drop. They then created a new classification system called the MASCAN score to help measure how difficult facemask ventilation was. Doctors sometimes find it hard to ventilate patients with a facemask during anaesthesia. There has not been a clear and reliable way to measure and document this problem. The researchers wanted to create a simple and objective system that doctors could use to communicate difficult facemask ventilation more easily and accurately. About 1 in 10 patients had difficult facemask ventilation. The researchers found five important signs that reliably describe difficult facemask ventilation. These include using two hands to hold the mask, using an oral airway tool, doing a jaw thrust, low airflow into the lungs and a drop in oxygen levels. The new MASCAN score was very good at classifying difficult facemask ventilation and may help doctors improve their record keeping and future patient care.
Prior research has explored factors influencing COVID-19 vaccine decision-making among older adults at the national level, but limited work has focused on this population within the Southeastern U.S. context or compared vaccinated and unvaccinated older adults within the same study. To examine COVID-19 vaccination decision-making in the U.S. South among a sample of vaccinated and unvaccinated adults aged 65 years and older. A cross-sectional, mixed methods study design was conducted from November to December 2021. Groups and interviews were stratified by whether participants were fully vaccinated or not against COVID-19. The study's sample draws on insights from 73 participants aged 65 years and older purposively recruited from three Southeastern U.S. states with various COVID-19 vaccination statuses. Online focus groups, interviews, and a pre-group questionnaire were conducted. Analysis of transcripts leveraged a line-by-line, team-based coding approach drawing on perspectives from grounded theory and thematic analysis. Questionnaire data were analyzed descriptively and via bivariate testing. All data were analyzed separately, but in parallel, and merged for confirmation and expansion using a narrative weaving approach. Results from the study indicated both vaccinated and unvaccinated participants' COVID-19 vaccination decision-making leveraged similar processes, including "doing their own research" and having conversations with trusted others like adult children or personal healthcare providers. Vaccinated participants more often described getting a COVID-19 vaccine to avoid death, protect loved ones, or because they trusted its development. Unvaccinated participants more often expressed a lack of trust in the vaccine due to its novelty, potential side effects, and the politicized environment surrounding its development and deployment. Results underscore the need for patient-centered communication strategies, trusted local health information resources, and expanded vaccine access efforts that meet older adults where they are to promote informed COVID-19 vaccine decision-making among those aged 65 years and older.
Multiple myeloma (MM) remains an aggressive and largely incurable plasma cell malignancy, with relapse common despite therapeutic advances. Although CAR-T cells have transformed the field, their clinical use is constrained by toxicity, complex manufacturing, and limited accessibility. These limitations have accelerated interest in CAR-engineered natural killer (CAR-NK) cells as a safer, more scalable, and potentially off-the-shelf immunotherapeutic platform. This review goes beyond a descriptive summary of CAR-NK research in MM by providing an integrated framework that connects antigen targeting, synthetic engineering, tumor microenvironment adaptation, biomarker-guided response monitoring, and translational manufacturing barriers. In doing so, it highlights not only what has been achieved, but also what currently limits clinical implementation and where the field is most likely to advance next. We performed a comprehensive literature analysis of preclinical and clinical studies on CAR-NK cell therapy in MM, focusing on target selection, persistence-enhancing strategies, immune evasion, biomarker development, combination approaches, and GMP-compatible manufacturing platforms. CAR-NK cells offer several advantages over CAR-T therapy, including lower risks of cytokine release syndrome, neurotoxicity, and graft-versus-host disease. Beyond summarizing currently explored targets such as BCMA, CD138, SLAMF7, and GPRC5D, this review identifies the main design principles driving next-generation CAR-NK development: cytokine armoring, genome editing, dual-targeting strategies, and nanotechnology-enabled delivery. Importantly, we also synthesize emerging translational priorities, including predictive biomarkers for patient stratification, serial monitoring of treatment response, and scalable closed-system manufacturing approaches that may determine clinical feasibility. CAR-NK therapy is evolving from a promising concept into a realistic therapeutic platform for MM. This review contributes a forward-looking translational roadmap by integrating engineering innovation, biomarker-based precision medicine, and manufacturing scalability, thereby defining the key steps needed to move CAR-NK cells toward durable and clinically meaningful impact in refractory MM.
