Despite legislative advances supporting the rights of non‑cisheteronormative individuals, European universities continue to exhibit exclusionary dynamics and cisheterosexist structures that render LGBTIQA+ teaching staff both invisible and marginalized. In this context, life stories emerge as an effective pedagogical resource to foster critical reflection and inclusion. This study examines the impact of a training activity based on the life stories of LGBTIQA+ teachers in Primary and Early Childhood Education programs at a public university in Spain. A validated questionnaire with four dimensions-professional identity construction, beliefs about sex‑gender diversity, school context, and training in sex‑gender diversity-was used to collect both qualitative and quantitative data. A total of 108 students participated. Fifty‑five students received an intervention centered on LGBTIQA+ teachers' life stories (experimental group), while fifty‑three received no intervention (control group). Inferential analyses revealed statistically significant differences between groups across all factors and overall (t = 4.56, p < 0.001), with a large effect size (Hedge's g = 0.88). Qualitative results indicated that the experimental group demonstrated greater awareness, deeper reflection, and stronger argumentation concerning barriers faced by LGBTIQA+ teachers. These findings suggest that integrating LGBTIQA+ teachers' life stories can meaningfully enhance teacher education and contribute to more inclusive academic environments.
To assess the quality of life of relatives of palliative care patients and to raise awareness about practices that may improve it. In this cross-sectional analytical study, the data collection form and the SF-36 Quality of Life Scale were applied to the participants. The study was conducted with 409 relatives of patients who cared for inpatients in the Palliative Care Department of Izmir City Hospital between 25.02.2024-25.08.2024. Among the caregivers included in the study, 71.1% neglected themselves, 69.7% had restricted social lives, 61.9% had sleep problems, and felt that their quality of life had declined since becoming a caregiver. However, receiving professional training about the caregiving process and being informed about legal rights increased the quality of caregiver's lives. Family physicians should focus on both caregivers and patients, supporting caregivers psychosocially, and provide education on palliative care and legal rights.
Humic substances (HS) are increasingly investigated as natural additives to support health in humans and animals, yet their effects on honey bees remain insufficiently characterised. This study evaluated the impact of a commercial HS-based product on immunity and oxidative status of Apis mellifera. Newly emerged worker bees were kept under laboratory conditions and fed sugar syrup supplemented with 0.5% HS for seven days, while the control group received unsupplemented syrup. Effects of HS were evaluated by analysing the expression of selected immune-related genes, quantifying antimicrobial peptides (AMPs), measuring the activity of antioxidant enzymes, evaluating lipid peroxidation, and characterising hemocyte populations. HS supplementation significantly increased relative gene expression of superoxide dismutase 1 and prophenoloxidase, while expression of genes for apidaecin and defensin 1 decreased. HS supplementation significantly increased relative gene expression of superoxide dismutase 1 and prophenoloxidase, while expression of genes for apidaecin and defensin 1 decreased. Similarly, catalase enzymatic activity was significantly decreased in the HS group. No significant changes were detected in gene expression for other AMPs and relative abundance of AMPs, or other antioxidant parameters. HS supplementation significantly increased the proportion of medium granular hemocytes (p < 0.05) at the expense of high granular cells (p < 0.01). In conclusion, the 7-day administration of HS at 0.5% did not adversely affect bee health and modulated selected immune parameters. The biological significance of these immunomodulatory effects requires confirmation through challenge studies and field trials under natural conditions.
To evaluate the influence of partnership status on the perception of menopausal symptoms and quality of life in women undergoing hormone replacement therapy (HRT). The study included 60 menopausal women aged 40-85 years with significant climacteric symptoms. Participants were divided into two groups according to relationship status: women living in a stable partnership (n = 30) and women without a partner for at least one year (n = 30). Menopausal symptoms and quality of life were assessed using the Menopause Rating Scale (MRS) and the Manchester Short Assessment of Quality of Life (MANSA). All participants received combined HRT. Assessments were performed at baseline and after three months of therapy. Changes in symptom severity (ΔMRS) and quality of life (ΔMANSA) were analyzed, and Pearson correlation coefficients with corresponding p-values were used to assess relationships between variables. HRT was associated with improvement in menopausal symptoms and quality of life in both groups. However, women living in a partnership showed a greater reduction in MRS scores and a greater increase in MANSA scores compared to women without a partner. After three months of HRT, statistically significant correlations (p < 0.05) between hormonal levels (estradiol, FSH), menopausal symptoms, and quality of life were observed exclusively in partnered women. HRT improves menopausal symptoms and quality of life; however, partnership status appears to play a moderating role. A stable partnership may facilitate the integration of psychobiological processes of hormonal changes and contribute to improved subjective adaptation to menopause.
