Early experiences shape how children understand food as part of their health, family, and culture. Pediatricians promote picture book reading to support developmental and relational health. We conducted a pediatric-informed content analysis of food and nutrition in US picture books. Using an interdisciplinary content analysis framework, we assessed food and nutrition content within a representative sample of US picture books (N = 159). Coders documented the presence and types of food, mealtimes, and social drivers of nutritional health. We assessed interrater reliability and summarized food-related content within the context of how the book depicted the role and function of food. The κ agreement ranged from 78% to 99% (strong reliability). Most books depicted food in text (67%) or pictures (68%). Fruit (39%) was the most depicted food group, milk the most depicted beverage (15%), and sweet the most depicted flavor (33%). Among books that included meals, snacks were most common (57%), followed by dinner (41%). Characters ate with their families in over half (53%) of books that depicted meals. Food often symbolized a role beyond satiating hunger (eg, rewarding behavior, fostering connection). Specific roles were associated with a higher appearance of certain foods (eg, fruits with pleasure). Picture books, which frequently portray food and reliably capture children's interest, are helpful tools to engage children in conversations about the social, cultural, and nutritional functions of food. Our findings suggest that picture books are a commercial-free early literacy tool that can support integrated interventions addressing both nutritional and relational health.
Children's picture books about dentistry can be used to prepare children for a dental visit and to familiarize them with oral care. Children's books play an important role in the social and emotional development of children and can thus have an influence on their perception of dental care. This study charted the representation of dentists and oral care providers in Dutch-language picture books. 29 books were analysed using a standardized questionnaire. The overall tone of most books was positive or neutral. Both the main character and the dentist were often depicted as animals. The dentist was usually presented as a friendly professional in a colourful practice, although the use of personal protective equipment was rare. Many books included educational elements, although the information did not always align with current professional guidelines and was sometimes inaccurate or outdated. Further research on the perspectives of parents, children, and oral care providers is needed to gain insight into actual usage and its impact, and to provide targeted recommendations. Kinderprentenboeken over tandheelkunde kunnen worden gebruikt om kinderen voor te bereiden op een tandartsbezoek en hen vertrouwd te maken met mondzorg. Kinderboeken spelen een belangrijke rol in de sociale en emotionele ontwikkeling van kinderen en kunnen het beeld van tandheelkundige zorg beïnvloeden. Dit onderzoek bracht de weergave van tandartsen en mondzorg in Nederlandstalige prentenboeken in kaart. Er werden 29 boeken geanalyseerd met een gestandaardiseerde vragenlijst. De meeste boeken hadden een positieve of neutrale toon. Zowel hoofdpersoon als tandarts werden regelmatig als dier afgebeeld. De tandarts werd meestal gepresenteerd als een vriendelijke professional in een kleurrijke praktijk, maar het gebruik van persoonlijke beschermingsmiddelen was zeldzaam. Verder bevatten veel boeken educatieve elementen, maar de informatie kwam niet altijd overeen met actuele professionele adviezen en was soms onjuist of achterhaald. Vervolgonderzoek naar perspectieven van ouders, kinderen en mondzorgverleners is nodig om inzicht te krijgen in daadwerkelijk gebruik en effect, en om gerichte aanbevelingen te kunnen doen.
Biographies of scientists are widely used to spark children's interest and broaden participation in science. In telling the stories of successful scientists, these books convey implicit "recipes for success"-yet no study has systematically examined whether these recipes align with what motivation research recommends. Here, we provide the first large-scale analysis of motivational messages in children's science biographies (422 best-selling books, 1,355 protagonists). Four main findings emerged. First, scientific ability was portrayed equally often as fixed and as malleable, a pattern unlikely to support motivation. Second, interest in science was overwhelmingly portrayed as fixed: Most scientists were said to be captivated by science from a young age. Third, scientists in physics, engineering, and computer science were portrayed as more reliant on fixed ability than scientists in other fields. Fourth, biographies of female scientists disproportionately emphasized effort even after adjusting for the obstacles they faced, consistent with stereotypes attributing women's success to hard work over talent. These findings suggest that well-intentioned efforts to diversify science through role model exposure in children's science biographies may fall short.
