This study aimed to review the self-care status of heart failure patients through the European Heart Failure Self-Care Behavior Scale. Eligible studies were retrieved by searching in PubMed, Web of Science, and Embase. The studies' title, abstract, and full text were screened and selected by two researchers independently. The data were analyzed using the Comprehensive Meta-Analysis software and a random effects model. A total of 7819 studies screened and 31 articles were included finally. The mean scores of selfcare in studies using the 12-item questionnaire were estimated to be 32.91 Å} 1.29 (95% CI: 30.38-35.44), in studies using the 9-item questionnaire it was 25.54 Å} 1.45 (95% CI: 22.68-28.40), in studies using the 9-item questionnaire with standardized score (0-100), it was 62.28 Å} 5.2 (95% CI: 52.08-72.47). The findings demonstrate that the level of self-care in heart failure patients is not satisfactory. Due to the high heterogeneity of the studies, the findings should be interpreted with caution. Cite this article as: Negarandeh, R., Hoseini-Esfidarjani, S.S., & Aghajanloo, A. (2025). Self-care behaviors in heart failure patients using the European Heart Failure Self- Care Behavior Scale: systematic review and meta-analysis. Florence Nightingale Journal of Nursing, 34, 0121, doi:10.5152/FNJN.2026.25121.
Peroxisome proliferator-activated receptors gamma (PPAR-γ) regulates lipid storage and is involved in placental trophoblast differentiation and placental vasculature development. In this case-control study, associations between maternal, placental and neonatal parameters and placental PPAR-γ transcript abundance has been investigated in a set of well characterized small (SGA) and appropriate for gestational age (AGA) births. From 39 SGA and 51 AGA singleton pregnancies, placental samples were collected. Information on maternal and newborn anthropometry and clinical variables were recorded. Placental transcript abundance of PPAR-γ, with respect to housekeeping genes ACTB, YWHAZ and B2M, was evaluated using realtime quantitative PCR. Associations between maternal, placental and neonatal parameters and placental PPAR-γ transcript abundance was evaluated and levels of placental PPAR-γ transcript abundance was compared between SGA and AGA births. Placental PPAR-γ transcript abundance was associated negatively with birth weight in all 90 births evaluated (β = -21.764, P = 0.026), in SGA births (n = 39, β = -19.533, P = 0.032) and in female AGA births (n = 29, β = -22.778, P = 0.041). Placental PPAR-γ transcript abundance was associated with placental length in all 90 births evaluated (β = -0.098, P = 0.005) and in SGA births (n = 39, β = -0.084, P = 0.032) and with placental breadth (n = 90, β = -0.095, P = 0.011). Female SGA placentae (n = 16) exhibited higher levels of placental PPAR-γ transcript levels compared to female AGA placentae (n = 29; P = 0.042). Findings from this study indicate that fetal sex modulates the relations between placental PPAR-γ transcript abundance and birth weight. Repression of placental PPAR-γ expression was associated with better fetal growth, amongst SGA births of both sexes, and amongst female AGA births. The underlying mechanisms need to be addressed in future studies.
Do the offspring of women with polyendocrine metabolic ovarian syndrome (PMOS) exhibit altered cardiometabolic profiles in early childhood? Of 2688 singletons born to women with or without PMOS who were conceived through assisted reproductive technology (ART), 2549 were eligible for study analysis. Propensity score matching was employed to mitigate confounding variables. Cardiometabolic profiles at 3-6 years of age were assessed. Compared with control participants, the offspring of PMOS mothers showed marginally higher total cholesterol concentrations (4.40 versus 4.23 mmol/l, P = 0.013, Q = 0.046), and a lower proportion had total cholesterol concentrations in the ideal range (49.3%, 107/217 versus 59.6%, 469/787; P = 0.007, Q = 0.046). Although these differences survived Benjamini-Hochberg FDR correction, they were small and the central tendency of all lipid measures remained within the normal paediatric range. In sex-stratified analyses, small but significant differences in lipids (PMOS versus controls: total cholesterol, 4.45 versus 4.27 mmol/l, P = 0.024, Q = 0.042; LDL-C, 2.53 versus 2.36 mmol/l, P = 0.007, Q = 0.042) were observed exclusively in female offspring. Although total cholesterol was higher in ART-conceived PMOS offspring during early childhood, the minimal lipid differences were within normal paediatric ranges. Longitudinal follow-up is warranted to determine whether these subtle deviations have long-term clinical significance.