This study examined the association of health literacy with quality-of-life outcomes among Jordanian adults with chronic diseases using two patient-reported outcome measures, the Long-Term Conditions Questionnaire (LTCQ) and the EuroQol five-dimension, three-level questionnaire (EQ-5D-3L). It also compared conventional regression and machine-learning (ML) approaches for modelling these relationships. In this cross-sectional online study, Arabic-language questionnaires were completed by Jordanian adults aged 18 years or older with at least one chronic physical, mental, or neurological condition. The survey, designed to take 10-12 minutes, included the LTCQ, EQ-5D-3L, Medication Adherence Report Scale (MARS-5), and 12-item Health Literacy Scale (HLS-Q12). A total of 901 complete responses were analyzed. Data were split into training (n = 633) and test (n = 268) sets. Multiple linear regression was used for LTCQ, Tobit regression for EQ-5D-3L index scores, and ML models were trained to explore nonlinear associations. Health literacy and medication adherence were positively associated with both LTCQ (beta = 3.923 and 2.219, respectively; both p < 0.001) and EQ-5D-3L index scores (beta = 0.025, p = 0.001; beta = 0.020, p = 0.009). Number of medications was inversely associated with both outcomes. In 10-fold cross-validation, Extreme Gradient Boosting (XGBoost) showed the lowest average root mean square error (RMSE) for LTCQ (9.18; coefficient of determination [R²] = 0.384) and EQ-5D-3L (0.172; R² = 0.193), although differences between the leading models were modest. LTCQ and EQ-5D-3L showed overlapping but distinct association patterns. LTCQ was more strongly linked with psychosocial and self-management variables, whereas EQ-5D-3L was more closely aligned with medication burden and clinical comorbidity. These findings should be interpreted as associative rather than causal and as differences in captured dimensions rather than evidence of instrument superiority.
BackgroundFamily and friend care partners play a vital role in supporting individuals with neurocognitive disorders, such as Alzheimer's disease dementia. Care partners are often uncompensated and face multifaceted challenges that contribute to stress. The Care Partner Stress Scale (CPSS) was developed to assess caregiver stress across seven domains: cognition, behavior, function; unmet needs and emotional impact; work and financial strain; family and interpersonal conflict; and situational perception.ObjectiveTo evaluate psychometric properties of the CPSS in care partners of individuals with neurocognitive or neurodegenerative diseases of aging.MethodsThe CPSS was completed by 168 (83.93% female, age = 61.98 years) care partners in the CAN-PROTECT online cohort. Participants completed measures of depression, anxiety, quality of life, function, loneliness, and life satisfaction and engagement. We assessed internal consistency, item-total correlations, convergent and discriminant validity, and floor/ceiling effects.ResultsThe CPSS demonstrated excellent internal consistency (α = 0.95, 95% CI: 0.94-0.96), with item-total correlations >0.23. Higher CPSS scores were associated with greater depression (b = 2.38, 95%CI [0.72, 4.03], p = 0.005), anxiety (b = 4.47, 95%CI [2.44, 6.50], p < 0.001), and anxious distress (b = 6.37, 95%CI [3.54, 9.21], p < 0.001), as well as lower life satisfaction (b = -3.42, 95%CI [-5.61, -1.23], p = 0.002), poorer social relationships (b = -2.31, 95%CI [-4.54, -0.09] p = 0.042), greater loneliness (b = 5.26, 95%CI [1.33, 9.19], p = 0.009), and poorer life engagement (b = 2.89, 95%CI [1.23, 4.65], p = 0.001). CPSS scores were not associated with self-care (b = -1.06, 95%CI [-5.03, 2.92], p = 0.600). Floor effects were minimal (0.60%), with no ceiling effects.ConclusionsFindings provide initial support for multidimensional assessment of care partner stress in neurocognitive disorders.