To evaluate whether a tactile-audio Chinese language book can function as an educational assistive technology for children with visual impairment by improving access to curriculum content, supporting comprehension, and enhancing user engagement. A mixed-methods case study was conducted across four phases: needs assessment, iterative product development, user testing, and implementation. Quantitative data included a questionnaire completed by 36 teachers from schools and organisations serving learners with visual impairment across nine Chinese provinces, and a repeated-measures comparison involving 12 visually impaired children (VIC) who used Braille-only materials, tactile graphics, and tactile-audio books. Qualitative data included field notes, design records, and semi-structured interviews with teachers, VIC, designers, and production partners. Teachers reported a substantial shortage of accessible graphic learning materials, with 97% identifying insufficient provision and 91.67% reporting inadequate standardisation. In student testing, the tactile-audio book outperformed Braille-only and tactile-only materials on learning cognition, graphic cognition, and learning interest. Qualitative findings showed that integrated tactile and audio cues improved recognisability, reduced uncertainty during exploration, and increased willingness to participate. Implementation data further indicated that product benefit depended on production quality, teacher mediation, audio access, and institutional support. The findings support the classification of tactile-audio curriculum books as educational assistive technology rather than supplementary teaching aids alone. Their value lies not only in the product itself, but also in the surrounding service system that enables selection, production, teacher use, and classroom integration. Educational tactile-audio books can be treated as assistive technology when they remove barriers to curriculum access for visually impaired children.Product effectiveness depends on the interaction between tactile design, audio support, production quality, and teacher-mediated implementation.Low-tech and mid-tech educational assistive products may offer scalable options in under-resourced contexts when service delivery is planned alongside product design.
Fine needle aspiration despite being an inexpensive, rapid, accurate and non-invasive diagnostic practice, particularly when used in oncology, is frequently underutilized. The World Health Organization - International Academy of Cytology - International Agency of Research on Cancer initiated a series of Blue Books devoted solely to cytology and reporting methods in particular entities of different organs. The use of ancillary techniques such as immunocytochemistry, molecular biology and flow cytometry was defined in detail. In this review, we have focused on the role of ancillary techniques in the cytological diagnosis of soft tissue tumors. Combination of cytological and histological cellular material with ancillary techniques increases the number of accurate diagnoses and improves clinical management of patients.
The development of electronic technologies capable of withstanding high-energy cosmic radiation is urgently needed to enable scientific exploration in increasingly extreme application scenarios, such as nuclear facilities, deep-space missions, and orbiting space stations. Conventional silicon-based integrated circuits (ICs) typically require additional radiation-hardening processes after design, resulting in structures that are more complex than standard devices. Moreover, many standard silicon-based ICs remain susceptible to total ionizing dose (TID)-induced degradation without dedicated hardening, leading to limited radiation tolerance. Consequently, the development of new materials, devices, and ICs with intrinsic radiation tolerance has emerged as a critical research frontier in recent years. Single-walled carbon nanotubes (SWCNTs) offer significant inherent advantages over conventional silicon-based technologies owing to their strong sp2 carbon-carbon bonds, one-dimensional quantum confinement, and minimal charge-trapping interfaces. This Review highlights the progress made at the Suzhou Institute of Nano-Tech and Nano-Bionics (SINANO), Chinese Academy of Sciences (CAS), in the development of semiconducting SWCNTs (sc-SWCNTs) as well as radiation-hardened SWCNT field-effect transistor (FET) devices and ICs. In this field, researchers at SINANO have also authored several books on carbon-based electronic materials, devices, and circuits, alongside publishing more than 200 papers and being granted more than 50 patents. Specifically, this Review covers the purification of sc-SWCNTs and single-chirality sc-SWCNTs by both commercial and self-designed conjugated organic compounds; the deposition of high-quality networked and aligned sc-SWCNT thin films on flexible and rigid substrates; and the design and fabrication of record-performance radiation-hardened SWCNT FET devices and ICs. Finally, the remaining challenges in sc-SWCNT materials, FET devices, and ICs for reliable radiation-hardened applications are discussed, followed by perspectives on future practical deployment in space and other nuclear extreme environments.
