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Beta-band (13-30 Hz) oscillations in the cortico-basal ganglia-thalamic (CBT) network strongly correlate with motor deficits in Parkinson's disease (PD), yet their synaptic origins remain unclear. Given that dopamine (DA) loss is necessary but not sufficient to produce sustained beta rhythms, we hypothesised that corticostriatal glutamatergic overdrive may function as a significant non-dopaminergic amplifier of pathological synchrony. Using an integrated experimental-computational approach, we combined 6-hydroxydopamine (6-OHDA) male rat models, ex vivo striatal patch-clamp recordings, chemogenetic modulation of corticostriatal projection, and multiscale computational network modelling to examine beta oscillation dynamics in the CBT network. Early DA denervation caused akinesia without beta elevation, while advanced degeneration triggered robust high-beta (25-40 Hz) oscillations and increased corticostriatal coherence. Ex vivo, medium spiny neurons (MSNs) exhibited heightened presynaptic glutamate release correlated with beta power. Computational modelling showed that excessive corticostriatal input under DA depletion increased MSN synchrony, disrupted striatal decorrelation, and was associated with the emergence of pathological beta rhythms, effects reversed by reducing glutamatergic input. In vivo chemogenetic silencing of corticostriatal projections suppressed beta synchrony and improved motor performance in 6-OHDA rats, whereas activation in DA-intact rats had no effect. Notably, striatal NMDA, not AMPA, receptor blockade reduced beta oscillations and motor deficits. Network simulations implicated the subthalamic → motor cortex feedback loop in the maintenance of this pathological beta state. Corticostriatal glutamatergic overdrive, through NMDA receptor-dependent signalling, is linked to the amplification and propagation of beta synchronisation across the CBT circuit, highlighting it as a potential biomarker and a promising therapeutic target in PD. This research was supported by the National Natural Science Foundation of China (32271173, 82371256) and the Natural Science Foundation of Beijing Municipality (7242214, 7252213). This study was also supported by the Swedish Research Council (VR-M-2020-01652), the Swedish e-Science Research Centre (SeRC), Science for Life Laboratory, KTH Digital Future, EU/Horizon 2020 No. 945539 (HBP 935 SGA3) and No. 101147319 (EBRAINS 2.0 Project), the European Union's Research and Innovation Program Horizon Europe under grant agreement No. 101137289(the Virtual Brain Twin Project).

West Nile virus (WNV) is increasingly reported in Italy, yet its population prevalence remains uncertain. People living with HIV (PLWH) may be at increased risk of WNV severe manifestations, including neuroinvasive disease. This study assessed the seroprevalence and factors associated with WNV seropositivity among PLWH in a large Northern Italian cohort. This retrospective single-center study included all PLWH followed at the Brescia HIV Outpatient Clinic with at least one serum sample collected in 2022 and stored in the institutional sero-repository. Samples were screened for WNV antibodies using ELISA; reactive or borderline samples were confirmed by immunofluorescence assay for IgG and IgM and further characterized by microneutralization assays to differentiate WNV from USUV infection. Associations with seropositivity were evaluated using univariate logistic regression. Among 2,843 PLWH, 76.2% were male, the mean age was 54.1 (&#xb1;&#x2009;10.5), and 87.2% were of Italian origin. Most participants had virologically suppressed HIV infection and were receiving stable antiretroviral therapy (94.2%). WNV serological screening by ELISA identified IgG positivity in 176 participants (6.2%). Of these, 166 tested positive by immunofluorescence assay. Neutralization assays subsequently confirmed WNV seropositivity in 86 participants (3.0%), USUV seropositivity in 12 (0.6%), and dual WNV/USUV neutralizing antibody positivity in 6 (0.2%). No neuroinvasive diseases were reported. Compared with seronegative individuals, seropositive participants were less frequently male (p&#x2009;=&#x2009;0.001), younger (p&#x2009;<&#x2009;0.001) and differed significantly by geographic origin (p&#x2009;<&#x2009;0.001), with a higher prevalence among PLWH born outside Europe. In logistic regression analyses, geographic origin was strongly associated with seropositivity: participants from Africa (OR 21.22, 95% CI 12.49-36.03), Asia (OR&#x2009;=&#x2009;23.31, 95% CI: 10.19-53.31), and the Americas (OR 19.16, 95% CI 9.45-38.83) had markedly higher odds compared with participants of Italian origin (all p&#x2009;<&#x2009;0.001). This is, to our knowledge, the first study evaluating WNV seroprevalence among PLWH. Seroprevalence was higher than that reported in comparable European blood donor populations. In this largely virologically suppressed, stably treated outpatient cohort, no severe manifestations were observed and symptoms were infrequently recalled.

