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This paper examines the methodological approach from a doctoral research project based on an ethnography conducted with children and young people living in shelters for domestic violence. Guided by the principles of critical social work research, this study was co-constructed in partnership with a feminist umbrella organization representing shelters across the province of Quebec, Canada. This collaboration ensured that the research had meaningful outcomes for both theory and practice. In this paper, I discuss how methodological and theoretical decisions worked to reduce power imbalances throughout the research process, emphasizing the critical role of interpersonal relationships in data collection. Drawing on feminist care theory (Brannelly and Barnes, 2022) and principles of feminist intervention in shelters (Côté, 2017), I highlight the importance of play, adopting a "least adult" posture (Mandell, 2003), supporting the mothers and a child-centered approach to establishing connections and navigating traditional power dynamics. This approach enabled a deeper understanding of the children's and young people's lived experiences in shelters. The findings suggest that research with children and young people necessitates adapting traditional research methods to better align with their realities. This requires critical reflection and proactive actions - such as thoughtful methodological and theoretical choices - to address power imbalances between adult researchers and child participants.

Cardiovascular disease is the leading cause of death in the United States, and cardiovascular mortality is higher in rural areas than in urban areas. However, innovations in cardiovascular care are typically produced in urban areas where social structures and culture can differ from those of rural areas. From 2023 to 2024, we surveyed rural-serving primary care health care workers and cardiologists (n = 31) and rural patients (N = 14) in Alaska, Idaho, and Washington about their priorities for cardiovascular health services and disease research in rural areas. We also conducted semi-structured interviews with 27 of the health care workers we surveyed to explore their prior experiences with barriers to and facilitators of intervention implementation. We summarized the quantitative survey results with descriptive statistics and write-in responses using content analysis. To analyze the qualitative interview results, we used thematic analysis. The highest rated research priorities focused on developing data sharing systems for rural clinics and hospitals and strengthening regional connections to support cardiovascular care. Patients also prioritized increasing health insurance coverage in rural communities. Both patients and health care workers rated studying the use of telemedicine and digital tools as their lowest priority but wrote in various technology-related topics as top research priorities. When evaluating key influences on previous implementation experiences, the interview participants highlighted factors including the need for time, money, and dedicated staff to run interventions; organization and provider buy-in; opportunities to partner with other organizations; and the importance of considering patients' perspectives and needs. Rural patients and rural-serving health care workers prioritize cardiovascular research areas that are patient-focused, focus on technology that is feasible in the rural context, and aim to increase resources in rural communities. Funding for rural health care and improving rural healthcare provider shortages remain key issues. However, partnering with other organizations may be a means to support intervention implementation in rural clinics.

This multi-source bibliometric and translational mapping study provides a panoramic synthesis of how research on microglia-mediated spinal pain signaling has evolved from foundational mechanistic studies to clinically oriented innovations. The aim is to identify developmental trajectories, mechanistic hotspots, and translational opportunities, thereby offering strategic insight into guiding the future direction of neuropathic pain research. We analyzed 1313 original research papers from the Web of Science Core Collection (WoSCC; 2005-2024) using CiteSpace and VOSviewer to construct collaboration networks, journal co-citation graphs, and keyword-driven mechanism clustering. To add a translational medicine dimension, we conducted a targeted PubMed search ("microglia AND spinal cord AND (translational OR therapeutic OR drug targets)"), retrieving 692 additional records, enabling cross-database overlay to link mechanistic themes with specific therapeutic targets. The scientometric model indicates that spinal pain research has shifted from primarily descriptive work to more detailed regulatory models. Key themes include glial cell activation, oxidative stress, mitochondrial dysfunction, and changes in microglia state. Research on heat shock protein pathways and sex-related microglial responses is also increasing. Some core terms have remained frequent over the years, such as "neuroinflammation" and "activated protein kinases". In contrast, the explosive emergence of brain-derived neurotrophic factor (BDNF) and spinal cord stimulation (2020-2021; burst intensity = 2.56) indicates a growing interest in synaptic and circuit control and neuromodulation-based approaches. In the PubMed subset, 33.6% of studies directly focused on treatment development, with gene therapy, intrathecal administration, and microenvironment remediation also appearing more frequently. When we combine data from WoSCC and PubMed over the past 20 years, we can see a significant shift in the explanation of spinal pain in this field. Early research often described the problem as "glial cell activation-cytokine release." Recent research, however, focuses on specific pathways, particularly microglial state regulation, oxidative stress-autophagy connections, and kinase signaling. This shift in treatment approaches is also reflected in translational studies. Many studies no longer rely primarily on systemic drugs but instead focus on targeted strategies such as intrathecal administration, gene or cell therapy, extracellular vesicles, and neuromodulation. These trends make polarization-related molecular nodes ideal candidate targets for precision analgesia. However, bibliometric results are dependent on database coverage, keyword processing, and clustering settings. Some "hotspots" may reflect changes in terminology or citation habits rather than true mechanistic importance. The rise of neuromodulation keywords may also reflect broader clinical applications; microglial mechanisms are plausible, but contributions from other circuit-level mechanisms may also play a role. These results indicate that the field is moving beyond a purely inflammatory perspective toward systemic intervention models. Currently, there is a greater focus on microglial homeostasis and M2-like anti-inflammatory/immune repair processes, as well as sex and metabolic factors that may influence responses. This research direction supports immune repair and more personalized analgesia. Simultaneously, stronger mechanistic arguments require cell state-specific measurements rather than broad phenotypic labels.

