Longstanding distinctions between "verbal" and "mathematical" minds continue to shape educational assessment, curriculum design, and how learners are categorized by perceived cognitive strengths. Yet plenty of evidence from psychology and cognitive neuroscience points to a more unified model of intelligence that refutes the false dichotomy. In this article, I propose dual-domain cognitive fluency (DDCF) as a way to describe how the human mind can move fluidly between words and numbers and derive meaning from both. Building on research in symbolic cognition, executive function, and cognitive flexibility, this article identifies three dimensions: symbolic translation between modalities, cognitive flexibility across task demands, and layered reasoning, which integrates propositional logic with linguistic abstraction. DDCF captures the symbolic agility now required in knowledge-based environments where the integration of representational systems matters more than isolated domain expertise. Examples range from data storytelling in journalism to algebraic modeling in the social sciences-contexts in which verbal and quantitative reasoning operate in tandem. These insights matter for pedagogy, curriculum design, and the evolving demands of data-intensive workplaces. Far from a niche ability, dual-domain fluency reflects a generalizable cognitive capacity that existing models of intelligence have struggled to measure, reward, or systematically support.
Lactylation, a recently discovered post-translational modification linking lactate metabolism to epigenetic regulation, has become a key player in metabolic reprogramming and disease development. Although this field is expanding rapidly, a comprehensive analysis of its growth and trends is still lacking. A bibliometric review of 798 publications (2019-2025) from the Web of Science Core Collection was performed using CiteSpace and VOSviewer to analyze research trends, collaboration networks, and knowledge structures. Annual publications grew rapidly, projected to exceed 450 by 2025. China led in research output, while the United States and South Korea achieved higher citation impact. Leading journals (e.g., Nature, Cell Metabolism) have driven key discoveries, with major focus areas including tumor-immune microenvironment interactions (such as therapy resistance), metabolic-epigenetic connections, and neurodegenerative disorders. Studies on histone lactylation dominate, but emerging frontiers involve non-histone targets and advances in detection methods. Bibliometric data reveal a disparity between publication volume and citation impact, particularly between China and other leading nations. Research hotspots are evolving from foundational histone mechanisms to systems-level exploration of therapy resistance and neurodegeneration. However, the field faces bottlenecks in non-histone detection technologies and a need for broader international collaboration. Despite progress, challenges persist, such as standardizing detection techniques, improving sensitivity for non-histone lactylation analysis, and clarifying microenvironment- specific regulatory pathways. International and interdisciplinary efforts, along with technological advancements, are essential to translate lactylation-mediated metabolic-epigenetic crosstalk into clinical applications, particularly in precision medicine and biomarker discovery.
Healthcare workers (HCWs) have been disproportionately affected by the COVID-19 pandemic, both as carers and as patients. Many individuals developed persistent symptoms following an acute SARS-CoV-2 infection, known as post-COVID-19 syndrome (PCS). Previous research indicates that a significant proportion of HCWs experience long-lasting and debilitating symptoms of PCS. The aim of this study is to investigate the longitudinal symptom burden as well as the care pathways and treatment experiences of PCS-affected HCWs insured by the German Social Accident Insurance Institution for Health and Welfare. The study uses a mixed-methods approach. The longitudinal survey will extend a cohort study of n=2436 HCWs (started in 2023) affected by PCS, adding two measurement points, set in 2025 (T3) and 2026 (T4). Additionally, interviews on care pathways and treatment experiences will be conducted with a subsample of n=60 PCS-affected HCWs. Another subsample of n=30 HCWs will be asked to participate in ecological momentary assessments of symptom burden, emotional well-being and coping strategies. Analyses of routinely collected data by the insurance company will complement the study data. The study is supported by an advisory board comprising PCS-affected HCWs who assist with the content of both qualitative and quantitative surveys. This study was approved by the Local Ethics Committee of the University Medical Center Hamburg-Eppendorf, Germany (LPEK-0909, 1 May 2025; amendment: LPEK-0954, 18 September 2025). The results of the study will be presented at conferences and published in peer-reviewed journals. https://drks.de/search/de/trial/DRKS00035957.