This open-label randomised phase 2 study aimed to determine whether a single versus two-dose BNT162b2 primary vaccination regimen in children 5 to 11 years old with prior SARS-CoV-2 infection was non-inferior in terms of immunogenicity and superior in terms of safety and reactogenicity. Participants were randomly assigned (1:1) to receive either one or two doses, spaced 3 to 12-weeks. The primary endpoint was geometric mean ratio (GMR) of neutralizing antibodies against wild-type SARS-CoV-2 at 28 days post-vaccination with non-inferiority margin defined as a 1.5-fold change in geometric mean titers (GMT). Secondary endpoints included safety and reactogenicity profile and immunogenicity up to 12 months against wild-type and Variants of Concern (VOCs). In total 31 participants from 3 European countries (median age 9, IQR7-10) were enrolled from May 2022 to January 2024, when the trial was prematurely terminated due to declining interest in COVID-19 vaccination among age-eligible children. Of these, 15 received two doses, and 16 received one. At day 28, GMT of neutralizing antibodies against wild-type SARS-CoV-2 was 1801.1 IU/mL(95%CI:1357.9-2388.9) in the two-dose arm and 1715.5 IU/mL(95%CI:1064.2-2765.4) in the single-dose arm. However, the non-inferiority of the single-dose could not be demonstrated (GMR:0.9; 95%CI:0.5-1.6). Titers remained above 100 IU/mL in both groups at 6 and 12 months. Both schedules elicited high anti-RBD IgG titers against wild-type and neutralizing titers against BA.5 variant at day 28. Eight participants (53%) in the two-dose arm and five (31%) in the single-dose reported a systemic adverse event grade ≥ 2 (P = 0.18) within 7 days of vaccination. Both regimens induced robust and sustained immune responses consistent with the possibility that, in children with prior infection, a single dose functions immunologically as a booster of the humoral response. However, the premature termination renders the primary non-inferiority comparison statistically underpowered. The vaccine was well tolerated in both groups. EudraCT registration: 2021-005043-71.
Ocular sarcoidosis is a frequent manifestation of sarcoidosis and may occur most commonly affecting adults between 30 and 60 years old. Uveitis may be anterior, intermediate, posterior, or present as panuveitis, with marked heterogeneity in severity and clinical course. Diagnosis relies on a combination of compatible ocular findings and systemic investigations, including serum biomarkers, thoracic imaging, and histological evidence of noncaseating granulomas while carefully excluding infectious and neoplastic mimickers, particularly in atypical or corticosteroid-resistant cases. Bilateral, intermediate, posterior, and panuveitis often require systemic corticosteroids. Because of the unfavorable long-term safety profile of systemic corticosteroids, early introduction of steroid-sparing therapy is recommended in chronic, severe, or recurrent disease. Emerging therapies such as interleukin-6 receptor antagonists, Janus kinase inhibitors, and mTOR inhibitors represent promising options on top of methotrexate and TNF inhibitors for refractory sarcoid uveitis, although their use requires careful risk-benefit assessment and further validation in controlled trials.
Rhodotorula toruloides is an oleaginous yeast with great potential for chemical and biofuel production, due to its ability to utilize lignocellulosic biomass and to produce high levels of carotenoids and storage lipids. However, its broader application in biotechnology has been limited by the lack of efficient genetic transformation methods. Although protoplast transformation is wildly used in fungal systems, it has remained largely unexplored in R. toruloides. In this study, we established a protoplast transformation protocol using linear DNA fragments and R. toruloides strain BOT-A2, a recently isolated strain with high lipid-producing potential. We first confirmed that BOT-A2 is a MAT A2 haploid strain. We then produced a β-1,3-glucomannanase (Man5C) that effectively digests the R. toruloides cell wall. Key parameters affecting transformation efficiency were systematically optimized, including the Man5C digestion conditions, antibiotic selection pressure, cell growth phase, protoplast yield and viability, PEG formulation, calcium ion concentration, and regeneration conditions. Using the optimized protocol, we successfully transformed BOT-A2 with three heterologous resistance cassettes (hygromycin R, bleomycin, and G418) yielding 190, 226, and 244 transformants per µg of DNA, respectively. This method provides a platform for genetic manipulation and is expected to facilitate both fundamental research and metabolic engineering in R. toruloides BOT-A2.