Academic AbstractChildren and adolescents are growing up in increasingly ethnically, racially, and culturally diverse and often unequal worlds. Therefore, how schools, as key developmental contexts, approach diversity has important implications at individual, group, and societal levels. Here, we present a review, integration, and expansion of research on cultural diversity climate in schools, focusing on five dimensions of diversity climate (the cultural diversity climate "Big Five") and their facets. We begin by distinguishing cultural diversity climate from other related terms (e.g., diversity ideologies, diversity policies). Then, we discuss the five core dimensions of diversity climate (intergroup contact theory's optimal contact conditions, multiculturalism climate, colorblind climate, critical consciousness climate, polyculturalism climate). We examine facets subsumed under the dimensions, propose new theory-based facets, and outline differences and commonalities between them. Next, we review measurement approaches and highlight future research directions. Overall, this integrative, multidimensional, and multifaceted framework advances psychological theory on diversity climate.Public AbstractSchools play a vital role in how children and adolescents experience and understand diversity. This article reviews the concept of cultural diversity climate in schools, focusing on five key aspects that shape how cultural diversity is approached (i.e., the cultural diversity climate "Big Five"). Our integration of the cultural diversity climate "Big Five" encompasses five main dimensions, such as multiculturalism climate (acknowledging and valuing diversity at school), critical consciousness climate (critically reflecting on and challenging racism and inequities), and polyculturalism climate (raising students' awareness of connections between groups and cultures). To move towards a more fine-grained understanding of diversity climate, we describe existing facets (i.e., sub-components of the different dimensions) and develop new facets based on theory. We also discuss different ways of measuring cultural diversity climate. This work is important for creating more inclusive, equitable, and critically conscious school environments, thereby supporting all students, especially those from marginalized communities.

Social determinants of health (SDoHs) are increasingly recognized as important contributors to the development, course, and outcomes of psychiatric disorders. However, their integration into clinical psychiatry and mechanistic models remains limited. This overview synthesizes emerging evidence on the biopsychosocial mechanisms through which SDoHs influence mental health. There is a need to distinguish between individual-level, clinically actionable health-related social needs and family-, community-, and society-level structural SDoHs, and to consider both adverse and protective social factors. Converging research demonstrates that social experiences are biologically embedded through interacting pathways, including exposomics, epigenetics, allostatic load, accelerated inflammaging, immune dysregulation, and gut-brain-microbiome signaling. These mechanisms influence neural circuitry underlying stress regulation, reward processing, and social cognition. Psychological processes-including individual differences in resilience, wisdom, compassion, and purpose in life-shape responses to SDoHs and are supported by identifiable neurobiological substrates. Social connection has emerged as a central, potentially modifiable SDoH that is strongly associated with whole health and longevity. Loneliness and social isolation have become major global public health challenges. The authors propose a biopsychosocial framework that integrates social exposures, biological mechanisms, neural systems, and psychological processes to better understand the risk, course, and prevention of mental illnesses. Clinical and public health implications include the need for routine assessment of SDoHs, incorporation of protective factors at individual and societal levels, and development of pragmatic, multidomain interventions. Finally, rapidly evolving digital technologies, including artificial intelligence, offer new opportunities but also require careful governance. Advancing toward human-centered "artificial wisdom" may enhance the capacity of technology to promote whole health in individuals with mental illnesses globally.

