Cancer is a complex phenomenon encompassing a range of cultural and biomedical dimensions. Traditional medical curricula often fail to reflect this complexity, highlighting the need for interdisciplinary approaches that help medical students develop a more integrated understanding of disease by connecting diverse knowledge, patient perspectives, and societal contexts. This study evaluates how framing analysis-a method from communication studies-can be used as a pedagogical tool to broaden medical students' understanding and critical thinking about complex health issues, using cancer as a key example. We conducted a course evaluation of a two-week elective titled "Cancer Communication" within the University of Oslo's medical program, offered annually to approximately 20 third-year students. Working in teams, students explored research questions related to cancer communication through lectures, workshops, guided research, and excursions. They learned framing analysis by applying a published tool for examining public cancer discourse. Anonymous pre-course free associations and post-course reflections were analyzed thematically to identify changes in students' understanding of cancer during the course. Students' team presentations, orally evaluated as part of the final course examination, supported our assessment of how students applied framing analysis to cancer-related communication topics. Students' initial responses reflected relatively simple and emotionally charged associations with cancer, often centered on fear, death, treatment burden, and familiar cancer stereotypes. Their post-course reflections suggested increased media literacy, critical thinking, and the ability to integrate multiple narratives about cancer. In their final presentations, students applied framing analysis to critically evaluate media portrayals and reflect on how different framings shape public and professional perceptions of disease. The post-course reflections further suggested greater empathy for cancer patients and an increased awareness of social and cultural influences on medical practice. Integrating framing analysis into medical education appeared to broaden students' understanding of cancer as a multidimensional phenomenon, supporting reflective and interdisciplinary thinking and encouraging them to move beyond traditional biomedical perspectives. These findings suggest that framing analysis and similar communication-based approaches may serve as useful pedagogical tools in health professions education to enhance critical reflection.
This study aimed to determine whether a distance-based CPR training program with asynchronous feedback for laypersons is non-inferior to the traditional in-person Heartsaver® First Aid CPR AED course. After approval by the ethics committee, 192 non-medical personnel were recruited to participate in this study. Participants were randomly assigned to two different training methods: Traditional in-person Heartsaver® First Aid CPR AED course (T-course).Distance-based course offering asynchronous feedback through an online platform (D-course). For the distance-based course, materials for practice were available at the participants' workplace (pad, resuscitation torso, an automated external defibrillator). The video-based assessment and feedback platform C1DO1 was used (https://c1do1.ai/). The course was structured in 9 stages on the platform, with theoretical and practical steps. Participants reviewed the videos and practiced unsupervised, uploading video recordings of their practice, and instructors assessed and provided feedback asynchronously on these videos. Participants then reviewed their own videos with the feedback and practiced again until approval. Both groups completed a pre-training (PRE) and post-training assessment (POST). During both assessments, participants were recorded performing CPR. Videos were evaluated by two independent, blinded reviewers who rated participants' performance using the AHA Heartsaver Adult CPR and AED skills testing checklist. Additionally, the quality of chest compressions (CC) was measured with the Prestan simulator application. Of the 192 participants recruited, 172 completed the training, and 158 took the PRE and POST assessments. (83 finished the T-course and 75 the D-course). Median Heartsaver Adult CPR and AED skills testing checklist scores increased from 2 (0-3) to 15 (14-16.5) points in the T-course and from 1 (0-2.5) to 16 (15.5-17) points in the D-course. The difference in POST assessment median scores between groups was -1 (95% CI: [-1.5, -0.5]), with the lower bound above the pre-established non-inferiority margin, confirming the non-inferiority of the D-course. The median CC rate increased from 82 (0-106)/min to 105 (102-110)/min in the T-course and from 86 (0-109.5)/min to 105 (105-108)/min in the D-course. The median CC depth rose from 38 (0-57.5) mm to 58 (49.5-60) mm in the T-course and from 32 (0-56) mm to 59 (55-60) mm in the D-course. Both training programs significantly improve participants' proficiency in CPR. The distance-based course with asynchronous platform feedback was non-inferior to the traditional Heartsaver® First Aid CPR AED course.