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have become the standard first-line treatment for advanced non-small-cell lung cancer (NSCLC) with EGFR mutations. As resistance to EGFR-TKIs is associated with significantly worse prognosis, there is a critical need to understand the mechanisms underlying resistance and to develop effective subsequent treatment strategies. Immune checkpoint inhibitors (ICIs) show remarkable efficacy in treating solid tumors, including melanoma, esophageal cancer, and NSCLC. The role of immunotherapy in EGFR-TKI-resistant cases has generated varied perspectives among researchers. This article reviews findings on the interplay between EGFR, the tumor microenvironment, and ICIs, as well as recent advances in post-EGFR-TKI resistance treatment strategies. By doing so, this review aims to provide insights for research and clinical management of EGFR-TKI-resistant NSCLC.
Slaughter without prior stunning as practiced under Jewish and Islamic religious law raises certain particular animal welfare issues, notably the time between the incision and loss of consciousness (LOC). LOC marks the point at which cortical processing required for perception, including pain, is no longer possible. Quantifying time to LOC in animals is challenging. To date, the most direct and potentially objective means of doing so is the use of electrophysiologic methods. These are the focus of this paper. This paper includes a concise discussion of electrophysiology as applied to slaughter, addressing a critical gap in foundational electrophysiologic knowledge required to interpret LOC and insensibility in the veterinary literature. Then, using a PRISMA-guided systematic approach, this review synthesizes neurophysiologic evidence on time to LOC in cattle. A review was conducted using PubMed/MEDLINE, Web of Science, Cochrane Library, and Google Scholar (through December 2025). Experimental cattle studies using EEG, ECoG, or evoked potentials were included, while non-bovine, behavioral-only, or methodologically insufficient studies were excluded. Nine studies were included, and risk of bias was assessed using ROBINS-I. Overall risk of bias across included studies was judged to be moderate. Studies using electrocorticography (ECoG) reported electrophysiologic markers consistent with LOC occurring between 4.4 and 13 seconds after incision, with mean values ranging from 7.5 to 10.8 seconds. Reported times vary across studies, particularly those using scalp EEG, likely due to methodological differences and limitations. The highest-quality available electrophysiologic data, suggests that LOC occurs rapidly following slaughter without stunning.
The study examines sibling brokerage as a form of cultural, linguistic and institutional labour performed by siblings of individuals with intellectual and developmental disabilities from historically marginalised communities. Ten adult sibling brokers were recruited and completed open-ended questionnaires. Data were analysed thematically, guided by conceptual frameworks of epistemic injustice. Findings reveal that sibling brokers serve as system navigators, translating institutional logics, advocating for services and rearticulating family knowledge. Their labour often began in childhood, was shaped by hegemonic expectations to fit into the system and was frequently unacknowledged or co-opted by professionals. Sibling brokerage is not ancillary but structurally embedded labour that compensates for systemic gaps in accessibility and inclusion. Future research should examine how such roles are institutionally produced and sustained and envision justice-oriented systems that recognise the expertise of sibling brokers. This study explores the experiences of siblings who help their families navigate disability services for a brother or sister with intellectual or developmental disabilities' service access, namely, sibling brokers. Many of these sibling brokers, especially from culturally and linguistically diverse communities, take on important roles like translating, interpreting, filling out forms and advocating for services—often starting at a young age. Their work goes far beyond helping out at home; they are doing important tasks usually handled by trained professionals, yet their efforts are often overlooked or taken for granted. This research calls for greater recognition of sibling expertise and urges systems to support these siblings with appropriate acknowledgement.
Members of the multidisciplinary healthcare team all have an important role to play in conducting clinical research and implementing its findings, yet researchers continue to face challenges in recruiting and retaining participants. In maternity research, midwives are often integral to the success of studies; however, their views about their role are often overlooked or underreported. The principal aim of this scoping review is to explore and synthesise literature on midwives' views of being involved in clinical research, both as facilitators and participants. Through this synthesis, we explore how clinical research is undertaken and what shapes it in settings where midwives provide the majority of care. Using Askey and O'Malley's scoping review approach, we undertook systematic searches and screening to identify relevant articles published between 1993 and 2026. A reflexive, interpretive process of thematic analysis was employed to analyse and synthesise data extracted from articles. Eighteen articles were eligible for review and analysis. Our analysis identified four themes: Being involved, Midwifery worldview, Involving others and Ethicality. The themes are interconnected and touch on issues of communication, knowledge, time and midwives' professional identity and expertise. Despite the increasing amount of clinical research on maternity care, there is comparatively little published on midwives' views of the research process, particularly from outside of the UK. There is also a compelling case for reassessing the ethics of doing research during labour and birth, especially concerning informed consent.
