This study aimed to validate and adapt the Turkish version of the Illness Identity Questionnaire (IIQ) for cultural use. The IIQ was developed by Oris et al. to assess the integration of illness into identity. This psychometric validation investigation used a sample of young adults with chronic illness (n = 166) to evaluate a questionnaire. The questionnaire underwent forward and back translation procedures, and content and language validity was approved by experts. Confirmatory factor analysis supported a four-factor structure (engulfment, rejection, acceptance and enrichment) and demonstrated good model fit (χ2/df = 1.963, RMSEA = 0.076, GFI = 0.940 and CFI = 0.934). Convergent validity analyses revealed significant relationships between dimensions of illness identity, depression and life satisfaction. Engulfment, rejection and acceptance were positively related to depression and negatively related to life satisfaction, while enrichment exhibited the opposite pattern. Reliability analyses showed internal consistency ranging from acceptable to excellent, with Cronbach's alpha coefficients ranging from 0.719 to 0.907. Item-total correlations (0.380-0.799, p < 0.01) confirmed homogeneity in measuring illness identity. The Turkish version of the IIQ demonstrated acceptable psychometric properties, thus supporting its use as a reliable and valid tool for assessing illness identity. The Illness Identity Questionnaire has been validated for cross-cultural use in Turkish.Illness identity largely affects quality of life and depression in young people with chronic illness.The Turkish Illness Identity Questionnaire is a valid and reliable tool for assessing illness identity in young adults with chronic illness.
Alcohol fermentation waste (AFW) is a by-product of the alcohol manufacturing process with a rich carbohydrate and protein, serving as a suitable substrate for biomethane production via anaerobic digestion (AD). This study investigated the methanogenesis feasibility of AD treating AFW (total solids of 100.0 ± 1.0 g/L) in a thermophilic continuous stirred-tank reactor and explored the optimal operational conditions by regulating the hydraulic retention time (HRT) from 100 to 60, 30, and 20 days, based on system stability, CH4 yield, and organic matter degradation efficiency. The results revealed that a higher CH4 yield of 0.51 ± 0.03 L/g-VSdegraded was achieved sustainably at an HRT of 30 days. System stability was disrupted at an HRT of 20 days, which was primarily attributable to the accumulation of propionic acid (2.47 ± 0.11 g-HAc/L). The modified first-order kinetic model accurately simulated the CH4 yield and organic matter degradation efficiency under varying HRTs (all R2 > 0.92). Mass flow analysis and critical parameter correlation analysis are beneficial for reducing operational costs and streamlining operational procedures. The combination of syntrophic acetate oxidation bacteria (SAOB) and hydrogenotrophic methanogen (HM) is the dominant metabolic pathway in the system. As the HRT adjusted from higher (100 and 60 days) to lower (30 and 20 days) levels, the dominant SAOB and HM shifted from p_Firmicutes_MBA03 to Coprothermobacter and from Methanothermobacter to Methanobacterium, respectively. The energetics evaluation results revealed that a lower HRT (from 100 to 30 days) was conducive to achieving higher net energy (from 17.43 to 46.06 kJ/d).
Aging impacts all facial layers, leading to aesthetic concerns such as lines, folds, and furrows. Injectable dermal fillers are commonly employed to address these changes, with polycaprolactone (PCL) emerging as a widely used and innovative option. Images from before and after PCL injection were analyzed from 31 medical records (n = 31). The treatment points were 11. Images were processed in GIMP, and the selection of the facial area was in Adobe Photoshop, and the selected area was calculated in ImageJ. Associations between measurement variations before and after the procedure were tested concerning the increase and decrease in projections and shadows in the places where PCL was injected. The margin of error was 5% (p = .05) in the Bootstrap test (n = 300), Tukey's post hoc test, and ANOVA. There was no statistically significant difference in the zygomatic (p = .093), angle and ramus of the mandible (p = .07), and labiomental sulcus (p = .3559). In all other areas, there was a reduction in the shadow area, which was associated with an increase in the projection/prominence of the regions adjacent to the injection. PCL proved effective in full-face use in most areas tested (eight out of 11): Mean percentage reductions were: infraorbital margin (-8.3%, p = .021), palpebromalar groove (-7.4%, p = .006), piriformis fossa (-11.9%, p = .000), nasolabial fold (-9.5%, p = .002), oral commissure (-5.5%, p = .002), mentolabial groove (-9.0%, p = .001), pre-jowl area (-6.9%, p = .001), and chin (-6.9%, p = .001).