Within allied-health programs, gross anatomy is widely regarded as a foundational and content-dense course challenging instructors and students alike to manage an overwhelming volume of information within an increasingly constrained curriculum. In the late 1960's, the Duke University medical curriculum was redesigned to produce 'scientists-doctors' intensifying the instructional challenges of gross anatomy. In the wake of a series of unsuccessful experiments, comparative anatomists Matt Cartmill and James Shafland were recruited to develop and teach a medical gross anatomy course at Duke. Drawing on comparative anatomy, embryology, and evolutionary theory, Cartmill and colleagues developed a distinctive pedagogical framework organized around an idealized vertebrate metameric Bauplan-the Typical Body Segment (TBS)-with an accompanying textbook: Human Structure. Rather than trying to memorize details about sprawling sets of isolated structures, the TBS approach transforms learning gross anatomy into a series of stories about how evolution and development regionally pattern and differentiate Typical Body Segments into functionally specialized, interconnected modules. This article discusses the circumstances leading to the emergence of Cartmill's course-directorship and the TBS approach to teaching gross anatomy at Duke. We argue that the consistent use of a central homological schema as a starting point for narratives about the complex human form offers many pedagogical advantages, including reduced cognitive load, improved organization of anatomical knowledge, as well as a better grasp on patterns of interaction and variation among parts. Drawing on qualitative data from student course evaluations at High Point University, we further illustrate how this approach appears to shift students' orientation from rote memorization toward a conceptual understanding of anatomy. Finally, we document the diffusion and transformation of the TBS paradigm through faculty lineages, postdoctoral training, and allied health programs, highlighting its enduring influence on contemporary anatomy education. Together, this history and analysis underscore the value of centering evolutionary and developmental narratives in the teaching of human anatomy and documents the major contributions from Cartmill and other gross anatomists who taught with the TBS approach at Duke University.
Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis (MOG-ON) is a subtype of demyelinating optic neuritis (ON) characterized by a considerable risk of relapse; however, the demographic and clinical factors associated with recurrence remain poorly defined, posing ongoing challenges for patient management. A retrospective analysis was conducted on adult-onset MOG-ON patients diagnosed in the Ophthalmology Department of the Chinese People's Liberation Army General Hospital (PLAGH) from January 2019 to January 2024. Patients were divided into two groups based on their experience of a relapse course: the relapsing group and the monophasic group. Multivariate analysis was performed to examine the effects of various clinical factors on the risk of recurrence. Among 126 screened participants, 56 were excluded. A total of 70 patients (median [IQR] age at onset, 35.50 [30.00, 48.75] years; 46 females [65.71%]) were included. During a median follow-up of 31.50 (IQR 21.25-52.75) months, disease relapse occurred in 54.29% (38/70) of patients. Multivariate analysis revealed that being female significantly elevated recurrence risk (hazard ratio [HR] 3.92, 95% CI 1.63-9.42, p = 0.002), while administration of immunosuppressive maintenance therapy after the first episode was associated with a lower likelihood of recurrence (HR 0.30, 95% CI 0.10-0.87, p = 0.026). At the final follow-up, the relapsing group had significantly worse visual outcomes compared with the monophasic group (median [IQR] VA, 0.40 [0.16-0.82] logMAR vs. 0.22 [0.10-0.40] logMAR; p = 0.012). In adult-onset MOG-ON, female sex is associated with an increased risk of recurrence, whereas early maintenance immunosuppressive therapy is associated with a lower recurrence risk. Furthermore, patients with a relapsing disease course exhibit poorer visual outcomes at follow-up compared with those with a monophasic course.