Interpersonal emotion regulation is a central means through which people seek and provide emotional support. Understanding people's motives for engaging in interpersonal emotion regulation-and how these motives relate to the strategies they report receiving from and providing to others-can reveal the potential alignment or mismatch in why certain regulation strategies are deployed. In two daily life studies (Ntotal = 402), we captured interpersonal emotion regulation from the perspective of the person soliciting emotion regulation from others (i.e., intrinsic regulation) and providing emotion regulation to others (i.e., extrinsic regulation). In doing so, we explored whether people's regulation motives (i.e., to feel better, get work done, build relationships, and seek or provide perspective) predicted their perception of the regulation strategy (i.e., reappraisal, valuing, distraction, and suppression) they received from and provided to others in everyday social interactions. We found motives people held for turning to others to regulate their own emotions were largely not associated with strategies they reported receiving. However, motives people held for regulating others' emotions were associated with strategies they themselves provided. For instance, people reported making others feel valued and cared for more when holding a motive of wanting others to feel better, recommended suppressing emotions less when holding a motive to build social bonds, and encouraged reappraisal more when holding a motive to provide advice and perspective. Overall, our research highlights a potential gap between the emotional support people want from others and the emotional support they feel they receive, pointing to an avenue of intervention to improve relational and individual well-being. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
This study aimed to systematically evaluate the effects of Baduanjin exercise on mental health, sleep quality and fatigue among university students, explore the influence of intervention parameters on the outcomes, and assess the methodological quality of relevant randomized controlled trials (RCTs). In doing so, it addresses the current evidence gap regarding this non-pharmacological intervention, which remains fragmented despite the limitations of conventional mental health approaches. Systematic searches were conducted in both English and Chinese databases to identify RCTs comparing Baduanjin intervention with routine care measures, covering all literature published up to January 15, 2026. Statistical analyses were performed using Review Manager 5.4 and Stata/SE 15.1, and subgroup analyses were conducted to explore how variations in intervention parameters influenced the measured outcomes. A total of 36 RCTs involving 3,233 university students were included in the systematic review, of which 35 studies with 2,846 participants were eligible for meta-analysis. Baduanjin practice significantly improved overall mental health (Symptom Checklist-90, SCL-90: 95% CI: -0.27 to -0.10, p < 0.0001), alleviated depressive symptoms (Self-Rating Depression Scale, SDS: 95% CI: -5.67 to -3.00, p < 0.0001), anxiety (Self-Rating Anxiety Scale, SAS: 95% CI: -6.30 to -1.73, p = 0.0006), reduced negative mood states (Profile of Mood States, POMS: 95% CI: -10.73 to -3.57, p < 0.0001), perceived stress (Perceived Stress Scale/Chinese Perceived Stress Scale, PSS/CPSS: 95% CI: -0.77 to -0.08, p = 0.02), and fatigue (Fatigue Scale-14, FS-14: 95% CI: -1.55 to -0.46, p < 0.0001), while enhancing sleep quality (Pittsburgh Sleep Quality Index, PSQI: 95% CI: -3.41 to -1.74, p < 0.0001). Subgroup analyses suggested practicing Baduanjin three sessions per week may be most beneficial for general mental health (SCL-90), and a duration of 12 weeks or less may be more effective for reducing depressive symptoms (SDS) based on current evidence. Follow-up assessment indicated that improvements in sleep and stress were not sustained after intervention cessation. The overall methodological quality of included studies was moderate. Regular Baduanjin practice effectively improves mental health, sleep quality, and subjective fatigue among university students. A frequency of a three-times-weekly schedule and a duration of up to 12 weeks appears to be associated with more favorable effects on selected outcomes. Given its low cost, ease of standardization, and scalability, Baduanjin may be considered as a potentially valuable complementary intervention for college mental health promotion. Future research should enhance methodological rigor to validate these findings and investigate the long-term maintenance mechanisms of therapeutic effects.