To synthesize recent multiscale evidence and propose a unified mechanical-metabolic-immune framework for the role of occlusal abnormalities in temporomandibular joint osteoarthritis (TMJOA) pathogenesis. A narrative literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science for English-language articles published between January 2011 and April 2026. Search terms combined concepts related to temporomandibular joint osteoarthritis, malocclusion or occlusal abnormalities, mechanotransduction, Piezo1, integrin signaling, mitochondrial dysfunction, cGAS-STING activation, single-cell transcriptomics, macrophages, and sexual dimorphism. Clinical, imaging, animal, cellular, omics-based, and mechanistic studies relevant to TMJOA were narratively synthesized. Occlusal abnormalities may alter mandibular kinematics and joint stress distribution, thereby activating mechanotransduction through Piezo1, integrins, and related developmental feedback loops. Sustained mechanical overload may promote calcium dysregulation, endoplasmic reticulum stress, mitochondrial dysfunction, and activation of the cGAS-STING pathway. These changes can shift cellular metabolism toward increased glycolysis and contribute to a pro-inflammatory microenvironment. Single-cell and lineage-tracing evidence further suggests that sex-related immune regulation, including macrophage ontogeny and Xist-associated inflammatory responses, may contribute to the female predominance of temporomandibular joint disorders, although TMJ-specific validation remains needed. TMJOA progression can be interpreted as a cross-scale process in which abnormal occlusal loading links biomechanical stress, metabolic dysfunction, and immune remodeling. These pathways may represent potential targets for future mechanism-based diagnosis and therapy.
The aim of this study was to determine the validity and reliability of the "Cardiac Self-Efficacy Questionnaire" in Turkish. This methodological research was conducted among 400 patients who were hospitalised at the Cardiology Clinic of Giresun University Training and Research Hospital between 25 March 2023 and 15 May 2024. The data were collected using the "Patient Introductory Form", "Cardiac Self-Efficacy Questionnaire", and "Chronic Diseases Self-Efficacy Scale". The scale demonstrated excellent content validity, with a content validity index of 1.00. Construct validity was examined using factor analytic techniques. "The Kaiser-Meyer-Olkin measure indicated adequate sampling adequacy 0.878, and Bartlett's test of sphericity was statistically significant (p < .001), confirming the appropriateness of the correlation matrix for factor analysis." Exploratory factor analysis supported a two-factor solution control of symptoms and maintenance of functionality which collectively explained 53.55% of the total variance. The results indicated that the model provided a goodto- acceptable fit to the data, as evidenced by the following fit indices: χ2/df = 2.172, Goodness of Fit Index = 0.91, Adjusted Goodness Fit Index = 0.87, Comparative Fit Index = 0.95, Incremental Fit Index = 0.95, Tucker-Lewis Index = 0.93, Normed Fit İndex = 0.91, and Root Mean Square Error of Approximation = 0.07. The reliability analysis indicated acceptable internal consistency, with Cronbach's α values of 0.88 for the overall scale, 0.86 for the symptom control subscale, and 0.76 for the functionality maintenance subscale. The Cardiac Self-Efficacy Questionnaire can be considered a valid and reliable instrument for assessing cardiac self-efficacy in the Turkish population. Cite this article as: Bayram, S., & G.k Uğur, H. (2026). Turkish validity and reliability study of the cardiac self-efficacy questionnaire. Florence Nightingale Journal of Nursing, 34, 0346, doi:10.5152/FNJN.2026.25346.