To address the rising threat of antimicrobial resistance, many countries are making efforts to establish baseline data and monitor antimicrobial use (AMU) in livestock. Although international reporting uses the total mass of antimicrobial agents standardized by animal biomass, other metrics may be more useful for individual countries, farmers or veterinarians to monitor progress over time. Using garbage can audits, we collected observational data on on-farm AMU from a convenience sample of 29 Argentinian dairy farms, separated into adult and youngstock groups, and calculated mass- and course-based metrics to benchmark estimated usage over the first 365 d of collection. Aggregated data from all farms gave an overall average (mean) usage of 25.8 mg/PCU; when calculated per farm, median AMU was 19.37 mg/PCU (range 4.97 to 58.90 mg/PCU). The third-generation cephalosporin, ceftiofur, was widely used as an injectable in adult cattle, while enrofloxacin was commonly used in youngstock. Oral ciprofloxacin - marketed as part of a multivitamin preparation for use in newborn calves - while only found on 4 farms, constituted 34% of all Category B antimicrobials, recommended as restricted for use in livestock by the European Medicines Agency. Course-based metrics demonstrated that high medicine usage on individual farms tended to occur in only one of the following categories: Category B medicines, youngstock, intramammary or systemic treatment in adults. These granular metrics help identify problem areas for individual farms, but may be less useful for formulating policy and measuring progress. A reduction in Category B usage appears to be a good opportunity for improved stewardship for the majority of participants and potentially for similar intensifying farms in the Argentinian dairy sector, although country-specific data (such as actual course doses and lengths used in the country) would improve calculation methodology for national monitoring.
Immunoglobulin A (IgA) nephropathy (IgAN) with superimposed minimal change disease (MCD) is a rare but increasingly recognized clinicopathological phenotype that is generally associated with a favorable renal prognosis. We present a case of IgAN with MCD complicated by severe acute kidney injury (AKI) during the clinical course and requiring temporary renal replacement therapy. A 38-year-old man presented with acute nephrotic syndrome. Renal biopsy showed mesangial IgA deposition, and anti-galactose-deficient IgA1 antibody (KM55) staining demonstrated co-localization with IgA deposits, supporting the diagnosis of IgAN with superimposed MCD. Electron microscopy revealed foot process effacement, leading to a diagnosis of IgAN with MCD. High-dose prednisolone therapy was initiated; however, the patient subsequently developed severe AKI requiring hemodialysis (HD). Concurrent treatment with cyclosporine A and steroid pulse therapy was administered, ultimately allowing successful discontinuation of HD. This rare case was diagnosed as IgAN with MCD based on mesangial IgA deposition supported by KM55 staining and characteristic electron microscopic findings, and this case demonstrates that severe AKI requiring temporary HD may occur during the clinical course of IgAN with MCD. Although IgAN with MCD has been increasingly recognized, reports of cases complicated by severe AKI requiring HD remain limited in the literature. This patient showed subsequent improvements in renal function and proteinuria, suggesting that this condition may be reversible. These findings highlight the importance of careful clinical management with attention to the potential risk of AKI even in patients with IgAN with MCD.
Epigenetic age accelerations have been associated with the clinical expression of BD; however, with few available studies. We calculated Horvath, Hannum, EN, GrimAge, and PhenoAge epigenetic ages in a sample of 139 individuals with BD. We used a latent profile analysis to identify subgroups of individuals based on their profile of epigenetic age accelerations. We compared these profiles for socio-demographic characteristics, course of BD, associated psychiatric conditions, current medication use, telomere length, mitochondrial DNA copy number (mtDNAcn), markers of metabolic syndrome, and of systemic inflammation. The latent profile analysis identified two subgroups, one with accelerated and one with decelerated epigenetic aging (respectively 58% and 42%). Subgroups did not differ for socio-demographic characteristics, course of BD, associated psychiatric conditions, nor current medication use. The accelerated aging subgroup was characterized by higher depressive symptoms (p < 0.001), lower mtDNAcn (p < 0.001), higher levels of systemic inflammation (platelet/neutrophil ratio, neutrophil/lymphocyte ratio, systemic inflammation index, p < 0.001) that remained significant after correction for multiple testing. Some associations with anxiety symptoms, social functioning, blood pressure, and waist circumference did not remain significant after correction for multiple testing. Most individuals with BD were characterized by an accelerated epigenetic age profile. This study suggests a link between epigenetic age acceleration, systemic inflammation, and mtDNAcn. This subgroup might represent a target for personalized prevention and treatment.