Involuntary psychiatric admission is associated with substantial distress, loss of autonomy, and strained therapeutic relationships for those admitted involuntarily and the healthcare professionals involved in their care. Psychosocial interventions may help mitigate these harms and support recovery, however, the literature in psychiatric inpatient settings has not been comprehensively mapped in relation to intervention characteristics, implementation, and context. To map the published literature on psychosocial interventions for adults admitted involuntarily to psychiatric inpatient settings and to describe intervention types, delivery characteristics, reported theoretical underpinnings and stated rationales, implementation factors, outcomes assessed, and key evidence gaps. A scoping review was conducted using Joanna Briggs Institute methodology and reported in line with PRISMA-ScR. Six databases and supplementary grey literature were searched to August 2025. Eligible studies included adults in psychiatric inpatient settings where more than 50% of the sample were involuntarily admitted and where psychosocial interventions of any design were reported. Interventions were categorised as direct patient, system-level, or combined approaches. Twenty-two studies evaluating eighteen distinct interventions were included, encompassing randomised, pre-post, quasi-experimental, mixed-methods, qualitative, and descriptive designs. Interventions were delivered across acute and forensic settings and varied considerably in content, duration, provider background, and reported theoretical underpinnings. Studies reporting more favourable outcomes in relation to patient experience, empowerment, or engagement often included lived experience involvement, trauma-informed elements, or co-produced features, although the evidence base was heterogeneous and clinical outcomes were more variable. Implementation barriers included staff shortages, organisational constraints, and difficulties integrating interventions into routine practice. The evidence base remains limited and heterogeneous. Important gaps include cultural adaptation, family involvement, longer-term follow-up, and sustained lived-experience involvement in intervention design, delivery, evaluation, and dissemination. This review adds to existing literature by mapping intervention characteristics, implementation issues, contextual factors, and lived-experience involvement. Future research should give greater attention to co-produced, trauma-informed, and rights-based approaches in psychiatric inpatient settings involving involuntary admission. This scoping review followed PRISMA-ScR and JBI guidance. The protocol is publicly available on the Open Science Framework (OSF) [https://osf.io/gtbxh/], registered on Jun 24, 2024. The review was not registered on PROSPERO, as scoping reviews are not generally eligible for PROSPERO registration.
To explore Practice Development interventions and associated contextual factors to understand their impact on patient and staff outcomes and experiences in healthcare settings. Systematic review. Preferred Reporting Items for Systematic Reviews and Meta-analysis informed design, conduct and management. A systematic approach was taken, utilising multiple reviewers and consensus methods. Mixed Methods Appraisal Tool informed quality appraisal. Qualitative findings were analysed using Reflexive Thematic Analysis. Quantitative results are presented as a narrative summary. CINAHL; MEDLINE; PubMed; Scopus; ScienceDirect; Nursing and Allied Health; Cochrane Library; Internurse.com; The Kings Fund; GOV.UK and Trip Database were searched between 1st January 1980 to 5th January 2026. Twenty-nine studies were included. Eighteen studies met all quality assessment criteria. Limited quantitative data was available, and inconsistent outcome measures constrained quantitative analysis. Qualitative analysis generated three themes: (1) Shaping Practice: the interplay of organisational context, culture, and structure, (2) Enablers and constraints in Practice Development, (3) Collective empowerment. Across diverse study designs, the majority of studies indicate that PD contributes positively to staff working environments and the contexts in which patient care is delivered. However, current findings do not demonstrate consistent improvements in clinical outcomes or quality of life. Practice Development may contribute to improvements in care environments for patients and staff, respectively. This review highlights knowledge gaps in the generalisability and transferability of Practice Development that would benefit from further exploration. Practice Development may enhance healthcare environments, but further research is needed to determine if these benefits impact upon clinical outcomes. Preferred Reporting Items for Systematic reviews and Meta-Analyses. No patient or public contribution. PROSPERO registration number: CRD42024557949.