Background: Hereditary angioedema (HAE) is a rare, potentially life-threatening bradykinin-mediated disorder with limited pediatric treatment options and little comparative evidence. Icatibant, a bradykinin B2 receptor antagonist, has demonstrated efficacy in adults and has emerging evidence in children. Objective: To evaluate and synthesize clinical evidence on the efficacy and safety of icatibant for acute HAE attacks in pediatric patients. Methods: A literature search was performed by using medical literature data bases, clinical trial and research registries, and key journals through January 2026. The primary outcome was the time to onset of symptom relief. Secondary outcomes included the time to minimum symptoms, pain scores, adverse events, and feasibility of self- or caregiver administration. All included studies were nonrandomized, single-arm trials with heterogeneous designs and outcomes definitions; therefore, a meta-analysis was not performed, and all studies were descriptively evaluated. Results: This systematic review identified three clinical studies of icatibant for acute HAE attacks in children ages 0 to 17 years. Three open-label, phase III studies, which included 43 pediatric patients were reviewed. Icatibant demonstrated rapid symptom relief, with a median onset at ∼1 hour and minimum symptoms within 2 hours, although repeated dosing showed variability. Icatibant was well tolerated, with injection-site reactions as the most common adverse events and no serious treatment-related events. Self- or caregiver administration was feasible and effective in adolescents. Conclusion: Icatibant was safe and effective in the pediatric studies, providing rapid symptoms relief and a favorable tolerability profile. Despite limitations from small sample sizes and lack of comparator trials, current evidence supports icatibant as a targeted, practical option for treating acute HAE attacks in children.
Over the past two decades, targeted biological therapies have profoundly transformed the management of type 2 (T2) inflammatory diseases, including severe asthma, atopic dermatitis, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, chronic spontaneous urticaria, and eosinophilic granulomatosis with polyangiitis. This paper reviews the key milestones of this twenty-year journey, focusing on the evolving therapeutic goals, from disease control to clinical remission. This paper synthesizes evidence from pivotal clinical trials, real-world registries, extension studies, and systematic reviews on biologics in T2 inflammatory diseases. A targeted literature search was conducted across PubMed and major respiratory, allergy, and dermatology journals, prioritizing publications from 2020 to 2026, with inclusion of landmark earlier studies. Clinical remission in biologic-treated T2 inflammatory diseases is achievable but not yet reliably predictable; the field urgently requires globally standardized, validated composite remission indices for each major T2 condition that integrate symptom scores, organ function measures, and biomarker profiles. The defining challenge of the next decade is determining whether early biologic intervention can genuinely modify the disease trajectory and achieve sustained off-treatment remission.
National research evaluation systems often rely on publication-based metrics that equate productivity with performance while overlooking scientific leadership and research integrity. This study examines the Peruvian National Registry of Science, Technology, and Innovation (RENACYT) to inform a more multidimensional framework for research evaluation. An observational, non-experimental, and analytical study was conducted using data from RENACYT, Scopus, and SciVal for 9,651 researchers during 2019-2024. Four dimensions were assessed across hierarchical levels: scientific production, journal-based impact (Q1-Q4), corresponding authorship as a proxy of leadership, and retractions as indicators of research integrity. Descriptive statistics, ANOVA, repeated-measures tests, and count regression models (Poisson, negative binomial, and zero-inflated specifications) were applied. A total of 92,284 publications were identified. Productivity increased across RENACYT levels (3.9 publications in Level VII vs. 62.5 in Distinguished; F = 1,162.572, p < 0.001), although with substantial within-level dispersion and differentiated temporal trajectories (Time × Level: F = 44.662, p < 0.001). Higher levels concentrated Q1 output (30.8 vs. 0.7 articles per author; F = 1,090.183, p < 0.001), while differences became less pronounced in Q3-Q4 journals. Corresponding authorship increased with level (β = 1.624 for Level I, p < 0.001) but remained heterogeneous even among top categories. Retractions were positively associated with productivity (coef. = 0.013, p < 0.001) reflecting differential exposure to integrity-related risks rather than uniform patterns across levels. RENACYT captures gradients in productivity and quality but insufficiently differentiates leadership and integrity. These findings support the proposal of a hybrid evaluation framework integrating productivity with explicit recognition of intellectual leadership and research integrity.