This article reports on the feasibility, acceptability of a trial design, and results of ¡Coma, Muévase y Viva!, an adapted version of the Eat, Move, Live! Curriculum, a 10-week diet and lifestyle change intervention for low-income Latina and Indigenous Mexican women in rural Inland Southern California. A pilot randomized intervention and wait-list controlled parallel trial. Latina and Indigenous Mexican women participated in ¡Coma, Muévase y Viva!, the adapted version of the curriculum customized for Spanish speakers with a focus on health literacy, cultural norms and values, and delivered by community health workers/promotoras. Participants were randomized into the intervention (n=19) or wait-list control (n=16). Most were Latino (88%), mothers (75%), and foreign born (87%). The adapted intervention was feasible and acceptable with 87.5% of participants retained at three months. The intervention was delivered with high fidelity. Intervention compared to control participants reported success with predetermined prioritized goals (OR=0.25, 95% CI: 0.06-0.99, p=0.03), showed a greater likelihood of cooking healthier food (OR=4.87, 95% CI: 1.04-22.90, p=0.05), enjoyment of cooking healthy meals (OR=3.94, 95% CI: 0.87-17.92, p=0.08), and doing physical activities (OR=5.30, 95% CI: 1.16-24.24, p=0.03). Healthy eating and physical activity as primary outcomes indicated the intervention group was more likely to eat healthy and be active (OR=2.08, 95% CI: 1.12 ∼ 3.89, p=0.02). The adapted intervention was feasible and acceptable and indicated an effect on dietary and lifestyle behavior change with significant changes in meeting desired goals and engaging in healthy eating and physical activity.
Protein functionalization is intrinsically solvent-dependent, with ionic liquids (ILs) capable of significantly perturbing protein dynamics through interactions with peptide backbones. As the correlated motion of peptide regulates intramolecular signal transmission, IL-dipeptide interactions critically influence protein structure and functional regulation, emphasizing the importance of their molecular-level investigation. In this study, we considered a set of dipeptides (AA) classified as neutral and ionic (mono and di) AA to explore their interaction phenomena with IL: [EMIM][TFSI]. In doing so, interactions between IL and individual amino acids (A) were also examined to establish residue-level insights. Our results reveal that each AA exhibits a distinct interaction profile with the IL, where the dominant interaction domain involves either the EMIM/TFSI or cooperative contribution from both, depending on the chemical nature of the constituent A. Notably, electrostatic nature dominates in an IL-ionic AA complex, whereas dispersion energy emerges as the primary stabilizing factor in IL-AA complexes involving aromatic A. Overall, molecular basis of AA-IL interaction profiles establishes a robust understanding of peptide-mediated solvent dynamics and activity regulation of protein in IL.
Liposomes are promising nanocarriers because of their ability to encapsulate and deliver therapeutic cargo with wide-ranging physicochemical properties. However, liposome delivery could be improved by enhancing triggered release of cargo and particularly doing so in a manner that is selective toward diseased cells. Reactive oxygen species (ROS) provide exciting targets to explore as triggers for the development of stimuli-responsive liposomes due to substantial differences in ROS abundance between diseased versus healthy cells. While our group previously reported ROS-responsive liposomes using a synthetic lipid switch, polar cargo release was slow and limited using our original platform. Herein, we report an improved ROS-responsive lipid switch (2) containing an ROS-responsive boronate ester headgroup attached using an advanced self-immolative linker (SIL) bearing an electron-donating methoxy substituent to a lipid scaffold. Both hydrophobic and hydrophilic fluorescence-based dye release assays showed that liposome formulations including lipid switch 2 were initially stable but successfully released cargo when treated with hydrogen peroxide. Furthermore, dynamic light scattering (DLS) analysis was used to characterize changes in the size and dispersity of liposomes before and after treatment. Ultimately, lipid 2 enabled dramatically faster polar dye cargo release at a lower percentage of incorporation compared to our initial lipid switch. Such improvements increase the prospects of ROS-responsive liposomes for delivery applications.
Nest architecture in social insects is often viewed as a static structural component providing shelter or storage1. However, the extent to which these constructed environments actively shape biological traits remains poorly understood. Although the genetic and nutritional drivers of honey bee caste determination are well established2-4, the role for specialized queen cells has largely been attributed to spatial or structural factors, overlooking the influence of the physicochemical microenvironment5. Here we show that worker construction behaviour actively engineers a physicochemical niche that is crucial for queen development in honey bees. Queen cells exhibit distinct mechanical and chemical signatures that differ markedly from those of worker cells. These properties are not an accidental by-product of worker cell construction: workers construct queen cells deliberately and, in doing so, undergo task-specific physiological and transcriptomic reprogramming that enables precise engineering of these cell properties. Experimental manipulations of the rearing environment demonstrate that these physicochemical cues are causally required for normal queen development, functioning as a critical checkpoint that can profoundly influence an individual larva's development. Together, our results establish a direct mechanistic link between social construction behaviour and developmental plasticity, revealing how an engineered environment can channel organismal fate.