The article presents an analysis of the dynamics in the number of healthcare organizations of various forms of ownership in the Russian Federation for the period from 2009 to 2024. The study was conducted using statistical and analytical methods of time series data processing. Opposite trends in the development of the public and private healthcare sectors have been identified. In the public sector, a reduction in the number of hospital organizations by 27.66% was recorded, alongside a simultaneous increase in the number of outpatient clinics by 23.63%, reflecting the optimization processes in the inpatient sector and the strengthening of primary health care. The private sector demonstrated exponential growth: the number of hospital organizations increased almost fourfold, and outpatient clinics more than doubled. The capacity of private outpatient clinics increased more than fourfold. All identified trends are confirmed by statistical significance. The results obtained indicate the transformation of private medicine into a significant element of the national health protection system, capable of filling the deficit niches of the public sector. В статье представлен анализ динамики числа медицинских организаций различных форм собственности в Российской Федерации за 2009—2024 гг. Исследование выполнено с применением статистических и аналитических методов обработки данных временных рядов. Установлены разнонаправленные тенденции развития государственного и частного секторов здравоохранения. В государственном секторе зафиксировано сокращение числа больничных организаций на 27,66% при одновременном увеличении количества амбулаторно-поликлинических организаций на 23,63%, что отражает процессы оптимизации стационарного звена и усиления первичной медико-санитарной помощи. Частный сектор продемонстрировал экспоненциальный рост: число больничных организаций возросло почти в 4 раза, амбулаторно-поликлинических — более чем в 2,5 раза. Мощность частных амбулаторно-поликлинических организаций увеличилась более чем в 4 раза. Все выявленные тренды подтверждены статистической значимостью. Полученные результаты свидетельствуют о трансформации частной медицины в значимый элемент национальной системы охраны здоровья, способный компенсировать дефицитные ниши государственного сектора.
Momilactones A (MA) and B (MB) are bioactive diterpenoid lactones found in rice husk; however, conventional extraction relies on solvent-intensive methanolic methods and exhibits limited efficiency, raising environmental sustainability concerns. This study evaluates water-based green extraction approaches to improve the yields and biological performance of momilactone-enriched extracts while reducing solvent consumption. Freezing (FRH), sonication (SRH), combined freezing-sonication (PFS), and cellulase-assisted extraction (E) were compared with conventional methanolic extraction (MRH) as a control. Freezing at -20 °C for 16 h (FRH2) and sonication for 2 h (SRH1) achieved the highest enrichment of MA (51.9 and 52.7 µg/g, respectively) and MB (32.5 and 34.3 µg/g, respectively), representing 1.2-1.4-fold increases over MRH. These extracts exhibited enhanced cytotoxicity against K562, U937, and THP-1 cell lines (IC50: 80.36-124.76 µg/mL) and antibacterial activity against Staphylococcus aureus (MIC: 2 mg/mL). Overall, water-based physical pre-treatments offer a sustainable platform for momilactone extraction in functional food and pharmaceutical applications.
