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Purpose: To compare microleakage resistance of resin infiltrant versus ion-releasing resin sealants on occlusal and proximal surfaces of permanent teeth and evaluate penetrability on occlusal surfaces while determining fissure morphology influence. Methods: Fifty-six extracted human premolars with International Caries Detection and Assessment codes 0 to 2 were randomly divided into occlusal (n=28) and proximal (n=28) groups, with 4 subgroups per surface (n=7 each) receiving 3 ion-releasing resin sealants (SealRite™, Embrace™ WetBond™, and BioCoat™) and Icon® resin infiltration. Following manufacturer protocols, specimens underwent thermocycling (500 cycles) and 24-hour methylene blue dye immersion at 37°C. Microleakage was assessed under stereomicroscopy following buccolingual sectioning for occlusal and mesiodistal sectioning for proximal surfaces. Penetrability was measured and compared according to material and fissure morphology. Statistical analysis employed Kruskal-Wallis and Dunn???s post-hoc tests for microleakage, and analysis of variance with post-hoc analysis for penetrability. Results: Icon® and BioCoat™ demonstrated significantly superior microleakage resistance compared to SealRite™ and Embrace™ WetBond™ on occlusal surfaces (P=0.001). On proximal surfaces, Icon® outperformed both conventional sealants, while BioCoat™ significantly exceeded only Embrace™ WetBond™. Critically, fissure morphology-not material type-significantly influenced penetrability (P=0.017), with V-shaped fissures exhibiting superior penetrability (95.55±7.24%) compared to I-shaped (75.26±17.62%) and IKshaped configurations (62.74±10.18%). Conclusion: Icon® demonstrates superior sealing properties across both surfaces, while BioCoat™ represents a viable ion-releasing alternative. Fissure morphology emerges as the critical determinant of penetration effectiveness, suggesting that preparatory techniques merit investigation for challenging configurations in early carious lesions. Long-term clinical validation and 3D imaging studies are essential to confirm these findings.

AimTo uncover the substance of how suffering is associated with human beings with thoughts or plans about ending their lives by suicide and to bring out more diversity, complexity, and contextuality of this phenomenon. Understanding as an important virtue underscores the safeguarding of the patient's dignity as a holy element.BackgroundThe study is grounded in a caring science perspective where suffering is seen as embodied in the human being. Methodology and design: This integrative literature review presents a combination of data from both theoretical and empirical literature with a reading of selected articles. Ethical ontological questions are prerequisites for highlighting caring understanding. Through the reading of a truthful written text of experienced suffering with love and compassion, it is possible to confirm and serve life and health.Data sourcesEmbase, CINAHL, PsycINFO, Scandinavian Journal of Caring Sciences, and Nursing Ethics. Ethical consideration: The study was conducted in accordance with the guidelines of the Finnish National Board on Research Integration.ResultsThree distinct themes were identified as a basis for considerations related to suffering: (a) Suffering in time and space, (b) Bearable and unbearable suffering, and (c) Language as essential for being.ConclusionThe language of suffering in caring science is made visible. Caring understanding has an inherent ought to, embraced by ethos towards alleviation. Life-threatening suffering is revealed. Thinking of suicide as a way out can make it possible to endure the suffering. Lack of caring understanding was a threat to some of the patients' dignity. Lack of evidence exists as to whether telling the suffering story is a movement in the direction of alleviation and this calls for further research to examine if caring and caring science can embrace this suffering.

Reframing nurses' core relational abilities from "soft skills" to "power skills" is essential to transforming health care. These capacities-such as effective communication, empathy, self-regulation, ethical grounding, and relational presence-aren't secondary to technical expertise but foundational to healing, trust, and professional identity. Power skills enable nurses to mitigate suffering, strengthen connections, and lead effectively across education, practice, and policy. This article calls on nurses in all roles to embrace, model, and structurally embed this narrative shift to reclaim nursing's authority, purpose, and enduring impact.