To investigate the current implementation of and key barriers to perioperative comfort therapy in pediatric anesthesia in China, and to provide evidence-based support for optimizing the perioperative anesthesia experience of children. A cross-sectional online survey was conducted from March 21 to May 21, 2025. Using convenience sampling, an anonymous electronic questionnaire was distributed to anesthesiologists nationwide via the WeChat group of the Pediatric Anesthesia Branch of the Chinese Society of Cardiothoracic and Vascular Anesthesia. Participants were invited to complete the survey anonymously and were requested to provide objective institutional data as completely and accurately as possible. The questionnaire comprised 22 closed-ended questions and 3 open-ended questions, covering preoperative and postoperative anesthesia management, parental presence rates, and other relevant indicators. Data analysis and visualization were performed using SPSS version 27.0 and GraphPad Prism 10. A total of 150 valid responses were collected. Participating hospitals were predominantly tertiary A-grade facilities, accounting for 79.3% of the sample. Preoperative visits were universally implemented (100%) and preoperative education, fasting instructions, and explanations of anesthesia plans were provided in 95.3%, 94.0%, and 92.7% of hospitals, respectively, non-routine premedication remained the most common anxiolytic strategy, reported by 59.3% of hospitals. When premedication was used, dexmedetomidine, midazolam, and ketamine or esketamine were the main agents, reported by 29.3%, 25.3%, and 20.0% of hospitals, respectively. Non-pharmacological interventions were widely adopted, including comfort toys or picture books in 84.4%, play therapy in 44.2%, and educational videos in 36.1% of hospitals, whereas virtual reality was rarely used, with a utilization rate of 9.5%. Parental presence was permitted during anesthesia induction in 30.0% of hospitals and in the post-anesthesia care unit (PACU) in 20.7%. Only 12.7% of hospitals had dedicated induction rooms. The main barriers to parental presence were concerns regarding parental emotional distress, reported by 75.3% of respondents, and increased workload, reported by 73.3%. Notably, only 34.0% of hospitals used standardized scales to assess emergence delirium. Propofol was the most commonly used intervention for emergence delirium, accounting for 48.0%, while early parental comforting accounted for 21.3%. In China, current pediatric perioperative anesthesia management remains insufficient in addressing children's psychological well-being, and interventions aimed at reducing perioperative anxiety are suboptimal. These shortcomings are mainly reflected in three areas: first, inadequate assessment of children's anxiety during preoperative education and insufficient preoperative anxiolytic measures; second, a substantial discrepancy between recognition of the importance of parental presence during anesthesia induction and recovery and its limited implementation in clinical practice; and third, underuse of standardized assessment scales for emergence delirium, together with limited diversity in management strategies. These limitations are likely attributable to constraints in medical resources and insufficient staffing.