The increasing complexity of genomic medicine has intensified the emotional, ethical, and relational demands placed on genetic counselling professionals. In response to these demands, genetic counselling supervision has been increasingly recognised as a core component of safe and sustainable practice. However, its implementation across Europe remains uneven, and empirical evidence on feasible and acceptable supervision models in clinical settings is limited. This study reports a mixed-methods pilot evaluation of a narrative-informed, group-based genetic counselling supervision programme implemented within Portuguese public genetic services. This is a foundational component of the first phase of the MAG-SUDOE project, a transnational initiative supported by the Interreg SUDOE programme aimed at developing a joint supervision solution for genetic counselling professionals in Portugal, Spain, and France. Eight genetic healthcare professionals were recruited, and seven completed the intervention. Feasibility and acceptability were examined through participation and attendance rates, session evaluations, and assessment of the supervisory working alliance. Preliminary impact was explored using self-report measures of psychological well-being and perceived counselling quality, complemented by qualitative data from written narratives, semi-structured interviews, and a final focus group. The programme demonstrated high feasibility, with strong engagement and completion despite clinical workload constraints, and high acceptability, reflected in positive session evaluations and strong supervisory working alliance. Qualitative findings indicated that participants experienced supervision as a safe and reflective space that reduced isolation, supported emotional regulation, and enhanced reflective awareness. Overall, this pilot study provides promising indications of benefit for reflective practice and professional well-being, supporting its further adaptation and implementation within a transnational European framework.

Increasing taxation is one of the most effective tobacco control policies. However, cigarette taxes in Switzerland remain lower than in other European countries. This study analyses the arguments supporting or opposing an increased taxation that were put forward by members of the Swiss Parliament and by the Swiss Government between 2010 and 2025. Arguments in favour of higher taxes are mainly youth protection and taxation according to product risk. Arguments against higher taxes are mainly illicit and cross-border trade, followed by the negative economic impact. The Government often takes a status quo approach when responding to parliamentary requests.

Hematopoietic cell transplantation, cellular and gene therapies, and (CAR)-T cells have revolutionized outcomes in hematologic disorders. However, major disparities persist in their availability, accessibility, and affordability, particularly in low- and middle-income countries (LMICs). The EBMT Global Committee aims to address these inequalities. A structured survey was distributed to EBMT members to identify regional and thematic priorities, assess current infrastructure, and assess willingness to contribute to global initiatives. Responses were analyzed descriptively and served as the basis for the current statement paper. A total of 145 responses from 43 countries were collected. Most respondents (67.1%) reported working in JACIE- or FACT-accredited centers. The highest priority regions for EBMT outreach were Eastern Europe (non-EU) (43.9%), Latin America (38.2%), and Africa (33.5%), followed by the Middle East (29.5%). The leading thematic priorities were education and training (74.3%), scientific collaboration (56.0%), and registry development (43.4%). Most respondents expressed willingness to actively contribute, particularly in educational activities (59.7%). Qualitative responses emphasized the need for practical guidelines, mentorship programs, telemedicine, virtual discussion/clinical rounds on difficult cases, and support for LMIC capacity building. The EBMT community strongly supports an expanded global role focused on education, capacity building, and collaboration in underserved regions.