Family caregivers often feel unprepared for the final phase of life, which is associated with distress and adverse bereavement outcomes. Structured family meetings are recommended, yet evidence from Middle-Eastern settings is limited. To explore how routine family meetings influence caregiver preparedness and communication when patient is judged to be approaching death in Saudi palliative care service. Qualitative descriptive study using semi-structured interviews. Data were analysed using grounded theory analytic techniques. A tertiary palliative care unit in Saudi Arabia. Seven family caregivers of imminently dying patients with cancer were interviewed in Arabic within 2-5 days after attending a protocol-mandated family meeting. Six themes were identified to describe the meetings' impact. Psychological relief: clear prognostic information reduced uncertainty and anxiety. Emotional burden: anticipatory grief was substantial despite valuing honesty. Communication style: direct, compassionate disclosure and stepwise foreshadowing aided understanding and acceptance. Religious framing: alignment with Islamic beliefs provided meaning and guided spiritually oriented bedside care. Caregiver support, including multiple relatives who distributed the emotional load, improved intra-family communication. Practical care guidance: specific advice on recognising signs of dying and interacting with unresponsive patients increased caregiving confidence and reduced crises. Caregivers in a middle eastern setting found routine, empathetic, and culturally sensitive family meetings helpful in supporting informational, emotional, spiritual, and practical needs during end-of-life. They valued clear communication, culturally sensitive religious framing, and practical guidance about dying. These findings suggest that structured family meetings can support caregivers and highlight areas for further research and development in family-centred end-of-life care.
Nephronectin (Npnt) is an extracellular protein with various functions during development and homeostasis of various tissues, but its role during early mouse cornea development remains unexplored. We characterized the expression of Npnt and investigated its function during cornea development. We performed in situ hybridization and immunohistochemistry on ocular sections obtained from embryonic day (E)11.5-E16.5 mouse embryos. Wild-type and Npnt mutant embryos were analyzed for corneal thickness, cell number, and cell proliferation. We assessed the expression of Npnt receptors, Integrin alpha 8 (Itgα8) and Epidermal growth factor receptor (EGFR). We performed in vitro migration assays using periocular mesenchyme (POM) explants in the presence of EGFR and STAT3 inhibitors. Npnt mRNA was expressed in the ectoderm, lens, optic cup, and subsequently in the cornea endothelium. Npnt protein correlated with mRNA staining with additional localization in the epithelial basement membrane and POM. Npnt mutants exhibited reduced corneal thickness and cell numbers compared to wild-type littermates, but there were no differences in cell proliferation. Itgα8 mRNA was diffusely expressed in the POM, but not in the migratory regions. EGFR mRNA was expressed in the region of migratory POM. Robust cell migration occurred from POM explants cultured on either Npnt or Fibronectin (Fn) substrates, but the EGFR pathway inhibitors only attenuated migration on the Npnt substrate. Npnt is expressed in the periocular region during ocular development and contributes to POM migration into the nascent cornea via a mechanism that involves activation of the EGFR signaling pathway.
Prenatal exposure to the Zika virus may have an adverse effect on communicative functioning in children, even in the absence of microcephaly associated with Congenital Zika Syndrome. This study characterized cortical auditory neural function and communication abilities in normocephalic children with and without prenatal Zika virus exposure. Cortical auditory evoked potentials were recorded in response to naturally spoken consonant-vowel syllables in 117 Brazilian children with prenatal exposure to the Zika virus (M age: 6.29 ± 0.42 years) and a comparison group of 90 non-exposed children (M age: 5.54 ± 0.95 years). Language and communication abilities in daily life were evaluated using a battery of standardized behavioral measures and caregiver reports. Caregivers of exposed children reported significantly lower than typical adaptive functioning in the communication and socialization domains. Cortical auditory evoked potential analyses identified earlier speech sound differentiation in the non-exposed controls than in the exposed group (P1 versus N2 response). Exploratory analyses controlling for multiple postnatal factors indicated that greater cortical N2 speech sound differentiation was associated with more adaptive communication abilities. Normocephalic children with prenatal exposure to the Zika virus may exhibit subtle differences in auditory processing of speech that are associated with less adaptive communicative functioning in daily life. These results highlight the value of longitudinal follow-up of children with prenatal virus exposures and the utility of auditory evoked potentials in assessing populations at risk for altered neurodevelopment.