Gastric ulcer (GU), characterized by complex and multifactorial etiology, remains a prevalent gastrointestinal disease globally. The traditional Chinese medicine Astragalus membranaceus (Fisch.) Bunge is recorded in numerous ancient books such as "Shennong Bencao Jing", "Bencao Gangmu", "Yao Lei Fa Xiang", and "Zhenzhu Nang" to have the functions of tonifying qi, strengthening the spleen, harmonizing the stomach, and promoting ulcer healing. Astragalus membranaceus, a classical Chinese medicinal plant embodying the concept of "medicine-food homology," prominently features astragaloside IV (AS-IV) among its active pharmacological constituents. Accumulating evidence suggests AS-IV confers gastroprotective benefits in various experimental gastric injury models through mechanisms likely involving antioxidant, and anti-apoptotic effects. However, the specific molecular nodes through which AS-IV modulates its gastroprotective effects have not been fully defined. This experiment combined network pharmacology and transcriptomics to elucidate the underlying mechanisms of AS-IV in alleviating acute ethanol-induced GU in a rat and cell model. This investigation employed Sprague-Dawley (SD) rats subjected to ethanol-induced gastric injury and human gastric epithelial GES-1 cells to establish robust in vivo and in vitro GU models, respectively. Initially, we comprehensively assessed the protective efficacy of AS-IV on gastric mucosal lesions using diverse analytical techniques such as Hematoxylin and Eosin (H&E) staining, Alcian Blue-Periodic Acid-Schiff (AB-PAS) staining, Enzyme-Linked Immunosorbent Assays (ELISA), real-time quantitative PCR (RT-qPCR), immunohistochemical (IHC) analysis, and immunofluorescence (IF). Next, we identified essential molecular targets and signaling cascades influenced by AS-IV through integrated analyses encompassing network pharmacology predictions and transcriptomic profiling. Furthermore, the transcriptome further revealed five key molecular nodes (Ereg, Tnfsf11, Nr1d1, Socs3, IL-6), from which we proposed the "triple imbalance - triple repair" model. Finally, in vitro and in vivo experiments verified the inhibitory effect of AS-IV on the EGFR-mediated PI3K/Akt/NF-κB signaling axis. Our in vivo findings revealed that AS-IV substantially ameliorated pathological manifestations in gastric tissues, markedly reduced inflammatory markers, alleviate oxidative stress, and decreased apoptotic cell death. Network pharmacology and molecular docking predicted EGFR as the key target. MD simulation and CETSA confirmed that there was a stable direct binding between AS-IV and EGFR. Transcriptomics analysis further identified five key molecular nodes on the EGFR/PI3K/Akt/NF-κB signaling axis - Ereg, Tnfsf11, Nr1d1, Socs3 and IL-6. Both in vitro and in vivo experiments confirmed that AS-IV exerted a protective effect against ethanol-induced gastric injury by inhibiting the abnormal activation of the PI3K/Akt/NF-κB signaling pathway mediated by EGFR. AS-IV has a significant gastric protective effect against acute gastric injury induced by ethanol. Transcriptomics screening identified five key molecular nodes on the EGFR/PI3K/Akt/NF-κB signaling axis - Ereg, Tnfsf11, Nr1d1, Socs3 and IL-6. Based on this, the "triple imbalance - triple repair" model was proposed. Experimental verification confirmed that AS-IV exerts anti-inflammatory and anti-apoptotic effects by inhibiting the EGFR-driven PI3K/Akt/NF-κB pathway. These findings provide valuable scientific basis for the development of new therapeutic strategies for gastric mucosal protection.
Non-destructively reading text on a sheet of paper with characters on both sides, when those characters might be obscured, unreadable visually, and the paper cannot be turned over, remains an open problem in document analysis. This problem has practical relevance to archival characterisation, fragmentology, and forgery detection. Terahertz (THz) time-of-flight tomography (TOFT) offers the ability to penetrate paper and parchment as well as sensitivity to the composition of inks. However, progress in data-driven THz analysis has been hindered by the absence of publicly available, labelled reference datasets. While a range of historical materials have been employed in manuscripts and printed books, it is favorable to phrase the problem in a way that is accessible to numerous laboratories to develop techniques to extract such texts. In view of this aim, we introduce a curated THz-TOFT dataset comprising raster-scan measurements of four distinct print/writing media (henceforth ink), namely toner, inkjet, iron gall ink, and graphite, deposited on standard copy paper. Samples were prepared from contemporary materials consisting of one sheet of standard copy paper with overlapping test patterns or characters on each side. THz-TOFT data were acquired in reflection mode under controlled, nitrogen-purged conditions, yielding per-pixel time-domain waveforms. Multiple checkerboard-style test patterns are provided per ink type, each covering four ink configuration classes: no ink, ink on the front, back, and on both surfaces. Raw data is distributed as CSV files encoding spatial coordinates, full time-domain waveforms (reflected THz electric field), and manually validated class labels. To demonstrate the suitability of the dataset for machine-learning applications, a convolutional neural network baseline is provided together with a PyTorch-compatible dataloader. This baseline is trained and tested separately for each of the ink datasets, and the predictions on unknown data are qualitatively evaluated to compare the characteristic media properties.