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This study systematically investigated the structure-immunomodulatory activity relationship of three ginseng polysaccharides (GPs). GP40015-1 was identified as a high-molecular-weight neutral glucan, whereas GP40025-1 and GP40030-1 were acidic heteropolysaccharides with distinct uronic acid contents and branching patterns. Controlled enzymatic hydrolysis combined with LC-ESI-MS/MS was employed to decipher their specific oligosaccharide sequences. Immunomodulatory assessment on RAW264.7 macrophages demonstrated that all three GPs promoted cell proliferation and phagocytic activity in a dose-dependent manner. GP40025-1 exhibited the strongest bioactivity, enhancing proliferation by 158.4% and phagocytosis to 246.6% at 100 μg/mL. Its superior immunomodulatory potential was attributed to a lower molecular weight, a unique β-linked backbone with →1)-α-Glc-(3→ and →1)-β-GlcA-(4→ branching motifs, and an optimal uronic acid content. These findings provide crucial insights into the structure-activity relationship of GPs and underscore the potential of GP40025-1 as a functional food ingredient with natural immunomodulatory properties.
This study examined the relationship between parental phubbing and social ostracism among adolescents. This correlational cross-sectional study was conducted between April 2025 and June 2025 using a cluster sampling method with 597 adolescents aged 11-15 living in a province in eastern Turkey. Data were collected using a 'Personal Information Form,' the 'Parental Phubbing Scale,' and the 'Ostracism Scale for Adolescents'. The mean total score for parental phubbing among adolescents was 20.72 ± 8.44; the mean total score for social ostracism was 22.32 ± 8.42. A significant difference was found in the relationship between parental phubbing levels and the number of siblings and family type (p < 0.05). A significant difference was found in the relationship between social ostracism levels and family income, the individuals with whom they lived, participation in school activities, and school success (p < 0.05). A strong, positive, and significant relationship (r = 0.667) was found between parental phubbing and social ostracism (p < 0.01). Parental phubbing was found to predict social ostracism at a significant level (β = 0.239, p = 0.001). Levels of parental phubbing and perceived social ostracism were low among adolescents. It was concluded that there was a statistically positive and strong relationship between parental phubbing and social ostracism. It was determined that as parental phubbing increased, social ostracism among adolescents increased. Interventions and strategies that help parents balance phubbing behavior with parental responsibilities should be prioritized to support children's healthy development and overall well-being.
Pig farming in Slovenia has a long tradition and is known for producing high-quality pork; however, almost two-thirds is imported, raising concerns about mislabelling. In addition to modern Slovenian breeds (MB), the Krškopolje pig (KP), the only preserved autochthonous pig breed in Slovenia, is highly valued for its high-quality, marbled meat, which is sold at a premium price. This study presents the first Slovenian pork database on stable isotope (δ2H, δ18O, δ13C, δ15N, δ34S) and elemental composition, comprising 148 samples: 107 authentic Slovenian pork samples (MB and KP), 22 foreign samples, and 19 samples labelled as Slovenian collected from supermarkets. We investigated the geographical origin of modern-breed pork and the breed authenticity of Krškopolje pig pork using DD-SIMCA class modelling. The established DD-SIMCA models showed high sensitivity (97 % and 96 %) and specificity (100 % and 89 %), respectively. When applied to commercial pork products labelled as Slovenian, 79 % of the samples exhibited isotopic and elemental profiles that differed from the authentic Slovenian reference class established in this study. These findings demonstrate the potential of combined isotope-elemental profiling coupled with DD-SIMCA modelling as a complementary tool for pork origin authentication and traceability verification. However, classification results indicate consistency with the reference class rather than legal origin status and should therefore be interpreted accordingly.