Previous research indicates worse outcomes for children and young people in out-of-home care compared to their peers. To improve the quality of current residential care, research is needed to deepen our understanding of the key factors and mechanisms that explain the effectiveness of residential care on child level. The aim of this study is to evaluate the short-term (i.e., during care) effectiveness of residential care as a child welfare intervention by different service providers. The study includes two pre-specified primary child-level outcomes 1) psychosocial functioning, assessed through the Strengths and Difficulties Questionnaires (SDQ) including both total difficulties scores and subscales and 2) attainment of individual goals of the child. Secondary outcome measures include improved experiences of emotional warmth and safety (CEWSS-A). Further associations between key characteristics of the residential care unit, the child and outcomes are assessed. The data consist of longitudinal survey data collected from 12-17-year-old children and staff in a total sample of public and private residential care units offering specialized care in three wellbeing services countries in Finland. The baseline (T0) data is collected between 1.4.2025-31.8.2026 with a follow up of 6 and 12 months for each child (T1 and T2). The data is primarily analysed with linear mixed models. Findings explore the short-term effectiveness and change mechanisms of residential care as "service as usual" to understand how it should be organised and produced to improve its ability to meet aims during care. The study design embraces the complexity and changeability on different levels of the residential care setting.

This paper presents "Neither/Nor," a philosophical synthesis which defines conceptual and experiential modes of knowing as complementary skills which can be deliberately trained and oscillated. The paper argues that neither theory (concepts) nor practice (experience) alone can suffice for desirable outcomes in personal flourishing or scientific inquiry. Drawing from Western and Eastern philosophical traditions-from ancient skepticism and Buddhism to modern pragmatism and cognitive science-Neither/Nor proposes that "latent Platonism," the unconscious preference for abstract concepts over direct experience, contributes to both personal suffering and intellectual impasses. The paper begins with a concrete example of Type I diabetes management, demonstrating the constant negotiation between abstract formulas and embodied experience required by the disease, before providing five practical principles: (1) regard concepts and experience as trainable skills; (2) commit to oscillation between skills; (3) prioritize relations and processes over objects and states; (4) embrace trial-and-error learning; and (5) employ conditional historicism over linear causal thinking. The Neither/Nor framework demonstrates how these principles can reduce personal suffering, enhance scientific inquiry, and provide a methodology for evaluating diverse philosophical positions pragmatically. Neither/Nor points towards a way of living rather than merely an abstract theory, contributing to both individual flourishing and more flexible approaches to complex societal challenges.

There have been a number of calls for neuroscience to embrace a wider range of model systems. Authors of these opinion pieces have emphasized the inherent value of explicitly evolutionary and comparative work in neuroscience and the value of diversity in applied and biomedical research. However, few of these papers address the role of undergraduate neuroscience education in preparing students to pursue, much less value, evolutionary and comparative neuroscience. Here, we argue that the field of neuroscience would benefit from the explicit inclusion of evolutionary and comparative neuroscience in introductory courses. We first review the state of introductory neuroscience curricula and available teaching materials, before discussing the importance of an early introduction to evolutionary and comparative ideas, challenges to incorporating these ideas into introductory courses, and finally offer a number of strategies to increase student awareness of the diversity of systems available for neuroscience research. We speculate that introducing students to evolutionary and comparative neuroscience early in their education may increase retention of students with an evolutionary or comparative bent, which may increase the number of researchers interested in pursuing these questions in their careers, while also making students bound for health, biomedical research, or engineering professions more aware of the value of evolutionary and comparative approaches.