Hypoxic ischaemic encephalopathy (HIE) causes significant burdens to families, health care systems, and society. At a multistakeholder meeting organized by the conect4children (c4c) project, families and advocacy groups noted that their voices are under-represented during the planning and execution of research. To provide the voices of a group of HIE families from Europe and North America METHODS: This is an informal description of the personal experience of 6 families with extensive experience of HIE and advocacy. The experiences of these families were captured during teleconferences and e-mail exchanges. The families agreed that high quality clinical care that is timely, well-organized, and evidence-based supports research. Unfortunately, best clinical practice is not universally followed. The literature provides many good practices for incorporating families into all stages of research that need to be implemented. Recommendations for engaging families in research are presented. Effective research will be promoted if families and people with lived experience of neonatal care are part of the study team, and study leadership, at all stages of research. Participation in research by families will be promoted by action to overcome the variations in care that affect families and to promote optimal care in all settings. What does this article add to the existing literature? Hypoxic Ischaemic Encephalopathy merits specific attention in the context of other types of neonatal encephalopathy. Family experience is central to research about hypoxic ischaemic encephalopathy. The voices of families with experience of hypoxic ischaemic encephalopathy are not listened to sufficiently. We propose an action plan to improve research for hypoxic ischaemic encephalopathy in the light of family experience.

South American camelids (SAC; llamas and alpacas) have expanded across Europe, yet registration, traceability and husbandry evidence remain inconsistent. A nationwide, cross-sectional survey of Austrian SAC owners (61 items; Jan-Jun 2024) was distributed via associations, social media and direct outreach. Responses from 448 holdings in all nine federal provinces were analysed descriptively. Most holdings kept alpacas (alpaca only 70.5%; llama only 13.0%; mixed 16.5%). Combining registered holdings with reported herd sizes yielded an estimated national population of about 26,891 SACs-substantially exceeding previous figures, indicating under-ascertainment; non-probability sampling likely introduced selection bias (over-representation of highly engaged owners, under-representation of unregistered or less compliant holdings). Identification and registration were incomplete: 88.8% reported individual animal identification (61.8% microchipping) and 88.9% holding registration. Legal minimum standards were widely met, and meat production was negligible. However, gaps relative to expert guidance persisted: around half of holdings reported fence heights below species-specific recommendations, and isolated single-animal keeping occurred in some mixed-species herds. Predominant uses were fleece production, trekking/walking tours, landscape management and breeding, reflecting many small hobby or part-time farms. Findings indicate a need for individual animal registration, improved traceability with routine reporting of national SAC numbers, integration of administrative and breeder-association datasets, and the inclusion of SACs in national animal health surveillance. Standardised, mandatory owner competency training is recommended, covering the legal framework, husbandry, routine management and care measures, biosecurity and zoonoses. Priorities for research include longitudinal studies of infectious diseases (including zoonoses), uptake of welfare guidelines, and access to veterinary services.

Endometrial carcinoma (EC) is a common gynecological cancer with rising incidence driven by obesity and aging populations. Accurate and timely molecular classification is critical for guiding personalized oncology treatment, especially in early-stage high-grade endometrioid carcinoma. Here we present a large scale, retrospective multicenter validation of a novel POLE-POLD1 mutation assay for use in molecular characterization of EC. We evaluated the analytical performance and robustness of the novel Idylla&#x2122; POLE-POLD1 Mutation Assay, a cartridge-based PCR platform optimized for FFPE tissue. Performance comparators were established NGS reference methods. Overall, 544 formalin-fixed, paraffin embedded (FFPE) EC cases from diagnostic pathology of ten centers in Europe and North America were included. Of 544 samples, 520 revealed POLE-POLD1 test and comparator results, yielding an overall concordance of 97% (PPA of 0.96 and NPA of 0.98). Discordance was limited to a small number of variants and was often associated with low input material or the detection of multiple concurrent variants. The assay demonstrated robust performance across variable FFPE slice thickness (4-10 &#x3bc;m), number of Sects. (1-6), and tumor cell percentage (from 10% to 100%), with an assay invalid rate of only 2.76%. Moreover, the Idylla&#x2122; platform offers rapid results (~&#x2009;2 h) with minimal workflow complexity. The Idylla&#x2122; POLE-POLD1 Mutation Assay is a reliable and rapid diagnostic assay for clinically relevant molecular classification of EC, demonstrating high concordance with NGS and robust performance under routine pathology conditions. Whereas NGS provides comprehensive genomic profiling, including rare variants of unknown pathogenic significance, the Idylla&#x2122; assay targets treatment relevant pathogenic variants with rapid turnaround time, supporting timely, individualized treatment decisions.