Bacteriophage Shea, which infects the opportunistic pathogen Pseudomonas aeruginosa, likely has a non-canonical pseudolysogenic lifestyle. Here, we present its complete 43,333 bp genome sequence. This announcement will contribute to investigations of this underappreciated phage lifestyle.
Schisandra chinensis has been reported to exhibit antitumor activity; however, its active components and molecular mechanisms in non-small cell lung cancer (NSCLC) remain unclear. Network pharmacology was employed to identify active compounds and potential targets of Schisandra chinensis against NSCLC, followed by protein-protein interaction analysis, GO and KEGG enrichment analyses, and molecular docking. A549 cells were used for experimental validation. Cell viability was assessed by MTT assay, oxidative stress markers (GSH, SOD, MDA) were quantified, and the expression of PTGS2, inflammatory factors, and apoptosis-related genes was examined by qRT-PCR and Western blot. Eight active components of Schisandra chinensis were identified, with seven overlapping targets related to NSCLC. Molecular docking revealed that Gomisin R exhibited the strongest binding affinity to PTGS2, with a docking score of -7.3 kcal/mol. In vitro experiments demonstrated that Gomisin R significantly inhibited A549 cell proliferation in a dose- and time-dependent manner, with a pronounced effect observed at 25 µM (p < 0.01). Gomisin R markedly downregulated PTGS2 expression at both mRNA and protein levels (p < 0.001), accompanied by reduced expression of inflammatory cytokines IL-1β and IL-6, increased antioxidant capacity (elevated GSH and SOD levels and decreased MDA content), and modulation of apoptosis-related genes, characterized by decreased Bcl-2 and increased Caspase 9 expression (p < 0.05-0.001). These effects were partially reversed by the PTGS2 agonist rebamipide. These findings suggest that Gomisin R may modulate PTGS2-associated inflammatory and redox pathways in NSCLC cells. The integration of network pharmacology with experimental validation provides a mechanistic framework for understanding the potential role of Gomisin R in NSCLC-related research, although further in vivo studies are required to confirm its translational relevance. Gomisin R exerts anti-NSCLC effects, in part, by regulating PTGS2 expression, leading to suppression of cell proliferation, attenuation of oxidative stress and inflammatory responses, and induction of apoptosis in A549 cells. This study provides quantitative evidence supporting Gomisin R as a key active component of Schisandra chinensis for the treatment of NSCLC.
Neurites of sensory neurons innervate the skin and are embedded within it. These delicate structures are chronically exposed to mechanical strain and yet their integrity is maintained throughout life. In C. elegans, UNC-70/β-spectrin functions in synergy with the small GTPase RAB-35 within the skin to stabilize neuron-epidermal attachment against mechanical strain, and prevent movement-induced damage to mechanosensitive axons. However, the molecular pathway regulating these specialized attachments remains elusive. Here, through an unbiased genetic screen we have identified a guanine nucleotide exchange factor (GEF), AGEF-1, that impacts axonal maintenance. This molecule is known to function in endocytic-recycling and its human ortholog, BIG2, is associated with the development of the periventricular nodular heterotopia. We show that AGEF-1 functions selectively within the skin to regulate axonal integrity of mechanosensitive neurons. Mechanistically, we reveal that AGEF-1 binds to epidermal RAB-35 and regulates its activity, modulating neuron-epidermal attachment stability. Finally, we demonstrate that this GEF is highly conserved, with its human ortholog BIG2, capable of replacing AGEF-1. Together, we reveal the molecular machinery responsible for fine-tuning neuron-epidermal attachments and maintaining axonal integrity during life. Resumo Neuritos de neurônios sensoriais inervam densamente a pele e situam-se inseridos nela. Essas estruturas delicadas são cronicamente expostas a tensão mecânica, contudo sua integridade é mantida ao longo da vida. Em C. elegans, a β-espectrina UNC-70 atua em sinergia com a GTPase RAB-35 dentro da pele para estabilizar adesões neuro-epidermais contra tensão mecânica e protege axônios mecanosensitivos contra dano mediado pelo movimento. No entanto, não são conhecidos todos os componentes da maquinaria molecular que regula essas adesões. Através de uma mutagênese química, identificamos que AGEF-1, um fator de troca de nucleotídeos de guanina (GEF), impacta a manutenção axonal de neuronios mecanosensitivos. Essa molecula funciona no sistema de reciclagem endocítica e seu ortologo em humanos, BIG2, é associado ao desenvolvimento de heterotropia nodular periventricular. Aqui demostramos que essa proteína atua seletivamente na pele para essa função. Mecanisticamente, revelamos que AGEF-1 liga-se a RAB-35 epidermal regulando sua ativação e modulando a estabilidade de adesões neuro-epidermais. Por fim, demonstramos que AGEF-1 é altamente conservado, com o seu ortólogo humano BIG2 sendo capaz de substituir a molécula nematoide. Ao todo, revelamos a maquinária molecular responsável pelo ajuste delicado das adesões neuro-epidermais e da integridade axonal ao longo da vida.