There has been an increase in interest in the health and well-being benefits of lifestyle factors such as physical activity, diet, sleep, and social interaction. Previous research has highlighted how lifestyle factors, both healthy and unhealthy, tend to covary or cluster together. Very little research has examined the degree to which the clustering among lifestyle factors and emotional health is unique to individuals. As such, this project examined the idiographic associations among lifestyle behaviors and emotional experiences in daily life, which could set the stage for individualized lifestyle interventions. Seventy-nine adults (Mage = 43.37, SDage = 17.26) in the United States participated in a 70-day daily diary study, where they reported on daily lifestyle engagement and affect each evening. Network models examined the associations among these variables at the between-person level and within-person level. Further, person-specific idiographic network models were analyzed. Results indicate that there were significant associations in the whole sample at multiple levels (between-person and within-person). Further, idiographic analyses revealed person-specific connections among lifestyle factors and affect. In conclusion, lifestyle factors and affect cluster together in daily life, and the clustering differs across individuals. Future research should explore the feasibility of intensive measurement-informed lifestyle interventions.

ObjectiveThe study aimed to examine empirical studies published between 2003 and 2025 to identify elements of physical environments influencing health outcomes and experiences of children and families.BackgroundIn the past 40 years, research has shown that the physical environment influences the health and well-being of patients in the healthcare environment. However, similar research in the context of "pediatric inpatient wards" remains underexplored.MethodsPubMed, Embase, Scopus, and Web of Science were used to identify relevant articles. All extracted articles underwent a three-step screening process using PRISMA. A total of 30 eligible articles were used for the analysis. The protocol is registered at PROSPERO (CRD42023408997).ResultsKey findings reveal positive and negative impacts of identified elements. Positive-effect elements include play spaces, space for parents, natural light, connections with nature, and so on, which promote comfort, healing, and emotional resilience. Conversely, negative-effect elements, such as noise, artificial lighting, uncomfortable temperature, and so on, contribute to stress and disrupted sleep. Mixed effects were observed for elements like art and television, which underscore the complexity of designing environments that address the diverse needs of different age groups and genders.ConclusionsThe review findings highlight significant knowledge gaps. The study also tries to bridge existing gaps between research and practice by systematically identifying environmental elements, offering actionable insights to architects, designers, healthcare providers, and policymakers. Future research must adopt rigorous, culturally inclusive approaches to advance the field of pediatric healthcare design and ensure equitable care across diverse sociocultural contexts.

The Big Five personality traits are often treated as common causes of the Big Five items in reflective measurement models such as factor analysis models and item response theory models. For example, extraversion items are modeled as reflective indicators influenced by the latent variable extraversion (i.e., the common cause). However, the Big Five do not correspond to five biological, environmental, or mental entities that could serve as common causes. The notion that the Big Five are common causes is furthermore challenged by direct causal effects, semantic overlap, and logical connections among the Big Five items. Despite these concerns, researchers continue to use methods and theories that implicitly or explicitly assume that the Big Five are common causes. I argue for three shifts: (a) Ontological shift: The Big Five are best understood as composites of personality items-not as real entities that cause item responses. (b) Methodological shift: For descriptive and predictive research, the composite-formative measurement model offers a more appropriate modeling approach than the reflective measurement model, with item retest reliabilities replacing Cronbach's α or McDonald's ω for reliability estimation. (c) Conceptual shift: For researchers interested in causal inference-which is essential for building theories and designing interventions-I recommend moving beyond the Big Five toward narrower personality traits grounded in clear theoretical conceptualizations and assessed multimodally (e.g., self-reported talkativeness, other-reported talkativeness, audio recordings). (PsycInfo Database Record (c) 2026 APA, all rights reserved).