The rapid expansion of immuno-oncology (I-O) and other advanced therapies is reshaping the complexity of early-phase clinical development. While core Phase I principles remain fundamental across oncology, emerging modalities introduce additional requirements for translational integration, specialized safety management, and therapeutic-specific infrastructure. However, the organizational functions of Phase I units have not evolved at the same pace and remain largely centered on conventional operational responsibilities. Drawing on the practices of leading Phase I units across the USA, Europe, and China, and comparing evolving regulatory frameworks of the US Food and Drug Administration, European Medicines Agency/Medicines and Healthcare products Regulatory Agency, and China's National Medical Products Administration, we propose a global perspective on the future development of Phase I units. We present a three-layer framework encompassing core Phase I foundations applicable across oncology, advanced translational capabilities, and ecosystem-level functions supporting emerging therapeutic development. Beyond ensuring patient safety and high-quality trial conduct, modern Phase I units should integrate translational research, artificial intelligence-enabled and model-informed drug development, regulatory science, and public engagement, while specialized centers may additionally support advanced therapy infrastructure, such as point-of-care manufacturing. Recognizing the diversity of institutional resources, we further propose a collaborative network model to facilitate scalable implementation and international harmonization. This framework positions Phase I units as integrated platforms connecting clinical investigation, translational science, regulatory innovation, and emerging therapy development, providing practical guidance for building future-ready early-phase clinical research infrastructure worldwide.

Chronic spontaneous urticaria (CSU) accounts for most cases of chronic urticaria; however, the prevalence and disease burden are not well characterized. A narrative literature review based on structured and targeted searches of the literature and iterative hand searches based on expert knowledge was conducted to assess the epidemiology and humanistic burden of CSU. Targeted searches were conducted in EMBASE (including conference abstracts), MEDLINE, and health technology agencies using a combination of terms related to "chronic spontaneous urticaria" between January 1, 2010, and June 13, 2023. The searches retrieved a total of 62 articles. CSU prevalence was reported at 0.08%-2% across Asia, Europe/UK, North America, and South America. Risk factors reported for CSU included female sex, older age, and autoimmune conditions. Itch was the primary and most troublesome symptom. CSU has a significant burden on physical and mental health-related quality of life (HRQoL). Healthcare resource utilization (HCRU) in patients with CSU was driven by outpatient physician office and emergency department visits. Poorly controlled CSU led to greater impact on HRQoL and HCRU. 24 articles reported on available treatment approaches and/or emerging therapies that target the underlying pathophysiology of CSU. Significant evidence gaps were identified, including the need for epidemiological data from a wider range of geographic regions and economic and cost-of-illness analyses. This narrative literature review demonstrates that CSU is associated with a significant burden of symptoms, reduced HRQoL, and HCRU. Early and appropriate diagnosis and new, effective treatment options are needed for patients with CSU.

Understanding how men who have sex with men (MSM) identify with sexual role labels such as Top, Bottom, or Versatile offers descriptive insights into how sexuality, identity, and self-presentation intersect on dating platforms. Drawing on cross-sectional data from 141,156 active users of the global gay dating app Surge, this study describes age-based and regional differences in sexual role identification. We model user-reported role preferences using Poisson regression with interaction terms for age and continent, accounting for non-linear age effects and regional heterogeneity. Younger MSM were more likely to identify as Bottom or Versatile, while older users more often identified as Top. Across continents, Versatile was the most common identification in Europe and Oceania, whereas Bottom was most common in the Americas and Africa. These descriptive patterns are consistent with sexual role labels being context-dependent and may reflect age-related and cultural variation in how roles are communicated and perceived within MSM communities. The study highlights how platform-based data may help illuminate patterns of intimacy and self-presentation among MSM worldwide.

NDM-14-producing Klebsiella pneumoniae ST147 has recently emerged as a high-risk clone in Europe, but its local dissemination dynamics remain poorly defined. We investigated a 6-month outbreak across three hospitals within a regional healthcare network in Lombardy, Northern Italy. Among 32 NDM-producing K. pneumoniae, isolated between December 2024 and May 2025, 19 belonged to ST147, including one NDM-1 producer and 18 carrying NDM-14 or its A233V variant NDM-61. Phylodynamic analysis of the ST147 NDM-14/NDM-61 genomes showed they were closely related (8-91 core SNPs) and descended from a most recent common ancestor dated to June 2024 (95% highest posterior density interval, 6 months). Reconstruction of the transmission network hints at the presence of at least three transmission clusters within the healthcare system: a major chain involving 11 of 18 cases spanning wards and facilities, a separate pair of linked cases, and 5 epidemiologically unlinked cases, suggesting missed intermediates or secondary introductions. The spread was characterized by rapid local expansion of the clone across intensive care, medical, and rehabilitation. These findings underscore the propensity of NDM-14-producing ST147 to disseminate efficiently within interconnected hospitals and highlight the need for enhanced genomic surveillance, coordinated infection control strategies, and judicious use of last-resort agents in regional healthcare networks. In a global phylogenetic context, the Italian isolates clustered within a broader NDM-14 ST147 population composed of several geographically distinct clades associated with France, Italy, Spain, Morocco, and the United Kingdom.