The Institute for Clinical and Economic Review (ICER) aims to publish health technology assessment (HTA) reports at or near the time of drug approval by the US Food and Drug Administration (FDA) to provide a timely, independent evaluation of the benefits, risks, and economic considerations surrounding a new therapy. To evaluate the timelines of ICER reports to inform pricing and coverage decisions, using FDA approval and list price announcement dates as a benchmark. With these data, we evaluated the availability of clinical evidence, specifically completion of pivotal trials and publication in peer-reviewed journals, at the time of ICER's review. We included drugs that were the primary intervention of interest in ICER reviews between 2017 and 2024. We extracted information on regulatory approval and list price announcements, and publication dates of ICER reports. We also extracted dates of publication of the pivotal trials that informed each ICER assessment to evaluate the time span between trial completion and publication. Our analysis of 73 ICER drug assessments showed that, on average, the launch price is announced on the same day as FDA approval. The majority of the ICER draft, evidence, and final assessments were published on or before the FDA approval and price announcement date (82%, 61%, 55%, respectively). In terms of data availability, the median time from primary trial completion to peer-review publication was 15 months. There were an average of 2 pivotal trials per drug assessment. The majority (71%) of the pivotal trials informing ICER assessments were published in peer-reviewed journals before the completion of the ICER draft assessment, although these publications were, on average, published approximately 1 month prior to the completion of the assessments. The majority of ICER drug assessments are published before FDA approval and price announcements, making them available for early decision-making at the time of drug launch. However, data availability is still a major challenge in making HTA available immediately after approval. Prioritizing early sharing of clinical trial data would foster timely and robust HTA, ensure clinical decisions and coverage policies are well informed, and improve early patient access.
We hypothesised that a patient-driven safety checklist would enhance patients' health literacy. This study was conducted as a sub-study of a multicentre cluster trial with a stepped wedge design. Data were collected between March 2022 and February 2024. Healthcare personnel were partially blinded to group allocation and fully blinded to the health literacy questionnaire outcome. The study included seven surgical specialties (clusters) from a tertiary teaching hospital and two community hospitals in Norway. The patients were included from a pool within the cluster trial. In each of these seven clusters, 50 patients were randomly selected from 100 eligible patients both the control and the intervention group using a computer-generated randomisation procedure. This resulted in a total sample of 700 patients: 350 in each group, response rate 49.3%. Adults (≥18 years) undergoing elective surgery, fluent in Norwegian, living at home, and without cognitive impairment were included. Standard surgical information combined with a patient safety checklist consisting of items with instructions and information (medication safety, preparations, activity restrictions, complications, and follow-ups). The checklist was delivered preoperatively (≤ eight weeks). Controls received standard surgical information. No significant differences were observed in mean scores across the nine health literacy questionnaire outcome domains between the control and intervention groups. In this stepped wedge cluster trial, a preoperative patient safety checklist did not improve health literacy scores compared to standard care. Nevertheless, an interaction effect with time for the domain "Actively managing my health", may indicate that the patient-driven checklist could support elective surgical patients' health management. This finding aligns with qualitative feedback and warrants further investigation using larger samples and more sensitive and context-specific measurement tools. Trial registration: Registration date in the ClinicalTrials.gov, 20 March 2017, ID: NCT03105713.