There are high rates of both alcohol abstinence and hazardous drinking among American Indian and Alaska Native (AI/AN) communities compared with non-Hispanic Whites. Few measures exist that examine alcohol use consequences within a relevant historical and cultural context for Indigenous populations, hindering the ability of communities, researchers, and practitioners to effectively address alcohol misuse. In the present study, we discuss a research collaboration to culturally re-center alcohol-use consequence measures among AI/AN adults. We convened a national and local Scientific Review Panel (SRP) with AI/AN research and clinical experts to reexamine the Drinker Inventory of Consequences (DrInC) and the companion measure, the Short Inventory of Problems (SIP; N = 5). We then completed 20 interviews with AI/AN adults currently in alcohol recovery or misusing alcohol. Interview questions included the alignment of items within measures to be more culturally relevant, identifying missing content, and a review of the research team's adaptations. We completed a thematic analysis. The SRP focused their adaptations on re-centering culture, assessing risk and protective factors, and important missing item content elements. Ultimately, the SRP recommended removing 20 items from the DrInC and adding 12 items to the SIP and adding 3 sub-scales, with an emphasis on the addition of items that were strengths-based and removal of stigmatizing language. Interviews were then completed to further refine the measures. In total, three themes emerged from these data: (1) Direct Reflections on Original and Adapted Items; (2) Negative Alcohol Consequences Specific to AI/AN Communities; and (3) Recovery Supports. Findings underscored the need to emphasize culture, prevention, and recovery supports when addressing alcohol misuse with AI/AN adults. The SRP also identified areas to expand the culturally centered framing of these measures by removing stigmatizing language, focusing on systemic factors, and prioritizing strengths-based approaches. The subsequent culturally centered tools will be validated with 150 nationally recruited AI/AN adults.

Reduced left atrial (LA) strain is associated with cerebral small vessel disease (CSVD). In memory clinic patients without atrial fibrillation, LA reservoir strain and LA conduit strain were significantly associated with white matter hyperintensity volume and cerebral microinfarcts. From plasma proteomic profiling of 1,441 proteins, we identified 23 proteins significantly associated with LA reservoir strain, 425 with LA conduit strain, 199 with white matter hyperintensity volume, and 247 with cerebral microinfarcts. Among them, 13 proteins were commonly associated with both LA strain and CSVD, with 8 proteins showing evidence of significant mediation effects for the association between LA strain and CSVD. The mediators included tumor necrosis factor receptor superfamily member (TNFRSF)-11A, TNFRSF1B, TNFRSF10B, cystatin-C, nectin-4, insulin-like growth factor-binding protein, CD27, and brorin. Partial correlation network analysis also supported TNFRSF11A and insulin-like growth factor-binding protein as highly interconnected proteins in this study population. These plasma proteins may offer pathobiological clues linking LA dysfunction to CSVD.

The history of AIAN people in the US has been told many times, but Western academic researchers have failed to shift that history into wisdom and uncover teachings for living in the present day. The aim of this paper is to document Indigenous elders' childhood experiences and stories, and to record the wisdom they wish to pass on to the next generation in an accessible, written form. This study used elder-centered research methods situated within a postcolonial paradigm. Methods centered on the lived experience and values of Indigenous people and a three-step process of identifying data, developing a methodology, and validating wisdom messages in a visual model. Participants were recruited for this study through existing connections and prior research experience. Inclusion criteria for participants were: (1) elder status in their community/Tribe, (2) willingness to share a story from childhood and wisdom, and (3) validate stories and the visual model presented in this manuscript. There were two open-ended questions asked during the information gathering interviews: (1) "Tell me a story from your childhood," and (2) "What is some wisdom you want to pass on?" Fourteen stories (vignettes) are presented in this section along with a visual model that highlights primary messages (themes). Past, present, and future messages from stories are illustrated using an Indigenous Life Course timeline against the backdrop of colonial events and American Indian policy. This study supported the transmission and continuation of Indigenous knowledge systems, lifeways, practices, traditions, values, and experiences that are often lost or never recorded. This study illuminates the life stories of elders who possess deep resilience and strength and have experienced the devastating impacts of colonialism and the loss of land, language, values, and family systems. Combined, these wisdom messages have the potential to heal individuals, inform community-based programs, and elevate Indigenous knowledge in public health. Elders' deep wisdom and legacy are reflected in what they wanted to share with readers, a call to action about how to live: Keep Praying. You Have A Voice. Go Back to the Old Ways, Share Your Stories About How to Live, Walk in Beauty. Love Your Family, Limit Technology, Protect the Land, and Medicines. Deal with Pain, Practice Ceremony and Self-care, Live in Balance. Pray, Help People, Commit to Something. Practice Ceremony, Forgive, Heal from Losses, Be Generous, Help Others, Seek Happiness.