The use of social media in cancer research, patient support, and information sharing has been well documented. Using retinoblastoma as a model, we use the information provided from Twitter (subsequently rebranded X) to understand patients' treatment-seeking behavior and barriers, as well as investigate its application in research and epidemiology for rare diseases. Posts on retinoblastoma were extracted from Twitter. We trained BERT (Bidirectional Encoder Representations from Transformers) models to identify relevance and conducted sentiment analysis. The hierarchical Dirichlet process was trained to identify topics with BERTopic used as a sensitivity analysis. We enriched user profiles with OpenStreetMap-based geotagging and CoreNLP-based occupation tagging. Retinoblastoma outcomes were obtained from a systematic review and meta-analysis, which covered articles published between January 1, 1981, and October 8, 2021. The dataset covered 2,382,511 posts from 797,870 Twitter users. Most of the information dissemination and discussion originated from North America and Western Europe. A lack of disease understanding and the need for more support and counseling remained the most significant barriers to receiving treatment worldwide, as reflected by both the intensity and number of posts. The number of new posts per year related to treatment barriers and enucleation hesitancy showed exponential growth after 2016 (&#x3b2;log-linear=0.957, P=.002). For the perceived barriers to treatment, sentiment was the strongest over time for worries over treatment failure (&#x3b2;linear=-0.003, P=.79, estimate2022=0.679). Posts with higher negative sentiment intensity related to enucleation were concentrated in Central and Southern America, Asia, and Africa. Stronger negative sentiment toward enucleation (&#x3b2;=-0.726, 95% CI -1.224 to -0.228) was associated with worse overall survival outcomes. The association between lower overall survival rates and enucleation hesitancy was observed in Asia (&#x3b2;=-1.518, 95% CI -2.602 to -0.434) and Africa (&#x3b2;=-0.812, 95% CI -1.412 to -0.021) in the subgroup analysis. The active participation of clinical staff (&#x3b2;=-0.105, 95% CI -0.186 to -0.024; P=.01) and academia (&#x3b2;=-0.116, 95% CI -0.208 to -0.024; P=.01) on retinoblastoma topics on Twitter correlated with lower enucleation hesitancy. Computational social media analysis can generate actionable insights for public health interventions for retinoblastoma. Negative sentiment toward enucleation is associated with poorer survival. The active participation of clinical staff and academia on Twitter is correlated with lower enucleation hesitancy. However, they remain underrepresented in social media discussions, suggesting a significant opportunity for greater engagement from stakeholders and targeted information dissemination to improve acceptance and outcomes in vulnerable zones.

We conducted a narrative review of peer-reviewed randomized controlled trials (RCTs) investigating low-concentration atropine for myopia management. Studies were identified using the terms "myopia" AND "atropine" and supplemented through reference searches. Key data on spherical equivalent refraction (SER), axial length (AL) progression, participant demographics, and ethnicity were extracted and qualitatively compared across trials. In addition, observed AL progression was contextualized against expected age-matched myopic axial elongation and physiological emmetropic eye growth derived from previously published normative models. Evidence from pivotal trials such as ATOM and LAMP, mainly conducted in Asian populations, demonstrated dose-dependent efficacy of atropine, with 0.05% showing superior outcomes compared with 0.01%. However, more recent studies in non-Asian populations, including STAR, MOSAIC, WA-ATOM, and MTS, have reported more modest treatment effects with 0.01% atropine. Differences in efficacy appear influenced by factors including age, ethnicity, baseline progression rates, environmental exposures, and placebo-group axial elongation rates. The coronavirus disease 2019 (COVID-19) pandemic also impacted outcomes in several trials, highlighting environmental influences on myopia progression. In addition, off-protocol use of myopia-control interventions in studies such as CHAMP further complicates interpretation of atropine efficacy. While low-concentration atropine remains a promising option for myopia management, rebound progression after cessation remains a concern. Emerging evidence suggests that future research should look at higher atropine concentrations, individualized treatment strategies, and comparisons against normative ocular growth trajectories rather than placebo alone. Licensed atropine formulations, particularly within Europe, are anticipated to improve treatment standardization, support regulatory oversight, and help refine future clinical guidelines for myopia management.