Pediatric psoriasis may result in significant cumulative life course impairment, and there is comparatively less evidence available than for adult psoriasis. The aim of this study is to provide an update on the management of pediatric psoriasis, integrating recent immunogenetic and therapeutic advances. It highlights challenges, including clinical heterogeneity, complex differential diagnosis, and limited treatment options, especially in Brazil. A narrative review was conducted, including studies published in English, Portuguese, and Spanish between 2009 and 2025, retrieved from the United States National Library of Medicine (PubMed), Cochrane Library, and Scientific Electronic Library Online (SciELO). The following descriptors were used: "psoriasis", "child health", "pediatrics", "therapeutics", "comorbidity", and "T-lymphocyte antigen differentiation". Pediatric psoriasis most commonly presents as chronic plaque. Differential diagnoses are broad and include atopic dermatitis and autoimmune diseases. Data about comorbidities, particularly cardiovascular risk, are controversial. Although severe cases are less frequent, they are associated with a substantial impact on quality of life. Conventional therapies include topical corticosteroids, phototherapy, and non-targeted systemic agents such as acitretin, methotrexate, and cyclosporine. Biologic therapies have been approved for pediatric use and demonstrate safety profiles and superior efficacy compared to conventional treatments. Scarcity of pediatric psoriasis guidelines. Despite advances in understanding adult psoriasis, evidence in pediatric populations remains limited, especially in Brazil. Expanding knowledge in pediatric psoriasis is essential to improve diagnosis, optimize treatment strategies, and increase access to innovative therapies, thereby reducing inflammatory burden and cumulative life course impairment.
As the scale of online learning expanded, students tended to exhibit declining learning behaviors and accumulating task backlogs during self-directed study. These issues further led to reduced learning motivation and increased psychological pressure. To address this, this study constructed an innovative model that integrated a knowledge graph with multi-agent reinforcement learning. The model enabled learning state risk identification and personalized intervention. The study conducted a systematic evaluation using comprehensive learning behavior data from seven selected courses. The results indicated that the model achieved a high level of risk identification at an early stage. The recall values for all courses ranged from 0.879 to 0.896. As the learning process progressed, accuracy steadily increased to above 0.889. The F1-score remained between 0.842 and 0.871 across all stages, which demonstrated strong stability. Furthermore, the intervention strategies significantly improved learning trajectories across two experimental semesters. Students' learning activities showed continuous improvement over time. Behavioral fluctuations and breakpoint frequency were both markedly reduced. These findings confirmed that the model consistently enhanced learning motivation, stabilized learning rhythms, and optimized patterns of resource utilization.
Andrological disorders, including male infertility, hypogonadism, and sexual dysfunction, are often managed in adulthood despite their origins in early life. This review proposes the emerging concept of 'pediatric andrology', which integrates pediatric urology, endocrinology, and reproductive medicine, and aims to highlight its clinical significance from a life-course perspective. Growing evidence suggests that common andrological conditions such as varicocele, cryptorchidism, and Klinefelter syndrome originate in childhood and have long-term implications for fertility and hormonal function. Advances in microsurgical techniques and assisted reproductive technologies, including microdissection testicular sperm extraction (micro-TESE), have improved reproductive outcomes even in severe cases. In parallel, recent guidelines emphasize the importance of early diagnosis, appropriate timing of intervention, and structured transition to adult care. However, controversies remain regarding optimal management strategies, timing of surgical intervention, and fertility preservation, particularly in adolescents. Environmental and lifestyle factors may also contribute to future reproductive health, although evidence is still evolving. Pediatric andrology represents a novel interdisciplinary field that bridges pediatric urology and adult reproductive medicine. A life-course approach is essential to better understand the pathophysiology of andrological disorders and to optimize long-term outcomes. Establishing structured transition care and promoting collaboration across specialties will be critical for advancing this field and improving male reproductive health.