The aim of this study is to examine the associations between smoking self-efficacy, health anxiety, and women's awareness of third-hand smoke (THS). This descriptive, cross-sectional study was conducted in Türkiye between June and July 2025 through an online survey with 335 women aged ≥18 years. Data were collected using a Descriptive Information Form, the Third-hand Smoke Awareness Scale, the Smoking Self-Efficacy Scale, and the Health Anxiety Inventory. Data were analyzed using descriptive statistics, Mann-Whitney U, Kruskal-Wallis, Spearman's correlation, multiple linear regression, and mediation analysis. A total of 335 women were included in the study (mean age: 34.67 ± 12.31 years). Significant differences in THS awareness, smoking self-efficacy, and health anxiety were observed across several sociodemographic and behavioral variables. Higher educational level was associated with greater THS awareness, while participants with children and those whose partners smoked had lower awareness levels (P < .05). Smoking self-efficacy was higher among nonsmokers and individuals with higher education, whereas health anxiety was higher among smokers and those exposed to smoking in their environment (P < .05). Spearman's correlation analysis revealed weak but significant associations, including a negative correlation between number of children and THS awareness (ρ = -.213, P < .01), and a positive correlation between THS awareness and smoking self-efficacy (ρ = .154, P < .05). Multiple linear regression analysis showed that the model explained a small proportion of variance (R2 = .06). Only the number of children was significantly associated with THS awareness (β = -.16, P = .02), while smoking self-efficacy and health anxiety were not significant predictors. Mediation analysis indicated that smoking self-efficacy did not mediate the relationship between THS awareness and health anxiety (P > .05). THS awareness was associated with several sociodemographic and behavioral factors; however, smoking self-efficacy and health anxiety were not significant predictors in the adjusted model. These findings suggest that awareness alone may be insufficient and that broader contextual and individual factors should be considered in strategies aimed at reducing tobacco exposure.
The article provides a comprehensive assessment of the psychological state of the Russian population in the face of multiple external challenges. According to the April 2024 survey conducted by the All-Russian Public Opinion Research Center, nine out of ten Russians experience stress on a regular basis, with one in five experiencing stress on a regular basis. The index of need for psychological assistance reached 30 out of 100 in late 2024, marking the highest level in the past 15 years. The purpose of this study is to analyze the current state of attitudes towards stress in Russian society based on data from large-scale sociological and psychological studies conducted in 2024-2025. The study examines the factors that influence an environmentally friendly attitude towards stress and the ability to cope with it. The main objectives include systematizing scientific approaches to studying stress, analyzing methods for diagnosing stress conditions, summarizing data on the prevalence of stress among the Russian population, and identifying dominant coping strategies. В статье проведена комплексная оценка психологического состояния российского населения в условиях множественных внешних вызовов. По данным Всероссийского центра изучения общественного мнения за апрель 2024 г., с разной периодичностью со стрессом сталкиваются 9 из 10 россиян, при этом каждый пятый испытывает стресс на регулярной основе. Индекс потребности в психологической помощи в конце 2024 г. достиг 30 пунктов из 100 возможных, что является максимальным показателем за последние 15 лет. Целью настоящего исследования является анализ современного состояния отношения к стрессу в российском обществе на основе данных крупных социологических и психологических исследований 2024—2025 гг. В работе исследованы факторы, влияющие на экологичное отношение к стрессу и умению противостоять ему. Основные задачи включают систематизацию научных подходов к изучению стресса, анализ методов диагностики стрессовых состояний, обобщение данных о распространённости стресса среди населения России и выявление доминирующих копинг-стратегий.
Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterized by fluctuating activity affecting multiple organ systems. Timely and accurate assessment of disease activity is critical for guiding clinical decisions and implementing treat-to-target strategies. The Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) is a recently developed, continuous, and weighted index for disease activity, though it has not yet been validated in Russian patients. To validate SLE-DAS in a Russian cohort of patients with SLE. We prospectively enrolled 200 SLE patients followed for ≥12 months at the V.A. Nasonova Research Institute of Rheumatology. The median age was 35.0 [26.0-43.0] years; 84.5% were female. Median disease duration was 63.0 [22.0-158.0] months. Clinical and laboratory data were analyzed to asses SLE-DAS performance. Internal consistency of SLE-DAS was assessed using Cronbach's alpha. Convergent validity was evaluated via correlation with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and Physician Global Assessment (PGA). To compare the ability of SLE-DAS and SLEDAI-2K to identify active SLE, we performed a receiver operating characteristic (ROC) analysis with determination of the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's kappa. Responsiveness was analyzed using the Wilcoxon test, SRM, and Cohen's d. At baseline, the median SLEDAI-2K was 8.0, PGA 0.99, and SLE-DAS 8.38. SLE-DAS showed excellent convergent validity (ρ = 0.878 with both SLEDAI-2K and PGA). Internal consistency was moderate for binary components (α = 0.663), while quantitative variables showed low agreement. According to DORIS remission framework, 90.5% of patients had active SLE. ROC analysis showed high diagnostic accuracy: AUC = 0.899 for SLE-DAS and 0.870 for SLEDAI-2K. After reclassifying 23 patients on glucocorticoids >5 mg/day without clinical activity as inactive, SLE-DAS showed superior performance: AUC = 0.973, sensitivity 96.2%, specificity 97.6%, PPV 99.3%, NPV 82.4%, κ = 0.86. Responsiveness at 6 and 12 months was also confirmed (SRM = -0.78 and -0.66, both p < 0.0001). SLE-DAS is a valid, responsive, and accurate tool for assessing SLE activity in Russian patients and may improve clinical monitoring in routine practice.
Osgood-Schlatter disease (OSD), also known as tibial tubercle apophysitis, is a traction apophysitis of the tibial tuberosity that disproportionately affects adolescents during periods of rapid skeletal growth (1). First described independently by Robert Osgood and Carl Schlatter in 1903, this condition represents the most prevalent cause of knee pain in the skeletally immature athletic population (3). Despite its self-limiting nature, OSD can result in prolonged symptoms lasting up to 24 months, with approximately 10% of affected individuals experiencing persistent pain into adulthood, particularly with activities such as kneeling. However, conservative management achieves successful outcomes in over 90% of pediatric cases (4). The burden of OSD extends beyond immediate symptomatology. Recent epidemiological data indicate that lower extremity apophysitis can result in pain lasting between 1 and 45 weeks, with potential consequences for physical activity participation during critical developmental periods (7). This is particularly concerning given the established relationship between childhood physical activity and long-term health outcomes. Furthermore, the condition's propensity to affect athletes during peak competitive years raises important considerations for talent development, psychological well-being, and long-term athletic participation. Historically, OSD management has relied heavily on activity modification and symptomatic treatment. However, advances in our understanding of its pathophysiology-particularly the identification of specific biomechanical risk factors and critical developmental windows-have enabled a more nuanced, multidimensional approach to care.
To determine the frequency of selected MKRN3 variants and to investigate genotype-phenotype associations in Uzbek children with central precocious puberty, with particular emphasis on sex-specific clinical, hormonal, and instrumental characteristics. This single-center study included 69 Uzbek children with CPP and 30 healthy controls (used primarily for assay validation). Targeted genotyping of three MKRN3 variants (c.1034G>A [p.Arg345His], c.1229G>A [p.Cys410Ter], and c.331G>T [p.Glu111Ter]) was performed using real-time PCR with TaqMan assays. Clinical, hormonal, skeletal, and ultrasonographic parameters were analyzed using non-parametric methods. Selected MKRN3 variants were identified in 21.7 % (15/69) of this cohort of Uzbek children with CPP. The most frequent variant was c.1034G>A (13.0 %), followed by c.1229G>A (8.7 %); c.331G>T was not detected. Variant frequency was higher in boys (28.6 %) than in girls (18.7 %), without statistical significance. In girls, variant carriers had significantly smaller uterine and ovarian dimensions, larger dominant follicle diameter, and lower basal LH levels, while bone age advancement and estradiol levels were comparable. In boys, variant carriers demonstrated higher testosterone levels, with no significant differences in gonadotropins, bone age advancement, or testicular volume. Selected MKRN3 variants were present in 21.7 % of this cohort of Uzbek children with CPP. MKRN3-related CPP demonstrated genotype-specific morphological and endocrine features, particularly in girls. These findings suggest phenotypic heterogeneity and warrant confirmation in larger sequencing-based studies.