Previous studies have used national data to assess readmission risk factors for patients with burn injury. This study sought to identify risk factors for readmission amongst unhoused burn patients. The 2022 Nationwide Readmissions Database, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality, was used for this study. Patients with International Classification of Diseases Version 10 codes for burn or corrosive injury between January 1, 2022, to November 30, 2022, were included in analysis. Readmission was defined as a subsequent encounter within 30 days with a diagnosis of burn. 18,607 encounters were identified as index admissions, 1,130 (6.1%) were unhoused. 8.6% of unhoused patients (n=97) were readmitted with a diagnosis of burn injury compared to 5.2% (n=908) of housed patients (p<0.001). Risk factors for readmission for unhoused patients included a third-degree burn (OR 2.4, [1.4-4.2], p<0.001), leaving against medical advice (OR 4.1, [2.6-6.6], p<0.001), burn of the trunk (OR 1.9, [1.2-3.0], p<0.001), burn of the upper extremity (OR 1.9, [1.2-3.0], p<0.001), and burn of the lower extremity (OR 1.6, [1.0-2.6], p=0.004). Despite higher rates of diagnoses such as schizophrenia, bipolar disorder, alcohol abuse, and/or substance abuse in the unhoused population, these factors did not increase risk for readmission. Unhoused burn patients were at higher risk of readmission than housed patients, even when adjusting for other risk factors for readmission. Severity of injury, location of injury, and leaving against medical advice were associated with readmission amongst unhoused patients. Leaving against medical advice was a potentially modifiable risk factor identified for readmission risk mitigation in this study.
Seed storage proteins (SSPs), which accumulate specifically during seed development, constitute a major source of plant-derived protein in the human diet. Despite their critical role in determining crop quality, the molecular mechanisms underlying the intracellular trafficking of SSPs remain poorly understood. Here, we characterize the rice glutelin precursor accumulation16 (gpa16) mutant, which exhibits defective dense vesicle (DV)-mediated post-Golgi trafficking of proglutelins, resulting in their overaccumulation in the apoplast. GPA16 encodes OsOSCA2.4, a member of the reduced hyperosmolality-induced Ca2+ increase channel (OSCA) family. OsOSCA2.4 localizes to post-Golgi compartments including the trans-Golgi network (TGN) and prevacuolar compartment (PVC) in vegetative tissue, and DVs in the endosperm. The OsOSCA2.4(P397L) variant disrupts the formation of the Rab5a molecular module, a process influenced by intracellular Ca2+ homeostasis. Ca2+ imaging assays indicate that OsOSCA2.4 functions as a regulator of Ca2+ homeostasis of PVCs/DVs, the primary sites of Rab5a module activity. Genetic analyses reveal functional redundancy between OsOSCA2.4 and OsOSCA4.1 in modulating post-Golgi trafficking of proglutelins. Collectively, our findings identify OSCA-mediated Ca2+ homeostasis as a previously unrecognized regulatory layer governing post-Golgi trafficking of SSPs and uncover an unexpected role for OSCA proteins in vesicular trafficking in eukaryotes.
Schizophrenia (SZ) is a chronic neuropsychiatric disorder with marked impairments in cognitive, behavioral, and emotional functions. Despite extensive research, reliable molecular biomarkers of the disease have not yet been identified. Long non-coding RNAs (lncRNAs) stand out as regulatory molecules with diagnostic potential in many neurological and psychiatric disorders. This study aimed to evaluate the serum levels of HOXA transcript at the distal tip (HOTTIP), colon cancer-associated transcript 1 (CCAT1), and CCAT2 lncRNAs as potential biomarkers in SZ. Seventy antipsychotic-naive patients with SZ and 55 healthy controls participated in the study from June 2023 to May 2024. Control and SZ serum samples were collected, and the relative expression levels of HOTTIP, CCAT1, and CCAT2 were analyzed using reverse transcription-quantitative polymerase chain reaction. Results showed that HOTTIP expression was significantly increased in patients with SZ (P < .05). However, no significant difference was observed in CCAT1 and CCAT2 levels between the groups. The association between increased HOTTIP levels and clinical symptom profiles suggests that this molecule may be linked to disease activity and SZ response. The HOTTIP showed modest discriminative ability (AUC = 0.60, 95% CI 0.50-0.70). The study was powered to detect moderate group differences; the null results for CCAT1/ CCAT2 therefore exclude moderate-or-larger effects but not small effects. HOTTIP may represent a noninvasive biological marker associated with SZ, although its standalone diagnostic utility appears limited. Cite this article as: Güzel Tanoğlu E, Çevik FE, Çakmur KN, Esen MF, Uzun FR, Erkıran M. Evaluation of serum long non-coding RNAs HOXA transcript at the distal tip, colon cancer-associated transcript 1, and colon cancer-associated transcript 2 as potential biomarkers in schizophrenia. Eurasian J Med. 2026, 58(4), 1271, doi: 10.5152/ eurasianjmed.2026.251271.