Patient narratives are foundational to diagnosis, yet clinicians frequently and unintentionally distort, minimize, or reinterpret these narratives during clinical encounters. These distortions - termed patient narrative distortion - are unmeasured contributors to diagnostic error [G.D. Schiff, O. Hasan, S. Kim, R. Abrams, K. Cosby, B.L. Lambert et al., Diagnostic error in medicine: analysis of 583 physician-reported errors, Arch Intern Med 169 (2009) 1881-1887; P. Croskerry, The importance of cognitive errors in diagnosis and strategies to minimize them, Acad Med 78 (2003) 775-780; H. Singh, A.N.D. Meyer, E.J. Thomas, The frequency of diagnostic errors in outpatient care, BMJ Qual Saf 23 (2014) 727-731; and M.L. Graber, N. Franklin, R. Gordon, Diagnostic error in internal medicine, Arch Intern Med 165 (2005) 1493-1499], emotional harm [J. Conway, F. Federico, K. Stewart, M.J. Campbell, Respectful Management of Serious Clinical Adverse Events, IHI Innovation Series White Paper, IHI, Cambridge, MA, 2011], and inequity [E.N. Chapman, A. Kaatz, M. Carnes, Physicians and implicit bias: how it affects clinical decision making, Acad Med 88 (2013) 354-360; and M. Marmot, R.G. Wilkinson (Eds.), Social Determinants of Health, 2nd ed., Oxford University Press, Oxford, 2005]. No existing safety tool captures the fidelity with which clinicians preserve patient stories [T. Greenhalgh, B. Hurwitz (Eds.), Narrative Based Medicine: Dialogue and Discourse in Clinical Practice, BMJ Books, London, 1998; and W. Levinson, D.L. Roter, J.P. Mullooly, V.T. Dull, R.M. Frankel, Physician-patient communication: the relationship with malpractice claims, JAMA 277 (1997) 553-559]. The stages at which narrative distortion emerges are illustrated in Figure 1. The objective of this article was to define patient narrative distortion as a measurable construct, develop a five-domain taxonomy, propose a scoring system (PNDI), and outline a workflow and validation strategy for clinical use. We conducted iterative conceptual modeling and structured synthesis of the diagnostic-safety and narrative-medicine literatures [G.D. Schiff, O. Hasan, S. Kim, R. Abrams, K. Cosby, B.L. Lambert et al., Diagnostic error in medicine: analysis of 583 physician-reported errors, Arch Intern Med 169 (2009) 1881-1887; P. Croskerry, The importance of cognitive errors in diagnosis and strategies to minimize them, Acad Med 78 (2003) 775-780; H. Singh, A.N.D. Meyer, E.J. Thomas, The frequency of diagnostic errors in outpatient care, BMJ Qual Saf 23 (2014) 727-731; and M.L. Graber, N. Franklin, R. Gordon, Diagnostic error in internal medicine, Arch Intern Med 165 (2005) 1493-1499] to identify core distortion modes, develop domain definitions, item-level anchors, and scoring thresholds. We propose a multi-phase validation plan including content validity, inter-rater reliability, construct validity, criterion validity, and responsiveness. The PNDI taxonomy includes five domains: Narrative Completeness Distortion, Meaning Substitution Distortion, Salience Distortion, Context Stripping Distortion, and Bias-Driven Distortion [E.N. Chapman, A. Kaatz, M. Carnes, Physicians and implicit bias: how it affects clinical decision making, Acad Med 88 (2013) 354-360]. Each domain includes 0-3 severity anchors and real-world clinical examples. The total PNDI score ranges from 0-15, with interpretation bands for narrative integrity and safety risk. Encounter-level, unit-level, and organizational-level workflows for implementation are outlined. The five-domain PNDI taxonomy is shown in Figure 2. PNDI operationalizes narrative integrity as a measurable dimension of diagnostic safety [The Joint Commission, National Patient Safety Goals: Improving Diagnosis in Health Care 2024-2026, The Joint Commission, Oakbrook Terrace, IL, 2024]. It provides clinicians, educators, and safety teams with a practical tool to detect narrative loss, reduce diagnostic error [G.D. Schiff, O. Hasan, S. Kim, R. Abrams, K. Cosby, B.L. Lambert et al., Diagnostic error in medicine: analysis of 583 physician-reported errors, Arch Intern Med 169 (2009) 1881-1887; P. Croskerry, The importance of cognitive errors in diagnosis and strategies to minimize them, Acad Med 78 (2003) 775-780; H. Singh, A.N.D. Meyer, E.J. Thomas, The frequency of diagnostic errors in outpatient care, BMJ Qual Saf 23 (2014) 727-731; and M.L. Graber, N. Franklin, R. Gordon, Diagnostic error in internal medicine, Arch Intern Med 165 (2005) 1493-1499], and strengthen patient trust [W. Levinson, D.L. Roter, J.P. Mullooly, V.T. Dull, R.M. Frankel, Physician-patient communication: the relationship with malpractice claims, JAMA 277 (1997) 553-559].