The purpose of this study was to investigate the effect of electrocardiography lead placement training on the performance and satisfaction of medical students using VR and compare it with training on a real patient and training on a mannequin. This was a true experimental study. Ninety undergraduate medical students in the internal medicine rotation course were included in the study. The simulation software for the insertion of electrocardiography lead placement training was designed. The students were then divided into three groups. Practical training for lead placement was conducted via three methods: training on a real patient, a mannequin, and training through VR simulation. The course was evaluated through the DOPS (Direct Observation of Procedural Skills) test and the satisfaction survey form. The analysis of the DOPS test scores revealed a significant difference between the VR group and the other two groups (patient: 15.2 (1.89), mannequin: 15.3 (1.71) and VR: 17.5 (1.35)) (P value < 0.001). The results of the survey also indicated that the satisfaction of the students in the VR group was significantly greater than that of the other two groups of patients: (0.24) 1.74, (0.18) 1.76 and (0.18) 2.35 (P value < 0.001). Considering the attractiveness of VR, the use of this software along with other teaching models in anatomy education can increase the motivation and satisfaction of learners.
Psychosis in epilepsy may be difficult to diagnose when altered consciousness, antiseizure medication changes, and psychotropic adverse effects coexist. We report a man in his late 50s with longstanding drug-resistant epilepsy and recurrent psychosis. His documented convulsive seizures were classified as tonic-clonic seizures of unknown onset; epilepsy type and etiology could not be assigned. During admission for medication adjustment, reduced responsiveness and fluctuating alertness developed. EEG showed generalized rhythmic epileptiform activity at 2-3 Hz with evolution, and EEG/awareness improved after intravenous diazepam before fosphenytoin was introduced, supporting nonconvulsive status epilepticus. After treatment with fosphenytoin/phenytoin and improvement of nonconvulsive status epilepticus (NCSE), continuous EEG monitoring was performed to assess the phenytoin response and monitor electrographic recurrence. Serum antiseizure medication levels measured at multiple time points, together with MRI, blood tests, and the clinical course, made overt intoxication, acute structural or metabolic disease, and dementia with Lewy bodies less likely. After epileptiform activity attenuated and antipsychotics were withdrawn, psychosis re-emerged without EEG evidence of ongoing status epilepticus. The course was interpreted as interictal psychosis with a possible alternative psychosis component. Aripiprazole improved psychosis but caused akathisia/dyskinesia, requiring cross-titration to brexpiprazole. Levetiracetam reduction was limited by worsening EEG abnormalities. This case emphasizes the need for a low threshold for EEG, structured diagnostic reasoning, and careful monitoring of pharmacokinetic interactions when treating psychosis in drug-resistant epilepsy.