Chronic knee pain is prevalent in the adult population and is the most common musculoskeletal complaint in the primary care setting. Although osteoarthritis is the most common etiology of chronic knee pain, other sources include osteochondral lesion, subchondral insufficiency fracture, patellofemoral maltracking, or chronic tendon, meniscus, or ligament abnormalities. Imaging plays a key role in the evaluation of chronic knee pain, noting that the etiology cannot be reliably diagnosed or excluded via physical examination alone. Radiographs are the initial imaging modality of choice for chronic knee pain. If radiographs demonstrate osteoarthritis, this document outlines specific scenarios in which additional imaging may be warranted. This document also discusses the appropriate imaging workup for the other entities described above, including soft tissue abnormalities and subchondral insufficiency fracture. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
Diaphragm dysfunction is associated with failure to wean from mechanical ventilation. Inspiratory muscle training (IMT) may help improve outcomes for difficult-to-wean patients, yet the optimal approach remains unknown. High load IMT causes a training effect on the extra-diaphragmatic inspiratory muscles, but does not improve weaning success, questioning the utility of frequently cited high intensity IMT loads. Additionally, patients may find IMT unpleasant and distressing due to dyspnoea experienced during IMT. The aim of this study is to define a diaphragm-focused IMT load which is acceptable to patients. This study is designed as a prospective, mixed methods study. Forty difficult to wean, tracheostomised patients on mechanical ventilation will perform IMT at 15, 30, 45 and 60% of their maximal inspiratory pressure (PImax) in a randomised order using a tapered flow resistive loading device (POWERBreathe KH2, POWERBreathe, UK). Electrical activity of the diaphragm will be measured using an oesophageal multipair catheter (NAVA, Getinge, Sweden); extra-diaphragmatic (parasternal, scalene and sternocleidomastoid) muscle activity will be measured using surface electromyography. Patient experience of each load will be explored by measuring perceived breathing difficulty and unpleasantness using 0-10 numeric rating scales, verbal or written communication techniques in line with the participants' communication ability, and/or bespoke communication boards co-designed with the study patient and public involvement (PPI) group. Quantitative and qualitative data will be integrated to inform a diaphragm-focused, patient-acceptable IMT load. Ethical approval was obtained from Wales Research Ethics Committee 4 (Reference 25/WA/0242) on 30 October 2025. Results from this study will be presented at scientific meetings and published in peer-reviewed journals. NCT07256821.
Capnocytophaga canimorsus is an emerging zoonotic pathogen associated with severe infections, such as sepsis, meningitis, and endocarditis following animal bites. Despite increasing clinical recognition, a comprehensive understanding of global research trends and collaborative patterns remains limited. This study aimed to perform a scientometric analysis of global scientific output on C. canimorsus infections from 2019 to 2024, focusing on research trends, collaboration networks, and thematic evolution within a One Health framework. A descriptive observational scientometric study was conducted using the Scopus database. A structured search strategy identified 104 relevant documents published between 2019 and 2024. Bibliometric indicators, including publication output, citation metrics, and author h-index, were analyzed using SciVal and Bibliometrix in R. Keyword co-occurrence, thematic evolution, and international collaboration networks were evaluated to map research dynamics. A total of 104 documents from 70 sources were analyzed, showing a slight negative annual growth rate (-5.59%). The mean document age was 2.64 years, with an average of 3.17 citations per publication. Research output involved 503 authors and 223 keywords, reflecting moderate thematic diversity but limited international collaboration (6.73%). Original articles predominated (n = 80), followed by reviews and other document types. Publication activity peaked in 2020 and 2022, with most studies appearing in mid-tier journals. Thematic analysis revealed a transition from early focus on infections and dog bites toward meningitis, bacteremia, and zoonotic diseases. Keyword clustering highlighted "meningitis," "bacteremia," and "dog bites" as central research themes. Spain and Belgium emerged as leading contributors in international collaborations, although global networking remained limited and unevenly distributed. Research trends increasingly emphasized zoonotic aspects of C. canimorsus within a One Health context. This scientometric analysis highlights evolving research priorities in C. canimorsus infections, with increasing emphasis on zoonosis and One Health perspectives. Despite growing scientific interest, limited international collaboration and underrepresentation of low-resource regions persist. Strengthening interdisciplinary and cross-regional partnerships is essential to enhance surveillance, diagnosis, and prevention strategies for this clinically significant zoonotic pathogen.