Most older adults with disabilities in China and across Eastern Asian prefer to age in place, relying on home- and community-based care. Their family caregivers frequently encounter significant challenges, including a pronounced lack of knowledge and skills for providing daily living assistance, highlighting a critical need for accessible, practical training. Furthermore, existing community-based support programmes for caregivers often fail to incorporate an integrated family perspective. This oversight neglects the crucial dynamics and internal interactions within the family unit, which are fundamental to the overall adaptation and resilience of the entire family system. This study aims to develop a nurse-led, family-oriented resilience intervention programme for caregivers of older adults with disabilities. The programme is designed to enhance caregivers' practical competencies and to strengthen overall family adaptation within the context of Chinese community settings. We followed the Medical Research Council (MRC) framework for developing and evaluating complex interventions to guide the development process. This involved integrating empirical evidence from our prior studies, identifying relevant theories of family resilience, and validating the preliminary intervention content. We employed a two-round Delphi method with an expert panel to validate the initial programme draft. For each proposed activity, we calculated the coefficient of variation (CV) and Kendall's coefficient of concordance (Kendall's W) to assess expert consensus. The two-round Delphi consultation yielded high positive and authority coefficients. In the first round, the mean importance scores for items ranged from 4.19 to 4.96 (overall mean 4.77&#x2009;&#xb1;&#x2009;0.21), with a coefficient of variation (CV) between 0.04 and 0.16 and Kendall's W was statistically significant (p&#x2009;<&#x2009;0.01). In the second round, scores ranged from 4.16 to 4.96 (overall mean 4.82&#x2009;&#xb1;&#x2009;0.19), with a CV between 0.04 and 0.15, and a significant Kendall's W (p&#x2009;<&#x2009;0.01). Based on this expert feedback, we refined the intervention into an 8-week programme, delivered via weekly home visits, integrating two core components: caregiving skill and family resilience. The weekly themes are (1) Getting to know each other; (2) I am not fighting alone (cleaning care and coping, social support for caregivers); (3) Thank you, embrace you (family resilience and internal support); (4) Love flows through communication (dietary care and coping, family communication and coping); (5) Riding the wind and waves together (excretion care and coping, social support for peers); (6) Community with me (mobile care and coping, social support for community); (7) Supplementing energy (safety protection and basic first aid, social support for external systems); and (8) Radiating the caregiver's radiance (individual self-resilience and self-support). Guided by the MRC framework, we developed a theory-driven, culturally appropriate, nurse-led and family-oriented resilience intervention for caregivers of older adults with disabilities. The program's flexible delivery allows adaptation to local resources and caregiver needs, help caregivers overcome practical challenges and enhance family resilience. Future research should utilize a three-arm randomized controlled trial to evaluate the feasibility, acceptability and preliminary effectiveness of this complex intervention. This nurse-led, family-oriented resilience intervention offers a practical, home-based training programme that equips family caregivers of older adults with disabilities with essential caregiving skills and strategies to strengthen family adaptation, thereby supporting the implementation of community-based aged care services in China and similar Eastern Asian contexts.

The field of gene therapy for neuromuscular dystrophies has evolved over the past two decades. Despite some outstanding positive outcomes, some unfortunate adverse effects also led to big setbacks. One important key point is to study relevant preclinical models and to embrace diverse strategies to mitigate or avoid such negative outcomes. Although at first, for some diseases, the promise of a one-treatment-for-all approach was envisioned, it has recently become clear that a personalized approach will likely be preferable given the high variability in response between individuals.

This article describes the pursuit of "flow" states within a global Christian following of two famous Chinese Christian preachers, Watchman Ni (1903-1972) and Witness Li (1905-1997). Within this group, whose ideas and practices are deeply rooted in wider Chinese patterns of thought and interaction, "the mind" is rejected. In an attempt to expand its meta-model of mind, I argue that while the "anthropology of mind" thus far has shown how mental health problems can arise from religious projects of "making god real", it has yet to investigate the impacts on wellbeing of rejecting "the mind" altogether. I describe these impacts upon members of the global following of Ni and Li. Tracing their embrace of "flow" over "the mind" to both deep precedents within Chinese history and society and to universal human capacities for "flow", I suggest that an "anthropology of anti-mind" would deepen and widen our understandings of how attitudes to the mind affect wellbeing.