Fibromyalgia remains a contested clinical entity, characterized by persistent uncertainty regarding its definition, diagnostic boundaries, and underlying mechanisms. Over the past three decades, diagnostic frameworks have evolved from the 1990 American College of Rheumatology (ACR) classification criteria, based on widespread pain and tender point examination, to symptom-based models emphasizing patient-reported outcomes, such as the 2010 and 2016 ACR criteria. While these developments have improved feasibility and expanded clinical recognition, they have largely remained confined to biomedical and neuropsychological domains. This narrative review critically examines the historical evolution, conceptual foundations, and methodological limitations of fibromyalgia diagnostic criteria, integrating evidence from major classification systems, including ACR frameworks and the ACTTION-American Pain Society (APS) Pain Taxonomy (AAPT). Across these models, fibromyalgia is predominantly operationalized through symptom aggregation, with limited incorporation of social and contextual determinants of health. The analysis highlights persistent epistemological tensions, including diagnostic inflation, the continuum of polysymptomatic distress, and debates regarding disease legitimacy. In response, emerging proposals advocate for a biopsychosocial diagnostic framework that formally integrates biological, psychological, and social dimensions into the diagnostic core. This review also critically evaluates alternative dual-framework approaches that separate biological diagnosis from psychosocial severity assessment, emphasizing potential limitations such as fragmentation of patient experience and underestimation of psychosocial mechanisms in symptom generation. The findings suggest that future diagnostic models should move beyond static, symptom-based thresholds toward dynamic, integrative, and context-sensitive approaches. Such models may improve patient stratification, clinical decision-making, and research validity, while aligning diagnostic practice with contemporary understandings of chronic pain as a multidimensional and interactive condition.
This study investigated the temporal dynamics of bromoform (CHBr3) dehalogenation from Asparagopsis taxiformis and its effects on fermentation characteristics and microbial composition in an in vitro batch culture system, generating data relevant to the safety and efficacy assessment of A. taxiformis as a methane (CH4) inhibitor. Per treatment, six bottles were incubated with individual rumen fluid from three rumen fistulated lactating Holstein-Friesian dairy cows, with duplicate bottles per biological replicate (3 biological × 2 technical replicates). These bottles were used for continuous measurement of gas production, spot CH4 measurements at 0, 1, 2, 4, 8, 12, 24, 36, 48, 60, and 72 h of incubation, as well as for sampling (at 72 h) of volatile fatty acids (VFAs), CHBr3 metabolites, total bromine, iodine and arsenic concentration, and microbiome composition. Substrate (0.5 g DM) comprised 60% grass and 40% corn (DM basis) with or without 0.01 g DM A. taxiformis (Asparagopsis and Control, respectively). Samples for CHBr3 metabolites, bromine, iodine, arsenic, and microbiome analyses were taken to study changes over time (at 1, 2, 4, 8, 12, 24, 36, 48, and 60 h) from extra bottles incubated at the same starting time containing the Asparagopsis treatment. Cumulative gas production was not affected by the addition of A. taxiformis, while cumulative CH4 production was reduced by 94 and 78% after 24 and 72 h of fermentation, respectively. Total VFA concentration and molar proportion of acetate decreased, and molar proportion of propionate increased in Asparagopsis compared to Control. After 1 h of fermentation, only 5.3% of the added CHBr3 was detectable, and it was below the detection limit after 8 h. The concentration of dibromomethane (CH2Br2) increased markedly within 1 h and remained relatively stable up to 72 h of fermentation. No bromomethane was detected. The lack of stoichiometric conversion between CHBr3 and CH2Br2 suggests that additional, unidentified brominated metabolites may have formed. Total bromine, iodine, and arsenic concentrations remained relatively stable over time. Supplementation of A. taxiformis resulted in large shifts in microbial community, including a decrease in the relative abundance of archaeal and ciliate species. Longitudinal microbiome analyses confirmed a progressive microbial community restructuring over time. The shifts in bacterial community generally indicate an adaptation to elevated hydrogen concentrations or alternative fermentation pathways. Further in vivo research is needed on the absorption, metabolism, distribution, and excretion of CHBr3 and its derivatives in ruminants, including potential metabolism in organs beyond the rumen.