Photobiomodulation therapy has emerged as an effective non-invasive intervention for preventing and managing chemotherapy- and radiotherapy-induced oral mucositis, a frequent complication that negatively affects oral health and quality of life in cancer patients. This bibliometric study was guided by PRISMA 2020 principles for study identification and selection. A total of 152 publications indexed in Scopus, Web of Science, and PubMed between 2016 and 2025 were analyzed using bibliometric indicators, including publication trends, authorship, institutional productivity, country contributions, citation analysis, and keyword evolution. The results demonstrated a substantial increase in scientific production between 2016 and 2025, with Brazil, the United States, and France leading research output. The most productive institutions included Universidade Federal de Goiás, Universidade de São Paulo, and Harvard University, while Supportive Care in Cancer and Lasers in Medical Science were the most influential journals. International collaboration networks showed strong global partnerships, and keyword analysis revealed increasing focus on photobiomodulation therapy, oral mucositis, chemotherapy, radiotherapy, and prevention. These findings indicate rapid global expansion and increasing scientific and clinical relevance of photobiomodulation therapy research, providing valuable insights into scientific development, key contributors, and emerging research directions that support future advances in evidence-based oral healthcare. However, the bibliometric nature of the study, heterogeneity of the included literature, and the lack of direct assessment of clinical outcomes should be considered as limitations.
A new study in PLOS Biology shows that neuronal firing is selectively tuned to oscillatory frequency in human intracranial recordings, complementary to phase tuning, suggesting an additional dimension in how brain rhythms may organize neural activity.
Psychedelics have received considerable attention due to their potential in treating psychiatric disorders. The "setting" during psychedelic-assisted therapy (PAT) is recognized as playing a central role in the experience, during which music features prominently. Although music is theorized as directing and shaping psychedelic sessions, its precise contribution to acute experience and therapeutic outcomes is unclear. This scoping review aimed to map quantitative research on the interplay of psychedelics and music by consolidating existing evidence, identifying gaps, and where possible, reporting on effects of psychedelics and music on subjective (e.g., psychological) and objective (e.g., biological) outcomes. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, relevant papers were identified through electronic databases (MEDLINE, Embase, PsychINFO, Scopus) using terms associated with psychedelic compounds, psychedelic-assisted therapy, and music. Papers were restricted to quantitative studies published in peer-reviewed journals investigating human subjects within therapeutic and controlled experimental contexts, focusing on interactions between music and psychedelics. A total of 19 papers (total human sample = 330) met inclusion criteria. Psilocybin and LSD were the most studied psychedelic compounds; no studies were found investigating MDMA and music. Characteristics of music conditions across studies have been limited. The findings suggest that music modulates the psychedelic experience through: (1) amplifying and intensifying emotions, (2) recruiting brain networks involved in meaning-attribution and visual imagery, and (3) increasing overall neural entropy. Considerable gaps remain in understanding mechanisms of action and how music is delivered to optimize therapeutic response, due in part to methodological inconsistencies and small sample sizes. This review underscores the critical role of music in shaping psychedelic experiences and therapeutic outcomes.
Coronary heart disease (CHD) is the leading cause of mortality in China, yet the alignment between pharmaceutical research investment and clinical therapeutic priorities remains uncharacterized. We conducted a dual-stream analysis. Stream A (Bibliometric): systematic searches of PubMed, Embase, Scopus, and Web of Science yielded 12,032 records; after deduplication and screening, 3,339 publications met inclusion criteria. Stream B (Clinical Trials): searches of CDCTP and ChiCTR identified 1,433 interventional drug trials after deduplication and quality control. Drugs were standardized to the WHO ATC classification; TCM ingredients to TCMID 2.0. CHD research output expanded exponentially: Publications increased from 41 (2006) to 353 (2020; 760% increase), with 265 in 2025 (546% increase from baseline). Strikingly, 76.4% of trials were bioequivalence studies, with chemical pharmaceuticals dominating (78.6%) over traditional Chinese medicine (21.4%); calcium channel blockers comprised the largest drug category (45.9%. Notably, Critical gaps emerged: genomic research concentrated on inflammatory biomarkers (CRP, IL6, TNF; 25.8% of gene associations) while lipid metabolism targets were underrepresented (12.4%) despite statin therapeutic dominance; publication venue prestige demonstrated inverse volume-impact correlation (19.7% Q1 vs. 33.6% Q3 journals). Thus, quantitative expansion (compound annual growth rate (CAGR) 10.4%) coexisted with qualitative ceiling effects and target-drug mismatches between research investment and clinical guideline priorities. China's CHD research landscape is policy-driven rather than clinically aligned: generic bioequivalence validation dominates (76.4%) while innovative therapeutic development and high-impact dissemination lag. Strategic rebalancing toward lipid metabolism genomic discovery, Phase II-III novel drug trials, and Q1 journal publication is imperative to bridge the research-clinical practice gap and align with global cardiovascular science standards.