Rapid identification of anterior circulation large vessel occlusions (LVOs) is critical for timely mechanical thrombectomy in acute ischemic stroke. Computed tomography angiography (CTA) interpretation can be challenging, particularly in settings without continuous subspecialty expertise. Artificial intelligence (AI) based decision support tools may improve workflow efficiency and diagnostic consistency. The purpose of this study is to evaluate the diagnostic performance, processing time, and generalizability of the Methinks CTA-LVO software for automated detection of anterior circulation LVOs. This retrospective multicenter study included consecutive CTA scans from four external institutions in the United States and Europe. After quality assessment, 379 patients were analyzed (142 LVO, 237 non-LVO). Ground truth was established by review with adjudication by independent expert neuroradiologists. Primary endpoints were sensitivity and specificity for LVO detection. Secondary analyses included performance by occlusion subtype (ICA, M1, M2), time-to-notification, false positive/negative characterization, and institution-level generalization. The algorithm achieved a sensitivity of 95.8% (95% CI: 91.0-98.4%) and specificity of 88.6% (95% CI: 84.0-92.4%), with an AUC of 97.6%. Sensitivity by subtype was 98.5% for M1, 89.7% for M2, and 97.1% for ICA occlusions. The mean time-to-notification was 3.30 minutes. Error analysis showed that several apparent false positives and negatives reflected ground-truth ambiguity, severe stenosis, or occlusions outside the study definition. Performance remained robust across institutions and CT vendors. The Methinks CTA-LVO software demonstrated high accuracy, rapid notification, and good generalizability for anterior circulation LVO detection, supporting its use as a triage tool to assist timely stroke care, with final interpretation remaining under expert supervision.

The people of the Faroe Islands are uniquely exposed to per- and polyfluoroalkyl substances (PFASs); despite no local production of these compounds or manufacturing of consumer products, residents exhibit elevated serum concentrations of PFASs. Consumption of pilot whales, a traditional part of the Faroese diet, contributes to exposure but does not fully account for observed trends in serum, suggesting the importance of additional exposure pathways. This research assessed the significance of indoor exposure pathways through measuring air and dust concentrations of a broad scope of PFAS nonvolatile precursors, volatile neutral precursors, and legacy ionic PFASs, and determining the estimated daily intake (EDI) for 15-year-old children. Across the 40 homes, the EDI for children from indoor exposure was 0.001, 0.012, and 0.129 ng/kg bw for low, intermediate, and high exposure scenarios, respectively. Indirect exposure to perfluoroalkyl carboxylic acids from air contributed the most to the EDI, followed by indirect exposure to perfluorooctanesulfonic acid in dust in the high exposure scenario. Indoor exposure equated to approximately 0.2% (low), 2% (intermediate), and 20% (high) of the European Food Safety Authority (EFSA) tolerable weekly intake, while the average consumption of pilot whale contributed about 60%. This study highlights the importance of understanding indoor exposure as a potentially significant contributor to total exposure to PFAS, especially with the declining consumption of pilot whales in the Faroese population.