While there is broad research among caregivers in general, much less is focused on caregivers living with HIV, a gap we beging to fill here. Data come from the Columbus Healthy Aging Project (N=794) which assessed several domains of health among adults aged ≥50 years in Columbus, Ohio, USA. Using multivariable regression models, we examined the likelihood of being a caregiver, number of care recipients, and caregiver strain among people living with HIV alongside measures of aging concerns. People living with HIV (n=32) were more likely to serve as caregivers (aOR=2.92; 95% CI: 1.22, 7.02) and experience elevated caregiver strain (B=1.31; 95% CI: 0.06, 2.56) than those who are HIV-negative. There was no association nor moderation between HIV status, caregiver status, and general aging concerns. Separately, caregivers (B=1.02; 95% CI: 0.20, 1.83) and those diagnosed with HIV (B=2.13; 95% CI: 0.60, 3.67) each reported increased sexual identity-specific aging concerns. We also observed significant moderation between these variables (B=6.53; 95% CI: 3.61, 9.46). These results suggest there are unique forms of stress that are elevated among caregivers living with HIV, a critical area of research as elevated stress is well known to lead to comorbid conditions among those living with HIV.
To determine the circumstances of acute poisoning cases at the Poison Control Center (2021-2024) and analyze their risk factors. We retrospectively analyzed the demographic characteristics, clinical features, and prognosis of patients with acute poisoning at the Poison Control Center. This study included 10,402 cases comprising drug poisoning (5,074), alcohol poisoning (2,316), carbon monoxide poisoning (1,803), pesticide poisoning (882), and chemical poisoning (327). The age group with the highest incidence of poisoning was 21-40 years old (37.94%, p < 0.01). Women have a higher proportion of drug poisoning (72.59%, p < 0.01), while men have a higher proportion of alcohol poisoning (74.31%, p < 01). Patients with pesticide poisoning were predominantly educated to the middle school level or below (73.02%, p < 0.01), whereas those with alcohol poisoning were mainly educated to the high school level or above (73.88%, p < 0.01). Carbon monoxide and pesticide poisoning occur primarily in rural areas. Poisoning incidents at home accounted for 74.32%, alcohol poisoning frequently occurred in entertainment venues (60.58%, p < 0.01). Carbon monoxide poisoning is more common in January and December, whereas drug poisoning has a higher incidence throughout the year. Carbon monoxide, chemical and alcohol poisoning were predominantly accidental, whereas drug and pesticide poisoning were mainly intentional. Gastric lavage dominated pestic ide poisoning; Antidotes prevailed in alcohol poisoning.The overall mortality rate was 1.56 %, highest for pesticide poisoning (8.28%, p < 0.01). Different types of poisoning have distinct sociodemographic characteristics, that should be considered when developing prevention and treatment policies. Personalized treatment plans should be tailored to different poisonings.
The clinical relevance of concordance between multidisciplinary tumor board (MDT) decisions and artificial intelligence (AI)-based treatment recommendations remains unclear. This study evaluated not only concordance but also the clinical impact of discordance direction on outcomes in endometrial cancer. We retrospectively analyzed 150 patients with endometrial cancer discussed at a single-center MDT. AI-based recommendations were generated using a large language model according to ESGO/ESTRO/ESP guidelines, based on standardized clinicopathological inputs without molecular classification. Concordance between MDT and AI recommendations was assessed at the patient level. Discordant cases were classified as relative undertreatment or overtreatment. Agreement beyond chance was evaluated using Cohen's kappa. Recurrence-free survival (RFS) was analyzed using Cox regression and Kaplan-Meier methods. Overall concordance was observed in 76.7% of patients, with fair agreement beyond chance (Cohen's κ = 0.365, 95% CI 0.181-0.549). During follow-up, 68 events (45.3%) occurred. Concordance was not independently associated with RFS in multivariable analysis (adjusted HR 1.26, 95% CI 0.64-2.48, p = 0.50). In contrast, relative undertreatment was associated with worse RFS (HR 1.94, 95% CI 1.03-3.64, p = 0.040), whereas overtreatment was not. Event rates were higher in the undertreatment group compared to concordant patients (67.9% vs 40.0%), despite more favorable baseline characteristics. Concordance alone may be insufficient to determine the clinical relevance of AI-based recommendations. Discordance direction appears more informative, with treatment de-escalation associated with inferior outcomes. AI-based systems may help identify potential undertreatment and support more consistent implementation of guideline-based care.