In low- and middle-income countries (LMICs), access to traditional oncology education through conferences, journals, and in-person mentorship is often restricted. Social media has emerged as a potential tool to bridge this gap; however, its educational and clinical influence on oncology professionals remains underexplored. We conducted a cross-sectional, anonymized, web-based survey of 202 oncology professionals from 13 countries. A 30-item questionnaire was used for the survey. Data were analyzed using descriptive statistics and chi-square tests. Among the respondents, 93% practiced in India, with 61% identifying Twitter (X) as their primary oncology information source. Daily engagement was reported by 53% of the respondents. The most valued benefits were early access to emerging research (30%) and trial updates (29%). Social media discussions atleast moderately influenced clinical decision making in 75% of respondents, with 29% reporting a substantial impact, which was a subjective assessment of the participants. Virtual tumor boards engaged 58% of the participants and prompted practice changes in 21%. Sixty-eight percent credited social media, with expanding their professional networks, and 25% initiated research collaborations through these platforms. Structured digital literacy training and tools, such as automated fact-checking and professional credential verification, were supported by over two thirds of the participants. Social media has become an essential educational and collaborative platform for oncology professionals, particularly in LMICs. By enabling timely access to research and supporting peer learning, it complements the traditional modes of oncology education. The formal integration of digital literacy training and content-verification mechanisms may enhance its safe and equitable use.
Although function-based interventions (FBIs) are effective for individuals with intellectual and developmental disabilities, less is known about FBIs for students with extensive support needs (ESN) and school personnel involvement in FBI development and implementation. As such, we conducted a systematic literature review of 14 single-case research studies involving FBI implementation in K-12 U.S. school settings to address challenging behavior among 18 students with ESN. To identify relevant peer-reviewed articles, dissertations, and theses published between 2006 and March 2025, we searched 10 online databases, reference lists of 10 published reviews, and 19 peer-reviewed journals. Descriptive analyses revealed school personnel involvement varied widely, with school personnel often assuming FBI implementer roles and researchers primarily leading functional behavior assessments. Findings may be limited due to the small number of studies and eligible students with ESN included in the analyses and the limited descriptions of student and study characteristics.
Immune checkpoint inhibitors (ICI) are a keystone in advanced hepatocellular carcinoma (aHCC) therapy. However, preclinical evidence suggests that mice with pure metabolic dysfunction-associated steatohepatitis (MASH)-related HCCs may not benefit from ICIs. This has tremendous implications for both therapy selection and future drug development. Viral and MASH-HCCs differ in molecular pathogenesis and immune microenvironment. Preclinical evidence has shown impaired immune surveillance and ICI-induced auto-aggressive T cells in pure MASH-HCC. Phase 3 clinical trials and meta-analyses have conflicting outcomes. For single-ICI regimens with anti-programmed-death 1/L1 (anti-PD1/L1), there was no apparent difference in the overall survival for patients with non-viral HCCs in the CheckMate-459, IMbrave150, COSMIC-312, and KEYNOTE-240 trials for ICI over tyrosine-kinase inhibitors or placebo, while patients with viral hepatitis seemed to have benefited more. Meanwhile, comparable outcomes were seen for patients with viral and non-viral HCCs in the HIMALAYA, RATIONALE-301, LEAP-002, and CARES-310 trials. There was no consistent difference in outcomes between patients with HBV or HCV-HCCs. For dual-ICI regimens with anti-PD1/L1 and anti-cytotoxic T-lymphocyte associated protein-4 (anti-CTLA-4), the HIMALAYA and CheckMate-9DW trials showed similar efficacy for ICI combinations across all etiologies. Important caveats in interpreting current evidence exist. All trial data are from unplanned subgroup analyses only, limiting the level of clinical evidence available. "Non-viral HCCs" are also a heterogenous entity, the composition of which varies from trial to trial. Fundamentally, defining HCC etiologies, especially in mutually exclusive terms, is challenging: Occult hepatitis B infections are inconsistently tested and reported; hence, viral HCCs may be underreported. HCCs are often multifactorial, with steatosis frequently co-existing and interacting with viral hepatitis, creating difficulty in translating findings from pure MASH-HCC mouse models. Current evidence is insufficient to support individualizing aHCC treatment based on etiology. Preclinical evidence for a lesser benefit with ICIs in MASH-HCCs exists, while data from clinical trials are mixed but limited. Major gaps in knowledge remain, and further studies are required to clarify this important subject.