Gut microbiota may modulate pulmonary inflammation through the gut-lung axis. This study investigated the association between washed microbiota transplantation (WMT) and short-term changes in pulmonary function, inflammatory markers, and gut microbiota in patients with abnormal spirometric patterns. A total of 110 patients who underwent fecal microbiota transplantation, also referred to as WMT, were consecutively screened between March 2023 and January 2025. Of these, 47 patients with paired baseline and post-WMT spirometric data were included in the primary spirometric analysis. According to baseline spirometric patterns, WMT recipients were classified into an abnormal spirometric-pattern group (DG, n = 19) and a normal spirometric-pattern WMT-recipient group (HC, n = 28; HC denotes WMT recipients with normal spirometry rather than healthy community controls). In addition, 43 patients receiving conventional treatment without WMT were included as a non-WMT comparison group (CON). The WMT group underwent multi-course interventions with longitudinal monitoring of pulmonary function parameters, inflammatory markers, breath-holding time (BHT), and 36-Item Short Form Health Survey scores (SF-36). Gut microbiota composition and predicted functional profiles were analyzed using 16S rRNA gene sequencing. After one WMT course, DG patients showed increases in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). Compared with the non-WMT comparison group, the change in FVC was greater in WMT recipients, whereas the between-group difference in FEV1 change was not statistically significant. Other spirometric indices, BHT, inflammatory markers, SF-36 scores, and microbiome-related findings were considered exploratory. Exploratory 16S rRNA gene sequencing identified differences in selected gut microbial taxa between WMT recipients with abnormal and normal spirometric patterns, including differences in Firmicutes, Faecalibacterium, and Alistipes. Predicted functional profiling suggested changes in glycerolipid metabolism-, Nod-like receptor signaling-, and bacterial chemotaxis-related functional potentials. WMT was associated with short-term changes in selected spirometric parameters, particularly FVC and FEV1, in patients with abnormal spirometric patterns. Changes in inflammatory markers, BHT, SF-36 scores, and microbiome-related findings were exploratory and hypothesis-generating. Further randomized, disease-specific studies with standardized pulmonary function testing and mechanistic validation are needed.
Meningiomas, particularly large temporocorneal meningiomas, pose significant surgical challenges due to their proximity to critical brain structures. Achieving optimal tumor resection while minimizing neurological deficits requires advanced decision-making strategies. This case report explores the integration of an explainable artificial intelligence (AI) system into the neurosurgical workflow to enhance preoperative planning, intraoperative decision-making, and postoperative outcome prediction. MAIN SYMPTOMS AND CLINICAL FINDINGS: We report the case of a 48-year-old Algerian Arab female with a one-year history of right-lateralized headaches that became generalized over time, along with episodes of loss of consciousness lasting 15-45 minutes, occurring 3-8 times daily. These episodes were characterized by a prodrome of palpitations and chest tightness, followed by transient unresponsiveness, urinary incontinence, and prolonged postictal periods. Neurological examination was unremarkable, with preserved motor and sensory functions. Initial evaluation in Algeria led to a diagnosis of epilepsy, for which the patient was prescribed multiple antiepileptic drugs. Further assessment in Belgium, including MRI and electroencephalogram (EEG), revealed a right temporal extra-axial mass (46 × 36 × 45 mm) consistent with meningioma. EEG findings were normal, suggesting psychogenic non-epileptic seizures (PNES) rather than epileptic seizures. A multidisciplinary approach, incorporating AI-driven imaging analysis and predictive modeling, was employed to optimize surgical strategies. The AI system provided insights into tumor segmentation, vascular involvement, and risk assessment, aiding in determining the safest resection trajectory. The patient underwent surgical resection of the tumor via a right pterional craniotomy, with total excision achieved with preserved neurological function. Intraoperative bleeding was significant (2 L), but the postoperative course was favorable. Antiepileptic medication withdrawal was initiated, and no recurrent seizures were reported postoperatively. This case demonstrates that explainable AI can enhance preoperative planning and surgical confidence by improving visualization and risk anticipation. However, its role remains supportive, as surgical outcomes continue to depend primarily on tumor characteristics and surgical expertise. The report also highlights the importance of accurate differentiation between PNES and epilepsy in patients with intracranial tumors. Overall, AI should be considered a complementary decision-support tool rather than a determinant of clinical outcomes.