A sustainable method was developed to synthesize zinc-coordinated lignin nanoparticles (LNP-Zn) from lignin derived from sugarcane bagasse, without the use of stabilizers. The direct coordination of Zn2+ within the lignin matrix creates a unique hybrid nanomaterial with several functions. At neutral pH, LNP-Zn had a mean particle size of 141.14 nm and a zeta potential of -30.41 mV, showing strong colloidal stability. BET analysis revealed a mesoporous structure with 37.16 m2/g surface area and 0.2858 cm³/g pore volume. XPS confirmed Zn+ coordination through oxygenated lignin moieties, while FTIR showed novel Zn-O functional groups having high thermal stability. XRD revealed that the LNP is amorphous, with a crystallite size of 0.42 nm. LNP-Zn demonstrated stronger antioxidant activity (IC50 21.26 ± 0.67 µg/mL), UV-shielding (SPF 23.87 ± 1.21), and efficient dye degradation. LNP-Zn showed remarkable biocompatibility (91.58 ± 2.08% viability of HEK-293 cells at 1000 mg/l) and dose-dependent cytotoxicity at high concentrations, indicating limited intrinsic anticancer activity and primarily supporting a biocompatible profile. Moreover, LNP-Zn boosted plant growth with a 189.17 ± 7.97% root enhancement in Vigna radiata (L.) R. Wilczek. Despite these promising results, further studies are needed to elucidate long-term biological safety, environmental fate, and the mechanisms underlying Zn-lignin interactions.
Emotional engagement is key to learning, yet empirical evidence on how specific activities and emotions remain salient over time is limited. The objective of this study was to descriptively examine the relationship between emotional experiences reported immediately after instruction and learning activities that remained subjectively salient one week later. This descriptive observational study with exploratory analyses used anonymous post-class and one-week follow-up surveys from two communication-skills classes of second-year pharmacy students. Students selected six predefined emotions related to achievement and cognitive disequilibrium. They also provided free-text descriptions of the most memorable learning activity at each time point. Exploratory chi-square analyses were used as descriptive indicators to examine patterns of emotion label distributions, similarities in emotion label distributions between Day 0 and Day 7, and activity-specific emotional profiles. Response rates ranged from 93.9% to 100.0% across sessions. Across both sessions, positive emotions were predominant. The emotional distribution observed on Day 0 showed similar tendencies one week later. Role-play (RP) was the most frequently reported salient activity. Values clarification showed a surprise-dominant profile, while RP was empathy-dominant in one session and showed a balanced emotional distribution in the other. Emotionally engaging experiential and interactive components remained salient one week later. These findings suggest that examining emotionally salient learning experiences may help inform instructional design and reflective educational practices in pharmacy education.