To qualitatively and quantitatively compare dual-energy computed tomography (DECT)-derived 55 keV virtual monochromatic images (VMIs) using deep learning image reconstruction (DLIR) with 70 keV VMIs using adaptive statistical iterative reconstruction (ASiR-V) in the Gastrointestinal (GI) system tumors and to investigate whether DLIR can influence the measured iodine parameters. This prospective, observational study included 47 patients with GI system tumors who underwent DECT. Qualitative and quantitative assessment was performed on 70 keV VMIs using ASiR-V40%, and 55 keV VMIs using DLIR at low (DLIR-L), medium (DLIR-M), and high strength (DLIR-H). Quantitative evaluation included calculation of the contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR). Overall image quality, lesion conspicuity, and diagnostic confidence were evaluated qualitatively by 2 radiologists. Iodine parameters of tumor lesions were compared among four groups of algorithms. There were no significant differences in the image noise between DLIR-M and ASiR-V40%, whereas image noise was significantly lower in DLIR-H than ASiR-V40% and DLIR-M (both phases, P < 0.001). DLIR-M and DLIR-H had significantly higher CNR and SNR compared with ASiR-V40% on both phases (all P ≤ 0.001). When compared to ASiR-V40%, DLIR-M and DLIR-H had similar or improved qualitative assessment metrics. DLIR-L yielded the highest image noise and the lowest overall image quality score among these algorithms. Lastly, the measured iodine parameters were equivalent among different algorithms (all P > 0.1). Abdominal DECT at 55 keV with DLIR (-M and -H) provided qualitative and quantitative performance for GI tumor evaluation comparable to or exceeding that of ASiR-V 40% at 70 keV.
The aim of this study is to examine the effect of psychological resilience on the caregiver burden among parents of children with special needs and the mediating role of internalized stigma. A descriptive, cross-sectional, correlational research design was used. The population consisted of 250 primary caregivers of children with special needs attending a Special Education and Rehabilitation Centre. A total of 235 parents (94%) voluntarily participated. Data were collected through face-to-face interviews between January-April 2025 using the Personal Information Form, the Brief Resilience Scale, the Affiliate Stigma Scale, and the Zarit Burden Interview. IBM SPSS v23 and AMOS v24 were used for statistical analyses. Mediation was tested using path analysis with the Maximum Likelihood estimation. The significance level was p < 0.05. Psychological resilience showed a weak negative correlation with caregiver burden (r = -0.329) and a moderate negative correlation with internalized stigma (r = -0.412), while internalized stigma showed a moderate positive correlation with caregiver burden (r = 0.446) (p < 0.001). Internalized stigma significantly mediated the relationship (indirect effect = 0.188; p < 0.001). Enhancing psychological resilience reduces caregiver burden both directly and indirectly by decreasing internalized stigma. Strengthening psychological resilience and reducing internalized stigma are critical for the sustainability of the caregiving process. Nurses can facilitate the establishment of social support networks among mothers/fathers who share similar experiences by forming parent support groups. Psychiatric and pediatric nurses can cooperate with psychologists, special education specialists, and social service workers to draw up a care plan that takes into account psychosocial factors such as psychological resilience and stigma.
Cell-surface glycans play essential roles in cell communication, immune recognition, and disease progression. Their medical applications are supported by two important technological pillars: glycan recognition and glycan editing. This Review focuses on three key directions: recognition technologies, namely, in situ imaging and glycomic profiling, for detecting and profiling glycans; functional editing technologies, including genetic, enzymatic, chemical, and metabolic approaches, for precisely remodelling glycans; and medical applications driven by the synergy between recognition and editing, with a focus on four areas: biomarkers, lectin-based therapies, precision glycan editing, and cancer immunotherapy. Throughout the Review, five representative glycan classes-high-mannose N-glycans, mucin-type O-GalNAc, heparan sulfate, ganglioside GM3, and glycoRNAs-are used as recurring examples wherever possible. This Review offers an integrated perspective to navigate the process by which glycan recognition and editing technologies collectively drive the translation of cell-surface glycan research into clinical practice.