Globally, the older population is increasing rapidly, becoming one of the most significant demographic trends of the 21st century. This growth poses important social, health, and technological challenges for societies that must adapt their environments and services to promote independent and healthy aging. In Spain, the population aged 65 years and older reached 18% of the total population in 2020, and projections indicate that this proportion will continue to rise in the coming decades. Within this context, smart homes have emerged as one of the most promising avenues to support aging in place and improve the quality of life. Smart homes encompass a wide variety of functions, including environmental control, safety monitoring, communication, and other assistive technologies, that may help older people stay healthy, safe, and independent in their own homes. However, older people are not a homogeneous group. Their lifestyles, health conditions, and technological experiences differ substantially, which means that, as with any assistive technology, smart home functions must match the real and perceived needs of the target users to ensure acceptance, adoption, and long-term use. In this study, as a step forward toward the adaptability of smart home technology, we present a method to analyze the practical needs of smart home functions for older people. Specifically, we aim to understand the Spanish older population's readiness and needs for smart homes and to provide insights that can guide the design of more adaptive and user-centered solutions. We conducted an online survey focusing on residentially based lifestyles, health conditions, and preferences for smart home functions, targeting older adults living in Spain. The survey collected information about participants' demographic profiles, daily activities, health self-assessment, and attitudes toward technology. A total of 102 valid responses were analyzed. We then classified the older adults according to their residentially based lifestyles using clustering techniques and analyzed the preferences and needs for smart home functions in each identified group. Four clusters emerged based on the information provided by the participants: (1) high quality of life and independent life, (2) poor quality of life, (3) social-centered life, and (4) creative and personal-centered hobbies at home. On the basis of this classification, we explored each group's specific needs for smart homes and estimated their readiness to embrace different aspects of technology. As a result, the top-priority smart home functions for each group were identified and compared. This research contributes to understanding the practical user needs of smart homes as assistive technologies for older people. It provides a methodological approach to anticipate and prioritize functions according to user characteristics, supporting the development of personalized, adaptive, and more acceptable smart home solutions for aging populations.

Plateau regions have emerged as pivotal epicenters of diverse zoonoses because of their distinctive ecological conditions and rich biodiversity. Against the backdrop of intensifying climate change, escalating interactions between wildlife, livestock, and humans, and expanding human activities, these regions now face formidable challenges. To assess public health threats within plateau ecosystems and establish targeted prevention frameworks, this review systematically synthesizes the prevalence and potential cross-species transmission risks of zoonotic pathogens-spanning parasites, viruses, and bacteria-carried by large- and medium-sized wild mammals across China's four major plateaus (Tibetan Plateau, Yunnan-Guizhou Plateau, Loess Plateau, and Inner Mongolia Plateau). Critical issues, including ecological fragility, complexity of pathogen transmission networks, and delayed responsiveness of control measures, are comprehensively analyzed. Future strategies must embrace the One Health concept to construct a multidimensional, coordinated prevention system. By integrating pathogen surveillance, ecological regulation, and technological innovation, a refined zoonosis control framework anchored in safeguarding plateau biosafety and public health can be systematically advanced.

Visual Thinking Strategies (VTS) is a structured, evidence-based pedagogical method that has been increasingly embraced in medical education to foster essential clinical competencies such as observation, interpretation, communication and empathy. Originally developed for use in K-12 classrooms, VTS involves a standardised facilitation method centred on three carefully sequenced questions posed in response to a visual artwork. Although deceptively simple in format, effective facilitation of VTS requires extensive training and adherence to specific practices that activate collaborative and critical thinking processes. As interest in arts-based pedagogies grows in medical education, VTS stands out as a method with defined guidelines and demonstrable educational outcomes. However, this paper argues that the expanding adoption of VTS be accompanied by a commitment to fidelity-in how the method is implemented, studied and described in the academic literature. While an increasing number of medical educators are enthusiastically incorporating VTS into their curricula, the literature belies a concerning trend of deviations from the method's core components. These include altered wording of the three core questions, inconsistent naming of the method, facilitation by untrained individuals and inadequate or inaccurate methodological descriptions. Such deviations, even when subtle, can compromise the internal validity of research findings and risk misrepresenting the nature and effectiveness of the intervention. This lack of fidelity could threaten the integrity of educational outcomes and the credibility of arts-based approaches in the broader field of medical education. Compounding the issue, peer reviewers and journal editors may lack sufficient familiarity with VTS to identify these inaccuracies, enabling flawed implementations to persist in the literature. We contend that ensuring fidelity to the original VTS methodology is a shared responsibility across researchers, educators, institutions and scholarly publications. Adherence to the method maintains its pedagogical and scholarly value. To that end, we offer practical recommendations, such as formal VTS facilitator training (with greater accessibility to educators in low-resource settings), accurate reporting standards, peer reviewer education and the cultivation of a community of certified practitioners. As VTS continues to gain traction, we recommend that educators aim for fidelity in its use and study, ensuring that its full potential to enrich clinical education is realised and preserved for future generations of learners.