Deep brain stimulation (DBS) is an increasingly promising approach for patients with drug-resistant epilepsy (DRE). However, there are limited studies characterizing patient complications from DBS placement. Using reports from the Manufacturer and User Facility Device Experience (MAUDE) database from January 2018 through March 2024, we systematically analyzed available data on patient complications/complaints, management strategies, and clinical outcomes. Only data from DBS implantations specifically to treat DRE were collected and analyzed. A total of 151 reports involving DBS treatment of DRE were analyzed. The most common DBS complications were device-related problems (DRPs, 95/151 [62.9%]) and patient complaints (PCs, 66/151 [43.7%]). The percentages exceed 100% because the categories overlap; some cases may fall into both categories, indicating that items in one category can also be included in another. The most prevalent DBS device-related complications included impedance issues (34/95 DRPs, 35.8%), device failure (32/95 DRPs, 33.7%), inadequate simulation (14/95 DRPs, 14.7%), and lead breaks (13/95 DRPs, 13.7%). The most prevalent patient complaints were worsening of seizure activity (20/66 PCs, 30.3%), psychiatric changes (9/66 PCs, 13.6%), and neurocognitive behavioral changes (8/66, 12.1%). Of the 151 reports, surgical intervention occurred for 20 (13.2%) patients; device failure had a surgical intervention rate of 9/32 (28%) while impedance issues had a rate of 7/34 (21%). Infections resulted in resolved outcomes in 6/13 (46.2%) of reports, most commonly treated with device removal (9/13, 69.2%). The MAUDE database helps to more clearly define the risks and complications arising from DBS implantation to treat DRE. These results will help in assessing the risks, treatment alternatives, and outcomes associated with DBS device therapy for DRE. This will facilitate enhancements in the effectiveness of the device, better management of complications, and provide more comprehensive information to ensure patients can give informed consent.
Chronic illness disrupts everyday routines, social roles, and sense of self, particularly among young individuals undergoing identity formation. With the expansion of digital media, social platforms have become key sites where patients narrate illness experiences, negotiate stigma, and seek support. However, such processes remain underexplored in non-Western, collectivist contexts. This study examines how young Chinese individuals with diabetes construct illness narratives and negotiate identity in digital environments. This study uses a narrative analysis approach, combining inductive thematic coding with culturally and critically informed interpretation. A total of 303 narrative posts were collected from RedNote, a Chinese social media platform characterized by diary-like user-generated content. The dataset includes both text-based and video-based posts, capturing longitudinal and first-person accounts of living with diabetes. In total, 4 distinct narrative types were identified. The chaos narrative captures experiences of cognitive dissonance, emotional breakdown, and disruption of daily routines following diagnosis, often accompanied by guilt toward family members and anxiety over future uncertainty. The stigma narrative reflects social withdrawal, concealment of illness, and perceived discrimination in intimate relationships and employment contexts, highlighting the role of externally imposed social judgment. The resilience narrative illustrates processes of self-acceptance, disciplined self-management, and the integration of illness into everyday life through routinized practices such as blood glucose monitoring and dietary regulation. The solidarity narrative emphasizes the importance of familial care and digitally mediated peer support, where users exchange practical knowledge, emotional encouragement, and collective identity markers, transforming isolation into shared experience. Across these narratives, illness is not only experienced as disruption but also actively reinterpreted through culturally embedded values such as familial responsibility and collective belonging. This study advances illness narrative research by demonstrating how digital platforms mediate culturally specific forms of meaning-making among young patients with chronic illness. It extends the concept of biographical disruption by conceptualizing it as a dynamic and relational process shaped by digital storytelling, familial expectations, and peer interaction. The findings highlight the importance of culturally sensitive and platform-aware approaches to health communication and digital patient support.