Motherhood is a meaningful part of the life plans of many women diagnosed with severe mental illness, but they often experience motherhood or the desire for it in a context of vulnerability, stigma, and poorly coordinated care. The literature on the meaning of motherhood in this group is limited, especially research offering the perspective of humanistic models centred on the person. Identify how women diagnosed with severe mental illness give meaning to their desire to be mothers (or not) and their experience of motherhood (or not becoming a mother), using the Tidal Model as an interpretive framework. Descriptive qualitative study with intentional sampling. Eight women diagnosed with severe mental illness in Catalonia, Spain participated in semi-structured interviews. Data were analysed using thematic analysis guided by the Tidal Model. We report the findings using the COREQ criteria for qualitative rigour. We identified six themes structured in the three dimensions of the Tidal Model: (1) sharing the desire (or not) to become a mother; (2) stigma related to the decision to become a mother (or not to become one); (3) taking care of myself to become a mother; (4) self-stigma; (5) lack of specialised support and misinformation; and (6) barriers created by stigma. The narratives reveal the importance of validation, the impact of internal and external stigma, and the difficulties arising from the lack of service coordination. Participants faced multiple personal, relational, and structural barriers to their plans to become mothers. The findings indicate the need for interdisciplinary, empathetic, and person-centred care, as well as coordinated care circuits that integrate reproductive desire into clinical practice in mental health. Mental health nurses can play a pivotal role in validating women's reproductive desires, mitigating internal and external stigma, and providing nuanced, person-centred guidance regarding risks, care needs, and reproductive options. They are also essential in fostering coordinated care pathways that support informed decision-making and accompany women throughout their reproductive journeys.

The Russian invasion of Ukraine caused a wave of emigration, with vast numbers of people fleeing Russia due to political persecution or safety concerns. The study explored how anti-war Russian emigrants negotiate their national identity and moral responsibility amid ingroup wrongdoing. Previous research has shown that having a stigmatized identity can lead to self-group distancing. Yet those studies concerned groups that can be characterized as victims of violence or discrimination, and there is a lack of research on identity performance and negotiation of people who represent perpetrator groups. We conducted semi-structured in-depth interviews with Russian emigrants (N&#x2009;=&#x2009;12) in two rounds between March 2023 and early 2024. We analysed data using Reflexive Thematic Analysis. Participants described feelings of collective guilt and fear from identity disclosure, accompanied by a sense of vigilance in how they perform their identity in interactions. To avoid any implication that they supported the State's actions, participants tended to mitigate potential moral judgement by positioning themselves as morally aware yet lacking agency. Although participants actively disidentified from Russian identity, they still emphasized struggling with navigating collective responsibility and guilt. We discuss the implications of our findings for the potential resistance and future post-conflict reconciliation.

Acute kidney injury (AKI) is a clinical syndrome characterised by a sudden deterioration of kidney function. It is common and usually occurs as a complication of severe illness or major surgery. Despite the high risk of complications and a decade of improvement initiatives in the UK, little is known about the quality of post-discharge AKI care. Our population-based cohort study investigated adherence to guideline-recommended post-AKI care in general practices in England. Using English hospital admission data (2017-2021), we created a cohort of discharged patients (&#x2265;&#x2009;18 years) with a hospital diagnostic code of AKI. Using linked Clinical Practice Research Datalink Aurum primary care data, we examined percentages of AKI episodes meeting the criteria of 14 guideline-recommended post-AKI care indicators, covering: AKI coding in primary care, post-discharge primary care contacts, kidney health and blood pressure monitoring, and guideline-indicated prescribing. Variations of indicator adherence according to patient characteristics were quantified using binomial mixed regression. 209,222 patients (48.0% females; mean age 74.1 years) were included, representing 279,187 AKI inpatient episodes. Only 19.5% (95% CI 18.5-20.5) of episodes had AKI coded in primary care within 30 days of discharge, while 72.6% (95% CI 71.8-73.4) had a documented contact with general practice. At 90&#x2009;&#xb1;&#x2009;30 days after discharge, serum creatinine was measured in 34.2% (95% CI 33.7-34.8) of episodes, blood pressure in 34.6% (95% CI 34.0-35.1), and albumin-creatinine ratio in 4.2% (95% CI 4.0-4.4). Testing was less common amongst younger patients and those without comorbid conditions. Renin-angiotensin system inhibitor prescribing rates were low in patients likely to benefit. There are multiple missed opportunities for improving post-AKI care. Rates of measuring albuminuria were particularly low, despite its strong association with subsequent kidney and cardiovascular events. The limited post-AKI clinical activity amongst younger patients and those without comorbidities undermines the prevention and early intervention of chronic kidney diseases. Clearer discharge arrangements, including case-specific guidance on discharge summaries, and the development and evaluation of concerted implementation strategies spanning secondary and primary care are needed.