General practitioners (GPs) function as the primary coordinative healthcare professionals for patients with persistent post-concussion symptoms (PPCS) who are at risk of protracted disability. The study aimed at exploring GPs' perspectives on managing patients with PPCS and at identifying the barriers they perceive in treating this patient group. Semi-structured in-depth interviews with 12 GPs from different geographical regions. All GPs had experience with management of patients with PPCS in general practice. The study identified three main themes representing the perceived challenges: (i) managing patients with PPCS, (ii) coordination with other actors, and 3) GPs' clinical gaze on patients with PPCS. GPs perceived management of this patient group as challenging due to the limited guidelines, diagnostic consensus, and resources. They struggled with insufficient referral options in the public healthcare system both regarding secondary sector and municipalities. The absence of biomedical evidence lead some to be skeptical about the condition, especially in female patients. However, ultimately they strived to embrace the biomedically unknown and approach their patients with trust. GPs face significant challenges in managing PPCS due to insufficient translation of guidelines, diagnostic uncertainties, and scarce referral options. Despite skepticism fueled by the lack of biomedical evidence, they endeavor to approach each patient with an open mind. The results underscore the need for improved resources and referral pathways to support GPs in treating patients with PPCS effectively.

This study aimed to assess the potential for a whole-family intervention for domestic violence and abuse (DVA) - the For Baby's Sake programme - to address both parenting and abusive behaviours in families experiencing DVA. This objective is achieved by investigating parents' perspective. This trauma-informed programme works separately with mothers and fathers and is intended to start in pregnancy and continue for two years. Three sets of individual interviews were conducted with mothers and fathers both at the start of the programme (during pregnancy); one year after programme enrolment and at programme end. Reflexive Thematic Analysis was employed. 26 mothers and 13 fathers participated with a total of 83 interviews. Parents reported perceived improvements in parenting knowledge and behaviours, notably through psychoeducation on child development and feedback on video recordings of parent-child interactions. Mothers acknowledged experiences of DVA, and found psychoeducation, insights into intergenerational transmission, and safety planning activities beneficial. Some fathers acknowledged perpetration of violent behaviours. Fathers embraced change by addressing their own Adverse Childhood Experiences (ACEs), acquiring emotional regulation skills, and committing to anger management. Both fathers and mothers stressed the importance of a non-judgmental environment and a desire to enhance parenting as motivating factors for acknowledging DVA and committing to change. The findings suggest that whole-family approach interventions - such as the For Baby's Sake programme - holds promise in addressing both parenting and abusive behaviours in families experiencing DVA.

The closed method for the treatment of compound fractures of the limbs emerged and popularised during the interwar period. The historiography on this procedure sustains an essentially Anglo-Saxon narrative focusing on contributions by the American surgeon Winnett H. Orr during the First World War and the Spanish Josep Trueta during the Spanish Civil War and his exile in Britain. This paper aims to 'open' this story by reconstructing the early work of another Spanish surgeon: Manuel Bastos. Although originally an army medical officer, Bastos specialised in the treatment of limb fractures in a dual military-civilian context. On the one hand, during successive assignments to the Spanish Protectorate in Morocco, he familiarised with the management of gunshot wounds. On the other hand, he specialised in the treatment of tuberculosis humerus fractures in children at the Instituto Rubio in Madrid. The visit to Spain of the Argentinian surgeon Pedro Chutr&#xf3;, who had acquired a great prestige in First World War Paris for his approach to fractures and osteomyelitis, and the escalation of the Moroccan campaigns to the so-called Rif War (1921-27) gave Bastos the opportunity, the idea, and the courage to develop a closed treatment of humerus fractures in soldiers. Chutr&#xf3;'s influence on Bastos persisted in the context of the Hispano-Americanist policy embraced in mid-twentieth-century Spain. Ultimately, this study questions the understanding of the closed method as a single, univocally traceable procedure, suggesting instead parallel versions emerging in different sites and transforming themselves and influencing each other as they circulated globally.