Gemcitabine-based neoadjuvant therapy is frequently employed to enable curative resection of pancreatic ductal adenocarcinoma. Gemcitabine plus nab-paclitaxel (GnP) is often given to patients who relapse post-resection, resulting in multiple courses of gemcitabine-containing treatment regimens. However, the effect of prior gemcitabine-based neoadjuvant therapy on the efficacy of GnP therapy remains unclear. This study aimed to determine whether prior gemcitabine-based neoadjuvant therapy affects the therapeutic outcomes of GnP in patients with recurrent pancreatic ductal adenocarcinoma following curative resection. We retrospectively analyzed 51 patients with resectable and borderline resectable pancreatic ductal adenocarcinoma who received gemcitabine-based neoadjuvant chemoradiotherapy, underwent curative-intent surgery, and were treated with GnP post-recurrence. Patients were divided into high-regression (≥ 30% reduction in tumor diameter; 32 patients) and low-regression (< 30%; 19 patients) groups based on the tumor reduction rate during neoadjuvant therapy. Multivariate analysis identified tumor regression and the time from surgery to recurrence as independent prognostic factors for progression-free survival of GnP therapy following recurrence. Median progression-free survival was significantly longer in the high-regression group (11.8 vs. 5.8 months, p = 0.010). The objective response rate to GnP was significantly higher in the high-regression than low-regression groups (43.8% vs. 10.5%; p = 0.015). Patients with greater tumor regression during gemcitabine-based neoadjuvant therapy had better progression-free survival and treatment response to GnP therapy following recurrence. These findings suggest that treatment response to neoadjuvant therapy correlates with post-recurrence outcomes and contributes to the advancement of treatment strategies for recurrent pancreatic ductal adenocarcinoma.
Athletes in weight category sports frequently practice short-term weight loss to make weight, which often involves manipulating total body water. In Eastern medicine and phytotherapy, dandelion has long been considered to have a diuretic effect, yet empirical investigations of this effect are scarce. This study investigated whether the ingestion of a commercially available dandelion root powder with a large bolus of water acutely elicited a diuretic effect beyond the effect on urine output elicited by the bolus of water alone. In an open-label counterbalanced, crossover design with two separate laboratory visits, physically active young adults (n = 14; M/F, 12/2; age, 25.5 ± 4.7 years) ingested 1 L of still water with (DAND) or without (CON) four capsules providing a total of ∼2.1 g of a commercially available dandelion root powder. The primary outcome was cumulative urine output over the 4 hr following ingestion. Cumulative urine output was 1,164 ± 244 g in CON and 1,268 ± 213 g in DAND, with the mean difference (95% confidence interval) of 105 (-35 to 244) g (p = .13; g = 0.45). Under the experimental protocol employed, the commercially available form of dandelion ingested, the dosing strategy used, and the cohort investigated, cumulative urine output was similar regardless of whether dandelion root powder was co-ingested with a large bolus of water. These results indicate a lack of support for the purported diuretic effect of dandelion. Future studies should investigate different time courses, dosing strategies, and sources of dandelion, as well as study designs with greater ecological validity for weight category sports, before definitive conclusions can be made.
In recent years, stress mindset-how individuals perceive and respond to stress-has drawn increasing attention from researchers. Studies have begun to explore its mechanisms of influence on students' mental health and academic achievement. A randomized controlled trial was conducted in a middle school in China. Two classes were randomly assigned to the intervention group and received a specially designed "Stress Mindset" course based on the B.E.S.T. principle, whereas the remaining two classes served as the control group. A total of 155 students participated, including 78 in the intervention group. The average age of participants was 12.25 years, with 49.70% females. Bayesian Causal Forest (BCF) analysis showed that, compared to the control group, the intervention group exhibited a 0.46 standard deviation increase in stress-is-enhancing mindset (95% confidence interval [CI] = [.18, .71]). No significant improvements were observed for other variables. A mediation model supported the intervention mechanism: Group assignment (independent variable) predicted changes in academic motivation through the change in stress-is-enhancing mindset (B = .12, SE = .05, and 95% CI [.03, .25]). Process evaluation and qualitative feedback from researchers indicated high satisfaction and acceptability of the intervention. The stress mindset intervention effectively promoted a shift in students' perception of stress as enhancing, offering a novel paradigm for future intervention research. The findings offer a novel paradigm for future intervention research.