  BJECTIVE: To characterise adaptive immunity in very and extremely preterm neonates and assess potential immunological markers that predispose them to infection.  Peripheral blood lymphocytes in 30 very to extremely preterm neonates (mean birth weight 815 g) were analysed using 9-colour flow cytometry at days of life 0-7, 8-14, and 15-28. Patients were prospectively recruited at the University Hospital of Zurich from 2021 to 2023. Statistical analyses included group comparisons and longitudinal assessments. Six of the thirty preterm neonates (20%) developed early- or late-onset sepsis, of whom one (3%) also exhibited signs of necrotising enterocolitis. T and B lymphocytes were predominantly composed of naïve T cells and unswitched CD27- B cells, respectively. The CD4/CD8 ratio was initially elevated, especially in extremely preterm neonates, and declined significantly after week 1. EPT neonates also had significantly fewer natural killer cells compared with very premature infants. Although no distinct immunological features were identified as predisposing to infection, B-cell proportions were significantly higher in infected neonates during the second week of life, possibly reflecting an immune response to infection. Adaptive immunity in preterm neonates is characterised by profound immaturity, including an almost complete absence of immunological memory and low CD8 T-cell frequency, which may limit effective pathogen elimination and increase susceptibility to infection. Immunophenotyping provides valuable insights into the immune processes in this vulnerable population and, when combined with clinical observations and routine laboratory findings, could aid in the earlier identification of high-risk neonates and guide targeted interventions.
Periodontal diseases are among the most prevalent noncommunicable diseases (NCDs) worldwide, with advanced stage contributing to disability, impaired nutrition, frailty, and reduced quality of life. Despite this burden, periodontal care remains weakly integrated into global NCD strategies, limiting public health advocacy and healthy aging. We conducted a conceptual and policy-oriented analysis to identify opportunities for repositioning periodontal care as a public health function. Key domains examined included (a) preventive healthcare through the common risk factor approach; (b) case identification and diagnosis designed to serve both clinical care and population surveillance; (c) de-implementation of care with limited incremental benefit at scale, including the role of payment incentives in shaping utilization. To evaluate long-term affordability, projected global periodontal healthcare expenditure through 2050 was modeled using a cohort-based Monte Carlo simulation, comparing current utilization patterns, expansion to 80% population coverage, and an alternative capitation-informed scenario. Reorienting periodontal care toward proactive, cost-effective prevention and integrating case identification within primary care and NCD platforms offer greater potential for equitable population health gains than simply expanding procedure-intensive treatments. Risk-stratified care pathways based on patient-important outcomes, combined with de-implementation of low-value practices, can preserve oral function while reducing avoidable service volume and costs. Expenditure modeling indicates that achieving high coverage under prevailing fee-for-service delivery would substantially increase global financial burden, whereas a capitation-informed scenario reduced projected expenditure by 30% at the same coverage level, suggesting alternative incentives could expand access with less cost escalation, including in low- and middle-income settings worldwide. Aligning periodontal care with public health principles-prioritizing prevention, value, and equity over treatment volume-is a paradigm shift essential for achieving sustainable improvements in population health, healthy aging, and long-term health-system affordability.