Patients with cancer often experience diverse psychosocial stressors that profoundly affect disease trajectories, treatment adherence, and overall quality of life. Understanding how patients experience and articulate these issues is critical for designing patient-centered interventions. Conventional data collection methods, such as surveys and interviews, provide depth but are constrained by recall bias and scalability and may overlook sensitive or underreported concerns. Patient-authored narratives in online health communities present a valuable opportunity to identify prevalent and underserved issues. However, critical analytic challenges remain in generating coherent and interpretable insights due to their unstructured and large-scale nature. This study aims to leverage TopicGPT, a prompt-based topic modeling framework powered by large language models (LLMs), in combination with network analysis for interpretable topic discovery and interrelationship analysis in the narratives of patients with cancer. Patient-authored posts describing psychosocial challenges about cancer experience were collected from 4 online health communities. Eligible posts were preprocessed and analyzed using TopicGPT, wherein topics were generated hierarchically and mapped at the sentence level. Comparison analyses were conducted among 3 state-of-the-art LLMs through cosine similarity and manual evaluation. Results from the best-performing LLM were further compared with 2 conventional topic models through topic diversity and were used to construct the network subsequently. Topic co-occurrence was examined using the pointwise mutual information algorithm and centrality metrics to reveal influential topics and thematic interconnections across narratives. A total of 11,306 posts were collected from Reddit, Macmillan, Mijian, and Douban between December 6, 2006, and September 24, 2025. Of these, 3169 posts were retained for topic modeling and network analysis. DeepSeek-V3.2 consistently outperformed Gemini-2.5-Flash and GPT-4o, with similarity scores of 0.6295, 0.5342, and 0.5247, respectively. TopicGPT maintained consistently high topic diversity across languages. "Fear of cancer recurrence" and "Psychological distress" emerged as both most frequent and bridging topics across a hierarchy comprising 42 top-level and 58 subtopics. Strong connections were observed among "Sexual health concerns," "Reproductive concerns," and "Quality of life impact"; "Family communication concerns" frequently co-occurred with "Employment concerns," "Diagnostic delays and misdiagnosis," and "Social support." This study demonstrates the potential of LLM-based topic modeling for large-scale, context-sensitive analysis of patient-authored narratives. The proposed integrated, domain-adaptable pipeline enables the identification of high-fidelity topics and their interrelationships, offering a scalable and interpretable approach to qualitative data in health care. Importantly, our findings reveal substantial concerns and unmet needs among patients with cancer, with potential to support patient-centered research and inform future clinical assessment and supportive care strategies.

Death literacy not only refers to the knowledge and skills of individuals; there is emerging evidence that death literacy is relational and is deepened via social networks and within communities. Exploring these relationships can improve our understanding of pathways that influence death literacy and public health palliative care initiatives. To examine how community-level resources (social capital) influence perceived emotional support, and to test theoretically motivated mediators-including community openness to conversations about death, participation in end-of-life activities, and death literacy (as measured by the DLI-R). Cross-sectional survey (N = 831) of adults aged 18+ in the Australian community. A mixed-link generalised structural equation model estimates pathways from social capital to perceived emotional support, via community openness (talking), participation as mediators of death literacy (measured by the DLI-R). Indirect effects and proportions mediated were obtained via BCa bootstrap (5,000 replications). Robustness checks compared alternative orderings. The total association of social capital with support was β≈0.305. About 35.1% (95% CI 24.6-45.6%) was mediated; 64.9% (54.4-75.4%) was direct. Structural pathways indicated that higher social capital was associated with increased conversation climate (β=0.255***), which in turn was associated with increased participation in end-of-life activities (logit β=0.794***; OR≈2.21) and higher death literacy (β=0.524***). Death literacy was also associated with higher perceived emotional support (β=0.140***). Feeling supported at the end of life (EoL) is influenced not only by how socially connected communities are, but by what people are able to understand, talk about, and act on death and dying. Open, everyday conversations about death matter and contribute to this, because they provide an opportunity to build understanding and because they signal willingness to support. This highlights two practical ways to grow compassionate communities, strengthen death literacy and socialising conversations about end of life alongside social connectedness. Many people think that feeling supported at the end of life depends mainly on having friends, family, or social connections. This study shows that while social connections are important, they are not enough on their own. Feeling supported also depends on whether people can talk openly about death, understand what is happening, and take part in end-of-life-related activities. Using survey data from over 800 adults living in Australia, we examined how community resources, such as trust and connection between people (often called social capital), are linked to feelings of emotional support. We found that people living in communities with stronger social connections were more likely to experience open conversations about death. These conversations were linked to greater participation in end-of-life activities, higher levels of death literacy (knowledge and confidence about death and dying), and, in turn, stronger feelings of being emotionally supported. Our findings suggest that feeling supported at the end of life is shaped not only by who is around us, but also by what we are able to talk about and understand together. Encouraging everyday conversations about death and strengthening death literacy alongside social connectedness may help build more compassionate and supportive communities.