This study examined psychological distress and financial toxicity among cancer patient-caregiver dyads receiving chemotherapy in Western India, focusing on emotional and financial interdependence. In this cross-sectional study of 357 chemotherapy patient-caregiver dyads, psychological distress (NCCN Distress Thermometer), financial toxicity (COST-FACIT), and adverse drug reactions (standard causality and severity scales) were assessed, with patient predictors analyzed by multivariable logistic regression and dyadic effects examined using the Actor-Partner Interdependence Model. Clinically significant distress was reported by 55.74% of patients and 10.92% of caregivers, while nearly 70% of both groups experienced mild-to-moderate financial toxicity. Patient distress was significantly associated with adverse drug reactions (AOR = 2.208), higher patient financial toxicity (AOR = 0.895), caregiver financial toxicity (AOR = 1.056), and caregiver distress (AOR = 1.951). Caregiver distress was significantly associated with caregiver financial toxicity (AOR = 1.19), patient distress (AOR = 0.72), breadwinner status, and marital status. APIM showed strong actor effects for patients (β = 0.446) and caregivers (β = 0.366), and partner effects indicating cross-dyad influence (β = 0.157; β = 0.168). Psychological distress and financial toxicity are prevalent, and addressing patient-caregiver interdependence-particularly in primary caregivers and patients with treatment toxicities-may improve outcomes.
The prevalence of Direct Coombs test (DCT) positivity in systemic lupus erythematosus (SLE) ranges from 12.8% to 65.2%. Approximately 5-11% of people with SLE have autoimmune haemolytic anaemia (AIHA), characterised by autoantibodies against erythrocytes that cause haemolysis. In about half of the SLE patients, DCT positivity occurs even in the absence of AIHA, likely due to immune complexes binding to red blood cells via complement receptor 1 (CR1), suggesting a higher immune complex load. To determine the DCT positive rate in SLE patients without AIHA and its association with disease activity, as measured by the SLE Disease Activity Index 2000 (SLEDAI-2K) score. This descriptive cross-sectional study was conducted at a tertiary care centre in South India from March 2023 to March 2025. SLE patients who met the 2019 ACR/EULAR classification criteria without AIHA were included. Disease activity was measured using the SLEDAI-2K. The DCT was performed using the standard antihuman globulin, and a reaction grade of 1+ or higher was considered positive. The study compared DCT-positive and DCT-negative groups using statistical analysis. The study included 92 SLE patients, most of whom were female (97.8%), with a mean age of 35.1 ± 9.49 years, and a mean disease duration of 4.56 ± 4.36 years. DCT positivity without AIHA was found in 33.6% of the patients. DCT-positive patients had a higher median SLEDAI-2K score than DCT-negative patients (8 [IQR 3.5-10.5] vs 0 [IQR 0-5]; p < 0.001). DCT positivity was also strongly associated with arthritis (p < 0.001) and with higher anti-double-stranded DNA antibody levels (p = 0.008). In individuals with SLE, DCT positivity without AIHA was common and was associated with higher contemporaneous disease activity, arthritis, and elevated anti-double-stranded DNA antibody levels. These findings suggest that DCT positivity may reflect increased immune activity at a single point in time. However, its utility in predicting future flares or monitoring longitudinal disease activity remains uncertain and requires prospective validation.
Women from minoritized backgrounds experience disproportionately higher perinatal mortality than white women, with stillbirth rates highest among Black women and elevated among some Asian ethnic groups. Despite this, women from the global majority remain underrepresented in National Health Service Perinatal and Maternal Mental Health Services, United Kingdom (UK). This scoping review aims to: (i) examine the use of creative health approaches to support mental wellbeing following baby loss among minoritized women, and (ii) identify priorities for future research into culturally informed creative mental health interventions. This scoping review employed a structured methodology to identify qualitative, quantitative, and gray literature exploring creative health approaches for women from minoritized backgrounds following baby loss. A total of 1808 records were identified. Following deduplication, 507 records were screened and 22 full-text articles assessed for eligibility and eight included in the scoping review. A content analysis identified three overarching themes: (i) navigating the unseen-meaning, identity, and silence in perinatal loss; (ii) healing through creative expression; and (iii) holding on and moving forward-creative connection after baby loss. Creative approaches supported women in making sense of baby loss by fostering continuing bonds with their baby and facilitating reflection on identity and future direction. Group-based creative methods promoted belonging and helped counter silence surrounding baby loss within communities. However, there remains a significant lack of research in this area, particularly involving global majority women.