Hybrid technologies enable the blending of physical and digital elements, creating new ways to experience and interact with the world. Such technologies can transform engagement with relics-both secular and sacred-but they present challenges for capturing faith, belief, and representation responsibly. Given the complexities of digital representation and the ethical challenges inherent in digitising culturally significant objects, a transdisciplinary understanding of these issues is needed. To inform this discussion from a linguistic perspective, we examined the representation of relics in historical and contemporary texts. Using a corpus linguistic approach to extract modifiers of the word 'relic' in corpora of Early Modern English books and contemporary web-sourced texts from 2021, we examined the multifaceted ways in which relics have been perceived and evaluated over time. Early texts consider relics as both objects of moral and spiritual significance, and tools of religious and political control, while they are more often framed as heritage symbols, reflecting past events, places, and traditions in contemporary texts. We discuss how hybrid, sometimes AI-based technologies can enhance accessibility and engagement, whilst also challenging traditional sensitivities around authenticity and sensory experience, which are integral to the meaning and significance of relics. The online version contains supplementary material available at 10.1007/s42803-026-00120-4.
A cross-sectional study across 80 Anganwadi centres in Kolhan, Jharkhand, involving 146 participants (80 Anganwadi Workers, 27 pregnant women, and 39 lactating mothers), found that while take-home ration (THR) was universally distributed, only 42% of it was consumed exclusively by beneficiaries. Dietary shifts toward packaged foods, erosion of traditional practices, and limited THR awareness emerged as key barriers. Locally co-developed recipe books, training of 4600 Sahayikas, and live demonstrations during Village Health Sanitation and Nutrition Days and Annaprashan events improved THR adoption. Findings suggest that integrating indigenous food knowledge with frontline capacity-building can enhance the effectiveness of government nutrition programs in tribal areas.