Grief is a stressful experience following the death of a loved one that differs among cultures. For decades, researchers have explored the connections between grief and culture, as well as their contextual influences. Our research question is: how do ethnoracial minoritized caregivers in the United States experiencing grief articulate their bereavement experiences and how might their experiences inform improved approaches to therapeutic relationships (e.g., fostering trust) when healthcare providers are working with ethnorocial minoritized clients? To address this question, we conducted a qualitative descriptive study to explore experiences of traumatic loss in the United States. Interviews were conducted until meaning saturation was reached. Nineteen ethnoracial minoritized caregivers completed the Prolonged Grief-13-Revised scale and the Multidimensional Existential Meaning Scale to assess their grief and meaning-making. Semi-structured interviews were conducted from April to July 2024. Participants were predominantly male (63.2%), married (73.68%), and had bachelor's degrees or higher (63.16%). Analysis revealed themes of different grief experiences and their associated contextual and emotional antecedents. Together, these themes illustrate ways in which bereaved caregivers face challenges with self-care, and this, alongside specific expressions of family grief, results in functional impairments. The study highlights the complexities of relationships, stigma, and resistance to grief therapy and the potential benefits of focusing on family dynamics to improve the treatment of prolonged grief disorder at an individual level.

Spontaneous portosystemic shunts are defined as venous conduits that occur in response to elevated portal venous pressure, resulting in alternative outflows from the portal circulation. We present a case of atypical portosystemic shunt formation between the inferior mesenteric vein branches and the left testicular vein resulting in hepatic encephalopathy in a patient with a history of cirrhosis, describing the access technique we used for successful portosystemic shunt embolization via a combined right common femoral vein and trans-scrotal approach. A 57-year-old male with a history of cirrhosis presented with a 1-month history of progressive cognitive decline despite adherence to a medical regimen of lactulose, rifaximin, and a low-sodium diet. Abdominal computerized tomography and scrotal ultrasound revealed shunt formation from the mesenteric venous system to the systemic circulation, with intermediate connections through the scrotal venous plexus and left gonadal vein. Following an outpatient consultation with interventional radiology for worsening hepatic encephalopathy, the inflow and outflow tracts of the shunt were visualized using digital-subtraction venography. Embolization with Penumbra Ruby XL coil packs and Sotradecol infusion was achieved using an ultrasound-guided trans-scrotal approach for the inflow tract and a femoral approach for the outflow tract. The patient's hepatic encephalopathy resolved shortly after the procedure. Mesogonadal shunts can be a sequela to portal hypertension and leave patients susceptible to hepatic encephalopathy due to direct entry of metabolic toxins such as ammonia into the systemic circulation. Although systemic access is the standard approach for existing coil embolization and balloon-occluded retrograde transvenous obliteration (BRTO) procedures used for the treatment of mesogonadal shunts, further consideration should be given for unconventional vascular access in difficult portosystemic shunt presentations to better address shunt inflow and prevent recurrence. Future avenues for research can include comparing shunt recurrences in patients with layered sclerosant and coil embolization to patients with BRTO or coil embolization alone.

Sindhis are an Indo-Aryan ethnolinguistic community primarily associated with the Sindh region of present-day Pakistan. The Sindhi community is celebrated for its vibrant culture, unique dialect, and notable accomplishments in commerce and the arts, reflecting a rich historical legacy. Following the partition of India in 1947, many Sindhis migrated from the Sindh region to India and around the world, establishing diaspora communities. Previous genetic studies on Sindhis have focused on those residing in Pakistan, with a notable lack of genome-wide research specifically addressing Indian Sindhis. In this study, we investigated the demographic history of Sindhi populations across India and Pakistan by analysing hundreds of thousands of biallelic markers from 113 Indian Sindhi individuals, alongside existing data from Pakistani Sindhis. Our allele frequency analysis revealed strong genetic connections between Sindhi populations in Pakistan and India. Haplotype-based assessments further confirmed recent shared ancestry between these groups and highlighted genetic similarities with neighbouring populations. Identity-by-descent (IBD) analyses reinforced the close genetic relationships between Indian and Pakistani Sindhis, as well as their ties to nearby Pakistani groups. Interestingly, analysis of Runs of Homozygosity (RoH) revealed distinct patterns of marriage practices, suggesting that Pakistani Sindhis exhibit higher homozygosity, likely due to the prevalence of consanguineous marriages. Additionally, local ancestry analysis identified a dominant ancestral component associated with modern populations of the Indus Valley region. The results illuminate the complex genetic structure of the Sapta-Sindhu region and trace the origins of Sindhi Diaspora communities back to the ancient region of Sindh.