Neuropsychiatric disorders are characterized by substantial biological heterogeneity, with patients sharing the same diagnosis often exhibiting distinct symptom profiles, treatment responses and longitudinal course of the disease. This heterogeneity limits the clinical utility of traditional symptom-based classifications, currently available biomarkers, and traditional group-level neuroimaging analyses, creating a major challenge for precision medicine. In this review, we provide a conceptual overview of recent paradigms for analyzing disease heterogeneity and integrate them into a coherent, comprehensive conceptual framework for the ultimate goal of disease progression modeling. We identify three gradual shifts of research paradigms in neuroimaging-based studies: (1) moving from group-level case-control analyses to normative modeling of individual variability; (2) transitioning from traditional subtype-oriented clustering to continuous dimensional generative modeling; (3) shifting from disease course analyses to virtual transition modeling according to digital twin brain models. These paradigm shifts are not isolated but can be integrated into a layered and interrelated logical framework, aiming to quantify individual deviations, characterize heterogeneous pathological dimensions and simulate disease progression trajectories over time. We further discuss how these paradigms can facilitate the development of biologically informed biomarkers, the formulation of personalized treatment plans, and the implementation of trajectory-based intervention measures. Finally, we critically examine the key challenges that must be addressed before clinical translation, including mechanistic interpretability, longitudinal validation, multimodal and multisite data integration, model reproducibility and prospective cohort validation. Our goal is to promote the development of novel approaches for disease progression modeling, thereby accelerating the translation of experimental research into clinical practice.
Mancozeb (MZB), a widely used fungicide, induces oxidative stress-mediated cytotoxicity through excessive reactive oxygen species (ROS) generation. Present study evaluated the cytoprotective potential of zerumbone (Zer), a bioactive sesquiterpenoid, against MZB-induced toxicity in Vero cells. Dose-response and time-course assays determined the EC50 of MZB and a non-cytotoxic dose of Zer. Pre-treatment with Zer (10 μM, 18 h) significantly improved cell viability (66 ± 7%) following MZB exposure (22 μM, 6 h) and markedly reduced intracellular ROS levels. Zer attenuated MZB-induced DNA damage, lowering genotoxicity from 44 ± 6% to 23 ± 12% (p < 0.05), and significantly reduced apoptotic and necrotic cell death. Expression of apoptosis (Bax, Bcl-2, caspase-3, -8, -9), antioxidant (Nrf2, Keap1, catalase, HO-1, NQO1, SOD, GPx, PHD2) and inflammation-related (p53, Akt) markers was analysed and validated by western blotting to characterize molecular responses to Zer pre-treatment. Dysregulated expression of apoptosis and antioxidant markers, including caspase-3, catalase and GPx, was restored by Zer. Additionally, Zer normalized MZB-elevated Nrf2 levels while inducing its regulatory partners Keap1, NQO1 and HO-1. Overall, zerumbone confers substantial protection against MZB-induced oxidative injury by restoring redox balance, reducing genotoxic stress and preventing cell death, highlighting its therapeutic potential against fungicide-induced toxicity.
Compression garments are commonly designed using elongation-based pattern reduction, but the validity of this approach under controlled static wearing conditions remains insufficiently verified. This study examined whether upper-arm sleeves designed from tensile elongation properties produced consistent compression responses during wear. Three knitted PET/PU fabrics with distinct structural characteristics were tested in wale, course, and bias directions, and 27 sleeve conditions were fabricated using single-layer, identical-material double-layer, and hybrid-material double-layer configurations. Clothing pressure, tissue viscoelastic response (frequency), and perceived compression were assessed. Despite the use of the same elongation-based design logic, compression responses varied substantially with fabric directionality and layering configuration. Bias-direction and several double-layer conditions produced excessive compression or non-wearable states. Layered structures showed nonlinear pressure amplification, indicating that compression was not governed by simple additive or linear effects. Although clothing pressure, tissue response, and perceived compression were generally associated, their magnitudes and rankings were not consistently aligned across conditions. These findings indicate that elongation-based pattern reduction alone may not ensure uniform compression in knitted compression sleeves and suggest the need for an integrated design framework that considers fabric anisotropy, layering structure, tissue response, and wearer perception.