Despite the increasing recognition of palliative care in the management of heart failure (HF), many patients continue to experience unmet care needs due to the delayed integration of supportive services. Identifying these needs is crucial for enhancing patient-centered care and informing healthcare policies. This qualitative study aimed to explore the palliative care needs of patients with HF. This qualitative study employed a directed content analysis approach. Semi-structured in-depth interviews were conducted with 22 adult patients with heart failure in Ahvaz, Iran. Data collection continued until saturation, ensuring no new themes emerged. To ensure the trustworthiness of the findings, Lincoln and Guba's criteria were used. A total of 22 adult patients with heart failure participated in the study, with a mean age of 58.45±18.07 years. Data analysis revealed eight main categories of needs, including 'care structures and processes', 'physical aspects', 'psychological aspects', 'social aspects', 'cultural aspects', 'end-of-life care', 'ethical and legal aspects' and 'spiritual and existential aspects' with 30 subcategories. This study highlights the urgent need for early and thorough palliative care in heart failure management. By meeting patients' diverse needs with team-based, patient-focused methods, we can enhance quality of life, manage symptoms better and reduce healthcare challenges. These results are important for clinical practices and policies, supporting the creation of specialised palliative care programmes for heart failure patients.
Nurses often intervene to extend patients' lives. However, sometimes patients may request euthanasia, and this situation can potentially affect their subsequent care. To examine the relationship between the caregiving behaviours of nurses caring for dying patients and their attitudes towards death and euthanasia in Türkiye. The study involved 229 intensive care nurses. Data collection was carried out using Attitudes Towards Euthanasia scale, and the caring behaviours assessment tool nursing version-short form. The termination of nursing care interventions for patients, defining euthanasia as a right to die and believing that individuals should have the right to euthanasia emerged as factors contributing to nurse's attitudes towards euthanasia and patients at the end of life. Also, the willingness of nurses to provide care for patients in the terminal stage, their thoughts that euthanasia can be applied to patients in the terminal stage, their questioning the reason for this request if their patients want euthanasia, and their attitudes towards death, emerged as factors contributing to the caring behaviours of nurses. Nurses should be aware of their attitudes towards dying patients and death, and they should be able to identify the effects of negative attitudes on the care they provide to terminally ill patients. They should also work on improving their caregiving behaviours.
Urban biodiversity has emerged as a major global concern due to rapid urban expansion. Accelerated urbanization in urban towns has caused loss of biodiversity, changes in land use land cover (LULC), and environmental imbalance. This study attempts to capture the ecological uniqueness of four Himalayan towns, i.e. Manali, Kullu, Mandi, and Bilaspur, through an integrated assessment of LULC and floristic diversity assessment. LULC classification was carried out using WorldView and GeoEye imagery (at 0.5 m resolution) through image segmentation and random forest classification. It was accompanied by field surveys to assess the floristic diversity in selected towns. Accuracy assessment yielded values above 0.90 for overall accuracy and kappa coefficient, confirming reliability of the results. The results revealed that trees were the dominant land cover in Manali and Bilaspur, whereas grasses in Kullu and buildings prevailed in Mandi. Open lands and water bodies consistently accounted for the smallest proportions. The results highlight the transitional nature of Himalayan urban systems, where vegetation still occupies larger extents than built-up areas, unlike bigger cities. Vegetation surveys using line transects across seven urban habitats identified 731 plant species, with herbaceous species as the most prevalent life form. Chi-square tests illustrated a highly significant association between species presence and habitat type in all four towns (p < 0.01), confirming that species distributions were strongly habitat-dependent. The cluster analysis test demonstrated strong associations between species composition and habitat heterogeneity, reflecting the combined influence of ecological and anthropogenic factors. Floristic diversity analysis indicated wide variations in alpha diversity (28-223 species), high gamma diversity (731 species), and beta diversity (β = 7.13) across habitats. These findings emphasize the need to conserve semi-natural habitats and maintain habitat heterogeneity to balance urban development with biodiversity conservation, thereby sustaining the ecological integrity of Himalayan towns.
This study evaluated the efficacy of endurance exercise on balance impairment and gait disturbance among individuals living with Human Immunodeficiency Virus (HIV)-related distal symmetrical polyneuropathy (DSPN). This was a multi-centre, single-blinded randomized controlled trial (RCT). The intervention consisted of moderate-intensity endurance exercise (three 30-minute sessions per week for 12 weeks) (n = 45). The control group was a non-exercise, waitlist group (n = 47). Non-parametric inferential statistics were used, with the Friedman test for within-group comparisons and the Mann-Whitney U test for between-group comparisons. The alpha level was set at 0.05. At 12 weeks, the training group showed significant improvements in balance performance (P = 0.001) and walking ability (P = 0.001). In contrast, no significant changes in balance (P = 0.531) or gait (P = 0.12) were observed in the control group. Endurance training can lead to improvements in muscle strength, coordination, balance, functional status, and quality of life. This study concludes that moderate-intensity endurance exercise has a positive effect on balance impairment and gait disturbance in individuals with HIV-related DSPN.