Nurse-physician dual leadership (NPDL) has gained attention in healthcare as a model particularly suited to innovation-driven environments, where the complex demands of leadership may outpace the capacities of a single leader. By combining the distinct yet complementary expertise of nurses and physicians, NPDL offers a hybrid structure that balances the clarity of single leadership with the breadth of shared leadership. Despite its growing presence in healthcare, the concept remains insufficiently defined in the literature. To clarify the concept of NPDL in acute hospital settings, ensuring consistent terminology and providing a solid foundation for further research, education and practice. Concept analysis guided by the Walker and Avant 8-step method. A systematic literature search was conducted through PubMed, ScienceDirect and Embase. Keywords included co-leadership, dual leadership and dyad leadership, with and without the prefix 'nurse-physician' and combined with healthcare-related terms. Peer-reviewed articles, books and grey literature, including definitions, attributes, antecedents, consequences and empirical referents, were identified and managed using EndNote. Of 247 identified articles, 23 were included, with eight additional sources retrieved through manual reference list searching. A definition of NPDL in acute hospital settings is proposed. Four defining attributes were identified: formalised dual leadership structure, joint responsibility, joint decision-making and role complementarity. The analysis also identified five antecedents that were categorised into organisational and relational factors. The consequences of NPDL include stronger leadership, enhanced interprofessional collaboration, improved decision-making and the presentation of a united leadership front. NPDL can be defined as a collaborative leadership model in which two formal leaders, a nurse and a physician leader, work together as co-leaders, with different skill sets and without a power difference, and they are jointly accountable and responsible for the organisational or unit results. Clarifying the concept of NPDL enhances future research. It could inform policymakers and support both educators, who provide formal leadership training, and facilitators, who guide professional development through coaching and mentoring, in fostering effective collaboration between nurse and physician leaders. This study did not include patient or public involvement in its design, conduct, or reporting.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established treatment for Parkinson's disease (PD). Beyond basic omnidirectional, monopolar stimulation, advanced stimulation settings (AS), such as directional or vertical current steering, variation of pulse width and frequency, bipolar and interleaving stimulation are increasingly available. Our aim was to summarize current evidence on AS in STN-DBS in PD and systemically report their application and potential benefits in clinical routine. In this retrospective single-center observational study, we analyzed stimulation settings of 145 patients with bilateral STN-DBS 3, 6, and 12 months postoperatively. Secondary outcomes included preoperative levodopa response, lead positions, and postoperative reduction of levodopa-equivalent daily dose (LEDD) in patients staying with basic stimulation settings (BS) compared to those initially with AS at 3-months follow-up and those with a change from BS to AS. AS were applied in 40.7%, 55.9%, and 73.8% of patients at 3, 6, and 12 months respectively. LEDD reduction after three months was higher in patients remaining with BS or initially AS than in patients with a switch to AS after three months, while there was no difference at 12 months. Median distance of leads to the center of gravity of the motor-STN was slightly larger when AS were applied. AS are frequently employed in clinical routine at a specialized DBS center. They may compensate for deviant lead placement in terms of stimulation efficacy measured by postoperative LEDD reduction. Prospective studies are warranted, focusing on specific AS indications in chronic DBS to optimize individual patient outcomes.
The quality of video content published by oncology media outlets is poorly characterized. We analyzed short form videos discussing oncology trials to determine the methodological rigor of their reporting, whether content invoked shared decision-making principles, and the prevalence of relevant financial conflicts of interest (FCOIs) among speakers. Videos discussing oncology trials published by Oncology Live TV [OncLive TV], Targeted Oncology, and the Video Journal Oncology [VJ Oncology] between January and April 2024 were analyzed. Abstracted data included whether study characteristics, therapy characteristics, treatment recommendations, and shared decision-making principles were discussed. Speakers' general payment data from 2021 to 2023 were extracted from the U.S. Centers for Medicaid and Medicare Services Open Payments database. A majority of the 97 identified videos did not mention inclusion criteria (72%), exclusion criteria (95%), study limitations (81%), study strengths (91%), standard of care (75%), cost (96%), or shared decision-making (91%). Nearly one in five (18%) made specific treatment recommendations, of which only 13% invoked shared decision-making principles. Over half (52%) had speakers who received general payments from an entity with a financial interest in the discussed therapy. Digital coverage of oncology trials has gaps in the transparency, methodological rigor, and disclosure of FCOIs, and rarely includes shared decision-making principles-representing a missed opportunity for outlets to disseminate patient-centered, evidence-based information to their audiences. Clear standards for reporting trial and therapy characteristics and FCOI disclosures among oncology media outlets would promote responsible dissemination of emerging evidence and further their mission to promote evidence-based and patient-centered care.