Social impact bonds (SIBs) represent a financial strategy designed to fund projects where financing is not tied to specific activities and outputs, but to the outcomes they aim to deliver. Although the project involves a wide range of stakeholders, the dynamics among them remain largely unexplored. To accelerate the advancement of SIBs in healthcare, this study aimed to clarify the challenges and connections between stakeholders with their perspectives for overcoming them. A qualitative investigation, underpinned by semi-structured interviews and grounded theory METHODS: Eight individuals were assembled via snowball sampling. Data were collected from June to August 2023. Nine categories of relationships were formed among stakeholders: conflictual, cooperative, and behaviour-change-enhancing relationships. The challenges and barriers faced by stakeholders were identified. Significant hurdles were found regarding the cultural context, the structure of the National Health Service, and stakeholder affinity for SIBs. This study illustrated the practical complexity of social impact bond implementation in healthcare and identified three pillars of success: decisive leadership, social impact outcome metrics, and a transparent framework aligned with public interests. Standardised evaluation tools and cross-system evidence remain scarce, calling for comparative research to refine SIB design and assess long-term value across diverse healthcare contexts.

The emerging field of cancer neuroscience has reshaped our understanding of tumor biology, showing that the nervous system is an active participant in the tumor microenvironment. It modulates tumor progression through synaptic communication with cancer cells, paracrine signaling via neurotransmitters and neuropeptides, and indirect regulation of the tumor immune microenvironment. Recent discoveries have shown that neurons form synapses with brain tumors and peripheral cancers, driving tumor cell proliferation and invasion. Neurotransmitter and neuropeptide signaling activates pathways in cancer cells to promote malignancy. Furthermore, the nervous system shapes anti-tumor immunity by modulating T cells, natural killer cells, macrophages, and myeloid-derived suppressor cells, creating either an immunostimulatory or, more commonly, an immunosuppressive microenvironment that facilitates immune evasion and treatment resistance. The clinical significance of the neuro-immune-tumor axis is confirmed across multiple cancer types. Consequently, therapeutic strategies targeting neural regulation are emerging, including neurotransmitter receptor blockers, denervation techniques, neuromodulation devices, and approaches to remodel the immune landscape through neural signals. This review synthesizes how nerves regulate tumor progression via synaptic connections, neurotransmitter release, and immune modulation. We also summarize current and emerging therapeutic strategies aimed at disrupting or harnessing neuro-tumor communication. By integrating recent advances, this review aims to establish a framework for understanding neural regulation of cancer and to guide future research and clinical translation in this evolving field.

A significant increase in the demand for radiography examinations and the corresponding rise in the workload of radiographers has been noted. Radiography imaging departments serve patients presenting with a wide range of conditions and abilities, and student radiographers have reported feeling unprepared, lacking confidence and experiencing stress and anxiety during such interactions. Additionally, they encounter challenges with effective communication and interpersonal engagement, making it difficult for them to recover from difficult experiences. These challenges highlight the need for research on resilience among student radiographers. The aim of the paper is to describe the process undertaken to develop a model to facilitate resilience in DR students, and to present the developed model. A qualitative, exploratory, descriptive, contextual and theory-generative approach was used to develop a model for facilitating resilience among diagnostic radiography (DR) students. Data were collected through focus groups with first-year DR students. Finalisation of the model was informed through input by experts in model development, radiography and nursing education. Five focus groups were analysed using thematic analysis, yielding four themes: students' understanding of resilience, students' readiness to commence in the clinical workplace, interpersonal interactions as they relate to the clinical environment and adapting to the clinical environment. Through inductive reasoning, central concepts were identified with facilitation, self-efficacy and social connections, forming the basis of the resilience model. The model designed for the facilitation of resilience is recommended for use as a framework for educators to foster resilience among DR students.