Stereotactic body radiotherapy (SBRT), most commonly delivered in 5 fractions, is an established treatment option for patients with localized prostate cancer. While efforts to further reduce treatment to fewer than 5 fractions are ongoing, the efficacy and tolerability of single high-dose SBRT remain to be established. To determine in men with localized prostate cancer whether a single-fraction SBRT can be a valid treatment option in terms of biochemical disease control and safety. This multicenter, single-arm, prospective, phase 1/2 nonrandomized clinical trial included men with localized prostate cancer at low or intermediate risk, with International Society of Urological Pathology grade group 1 or 2, and without significant tumor in the transitional zone. Participants were recruited between 2017 and 2022 in 5 academic centers in Europe and the US. Data were analyzed between February and May 2026. Participants were treated with a 19-Gy single-fraction prostate SBRT with urethra-sparing and intrafraction motion control. The primary end point was biochemical relapse-free survival (bRFS) at 3 years (expected value of 96% included in the 95% CI). Secondary end points included occurrence of genitourinary (GU), gastrointestinal (GI), and sexual adverse events (AEs) and quality of life (QOL) assessment. Among the 45 patients recruited (median age, 72 [range, 60-82] years), 43 were treated per protocol. After a median follow-up of 55.3 (IQR, 49.9-60.7) months, the estimated 3-year bRFS was 92.9% (95% CI, 85.4%-100%), meeting the primary end point. At 3 years, grade 2 GU and GI AEs were observed in 4 (9.8%) and 2 (4.9%) participants, respectively, with only a grade-3 proctitis observed in 1 patient at month 12. Grade 2 or higher erectile dysfunction increased from 9 of 42 patients (21.4%) at baseline to 15 of 39 (38.4%) at 3 years. A significant minimally clinically important change in Expanded Prostate Cancer Index Composite scores was observed in 6 (14%) and 12 (28%) participants for GU and sexual scores, respectively. The impact in GI bother scores was minimal. In this multicenter phase 1/2 trial, a single-fraction 19-Gy urethra-sparing SBRT met the primary end point, achieving a 3-year bRFS of 92.9%, with grade 2 GU and GI AEs remaining below 10% and 5%, respectively, at 3 years. Longer follow-up is warranted to assess long-term disease control. ClinicalTrials.gov Identifier: NCT03294889.
β-Thalassemia major typically manifests between six months and two years of age. It is characterized by chronic anemia, and a range of multisystemic complications lead to increased morbidity and disease burden. It has a significant influence on patients' mental and social health, making a biopsychosocial approach necessary for all encompassing therapy. This study examines how biopsychosocial, biochemical variables and genetic variants, namely the PDE7B gene SNP rs2327669, is associated with β-thalassemia major. Analysis of 400 patients and 400 controls, ages 2 to 18 years, was conducted with an emphasis on psychosocial aspects using a standardized questionnaire developed with the assistance of a psychiatrist and previously published studies to assess the psychological burden, biochemical indicators through biochemical analysis and genotyping with the help of Tetra ARMS-PCR. The findings presented here demonstrate the association between β-thalassemia major's biopsychosocial, biochemical aspects and genetic predispositions. A significant association between the rs2327669 and clinical indicators, were found by SNP genotyping with significance value < 0.05. In personality characteristics and SNP genotyping association it was found, neuroticism and introversion were associated to the GG mutant genotype, whereas conscientiousness and compassion were associated to the CC and CG genotype (p-value < 0.005). Through this study it was observed that, the PDE7B rs2327669 polymorphism is significantly associated with selected biochemical and psychosocial parameters in β-thalassemia major patients. Larger cohort studies are necessary in the future, so it could lead toward focused therapies that tackle physiological & biopsychosocial issues, enhancing the clinical results and quality of life for β-thalassemia major patients.