Automated thalamic nuclear segmentation has contributed towards a shift in neuroimaging analyses, from treating the thalamus as a homogeneous, passive relay, to a set of individual nuclei, embedded within distinct brain-wide circuits. However, many studies continue to widely rely on FreeSurfer's segmentation of T1-weighted structural MRIs, despite their poor intrathalamic nuclear contrast. Meanwhile, a convolutional neural network tool has been developed for FreeSurfer, using information from both diffusion and T1-weighted MRIs. Another popular thalamic nuclear segmentation technique is HIPS-THOMAS, a multi-atlas-based method that leverages white-matter-like contrast synthesized from T1-weighted MRIs. However, comparisons amongst methods remain scant, and the thalamic atlases against which these methods have been assessed have their own limitations. These issues may compromise the quality of cross-species comparisons, structural and functional connectivity studies in health and disease, as well as the efficacy of neuromodulatory interventions targeting the thalamus. Here, we report, for the first time, comparisons amongst HIPS-THOMAS, the standard FreeSurfer segmentation, and its more recent development, against two thalamic atlases. We used two cohorts of healthy adults, and one cohort of patients in the chronic phase of autoimmune limbic encephalitis. In healthy adults, HIPS-THOMAS surpassed, not only the standard FreeSurfer segmentation, but also its more recent, diffusion-based update. The improvements made with the latter were limited to a few nuclei. Finally, the standard FreeSurfer method underperformed in distinguishing between patients and healthy controls based on the affected anteroventral and pulvinar nuclei. We provide recommendations on automated segmentation methods of the human thalamus using structural brain imaging.
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Harassment, including sexual harassment, in the workplace poses a significant threat to workers' wellbeing and contributes to social inequities. Organizations play a pivotal role in both enabling and preventing workplace harassment. We use a grounded theory approach to understand how workers experience workplace sexual harassment. Drawing on semi-structured interviews with thirty U.S. workers, most from the service industry in the San Francisco Bay Area, who have experienced sexual harassment at work, we describe organizational practices that workers believe effectively prevent and respond to harassment. Findings demonstrate that workplaces may better support workers by (1) setting clear expectations that harassment will not be tolerated and (2) responding effectively to incidents of harassment by establishing an independent entity to whom victims can report incidents, providing verbal support, and taking appropriate actions to support and protect victims.
However helpful have been the papers, reports, and books Erik Parens has produced while at The Hastings Center, conversation with him has always been even better. In both his writing and conversation, he goes to core values. As Erik departs Hastings-retiring as of the end of June 2026 to commit himself more fully to teaching, his original professional love-the loss of these conversational interactions will be felt profoundly, not just at Hastings but in bioethics broadly.
To assess associations between symptomatic polysubstance use and symptom severity during adolescence and later substance use disorder (SUD) symptoms in midlife. Multi-cohorts of nationally representative US adolescents in 12th grade (N=12,025; baseline cohort years 1976-2002) were followed longitudinally to age 55 (follow-up years 1993-2019). Poisson regression models were fitted longitudinally, accounting for repeated measures, panel attrition, and covariates. An estimated 8.9% (95% CI=8.3%-9.5%) of US adolescents had moderate-to-severe SUD symptoms involving multiple substances (ie, 4+ SUD symptoms for 2+ substances). The bivariate and multivariate relationships between SUD symptom severity and multiple SUDs at baseline and subsequent SUD symptoms in midlife (ages 35-55) indicated a positive near-linear association. Over two-thirds of adolescents with moderate-to-severe SUD symptoms involving multiple substances had multiple SUD symptoms in midlife (68.6%, 95% CI=63.0%-73.7%). Most adolescents with moderate-to-severe SUD symptoms of one substance and those with fewer SUD symptoms involving multiple substances (ie, 1-3 SUD symptoms for 2+ substances) persisted with multiple SUD symptoms in midlife (57.2%, 95% CI=53.2%-61.0% and 56.4%, 95% CI=51.4%-61.4%, respectively). Adolescents with moderate-to-severe SUD symptoms involving multiple substances had substantially greater odds of SUD symptoms in midlife relative to asymptomatic adolescents (aRR=2.80, 95% CI=2.49-3.15). Most US adolescents with symptomatic polysubstance use or moderate-to-severe SUD symptoms persisted with multiple SUD symptoms in midlife. Adolescent symptomatic polysubstance use is associated with a more severe developmental course in midlife than those with the same SUD symptom burden concentrated within a single substance, therefore, early comprehensive screening and intervention strategies are needed.