Children and families from priority populations (e.g. culturally and linguistically diverse and regional/rural communities) often experience significant psychosocial challenges and barriers to accessing health and social care. These inequities were further exacerbated during the COVID-19 pandemic. Integrating social care with health services has been proposed as an approach to improve service access and address unmet needs. A two-site parallel randomised controlled trial was conducted in Australia between August 2021 and 2023. Parents/carers of children from priority populations were recruited through Child and Family Health services (n = 288) and randomised to the Watch Me Grow-Electronic (WMG-E) intervention (n = 145) or care as usual (n = 143). The WMG-E program comprised digital developmental screening and community navigation to relevant health and social services via a service navigator. The primary outcome was change in unmet social needs measured using the WE CARE instrument. Intention-to-treat generalised linear mixed-effects models adjusted for child developmental concerns, parental mental health, and sociodemographic factors. Unmet social needs decreased over time across both groups (β = -0.23, SE = 0.11, p = 0.036). At 12 months, the intervention group showed greater reductions in unmet needs than the control group (β = -0.35, SE = 0.17, p = 0.046), although the time × group interaction was not significant. The WMG-E platform demonstrated feasibility as a digital developmental screening and navigation tool supporting families from priority populations. WMG-E shows promise in improving access to health and social care and reducing unmet social needs; however, further research is needed to assess sustained impacts across diverse settings. The study (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21st 2021, and the trial results are being reported according to recommendations in the CONSORT Statement. What is already known on this topic Significant inequities exist in the access to healthcare for priority population families with preschool children and this results in children missing opportunities for early identification and intervention for health and developmental problems.While addressing heath care inequities is critical for providing children a healthy start to life, there are no effective and systematic ways to reach such families as they do not engage with services early, and often experience significant barriers due to social care needs.Addressing health inequities by tackling social determinants of health alongside healthcare is critical to supporting families in priority population groups, aligning with the Sustainable Development Goals (SDGs) of the World Health Organization (WHO). What this study adds This study is one of the first Australian randomised controlled trials evaluating the effectiveness of a digital developmental screening program coupled with service navigation for improving unmet social care needs in multicultural and rural/regional communities.Significant reductions in unmet need scores were observed over time in both intervention and control groups, with a greater reduction in the intervention group, though no significant interaction between time and group was found.The Watch Me Grow Electronic (WMG-E) platform was shown to be a feasible and effective tool for developmental screening and navigation to address unmet social needs in diverse, priority population families.
Topical dosage forms are widely used to treat various skin disorders, but increase healthcare costs because of the limited number of generic competitors. The development of a generic version of complex topical products is facing several scientific and regulatory challenges related to demonstrating bioequivalence, advanced physicochemical characterization, and the requirement of clinical endpoint equivalence. This narrative review explores the contemporary scientific and regulatory approaches used for BE assessment of topical generics, with a greater focus on in vitro alternatives and Q3 microstructural characterization. The integration of quality by design principles can support the development of robust Q3-based BE strategies. Key in vitro tools such as IVRT, IVPT, and dermal PBPK modeling are emerging approaches for identifying scientific parameters for regulatory acceptability and overcoming these methodological challenges. Case studies involving bifonazole, acyclovir, clotrimazole, and innovative vehicles such as Recura illustrate the practical challenges of existing regulatory frameworks and the increasing use of in vitro and Q3-based approaches. This review highlights the critical gaps in harmonizing global regulatory requirements and underscores the need to foster early regulatory engagement and standardize methodological protocols. Together, these initiatives pave the way for a more predictable, scientifically sound, and cost-effective regulatory environment. This transformation is essential for improving access, reducing development timelines, and advancing the future of topical generic medicines.
Traumatic thoracic injuries are a leading cause of morbidity and mortality worldwide, not only as a direct consequence of the injury itself, but also due to development of secondary insults such as infection; acute kidney injury; acute respiratory distress syndrome; and shock. The thorax houses vital structures, and even seemingly trivial trauma may result in catastrophic damage particularly in children or older patients. This review aims to highlight important considerations in diagnosis and management of major thoracic injuries and the crucial role of appropriate supportive interventions such as airway control, ventilation strategies and optimal pain management to aid in recovery. We undertook a narrative review of the contemporary literature. We synthesised evidence related to mechanisms of thoracic trauma and initial assessment and diagnosis of major thoracic injuries. We also highlight key considerations in chest wall, pulmonary, cardiac and diaphragmatic injuries; supportive management strategies for patients with thoracic trauma; and special considerations in older patients. Thoracic injuries are broadly classified by the mechanism of trauma (blunt, penetrating or blast) or by the anatomical structure involved. Initial assessment and diagnosis follows general trauma principles. Depending on the injuries sustained, surgical intervention may be indicated. Equally important is appropriate supportive management. Older patients are often overlooked as a high-risk group and a lower threshold for specialised trauma care or critical care services is recommended in this cohort. A multidisciplinary approach is key in management of patients with thoracic trauma due to their numerous needs, ranging from surgical intervention and critical care support to physiotherapy and rehabilitation. We reviewed many recent research papers about serious injuries to the chest. We looked at how these injuries happen, how doctors find and diagnose them, and how patients are treated. We also examined the different types of chest injuries, such as injuries to the ribs, lungs, heart and diaphragm, and the care patients may need to help them recover. Chest injuries can be very dangerous because the chest contains important organs like the heart and lungs. Even injuries that seem small can cause serious problems, especially for children and older people. We wanted to explain the key things doctors need to think about when treating chest injuries so that patients can receive the best care and recover as well as possible. We found that chest injuries can happen in different ways, such as from blunt force, penetrating objects or explosions. Doctors must carefully assess patients and sometimes perform surgery if the injury is severe. Good supportive care is also very important. This includes helping patients breathe, managing pain and treating other problems that may develop. Older patients are often at higher risk of serious complications, so they may need specialist trauma care sooner. Treating chest injuries works best when different healthcare professionals work together to support the patient's recovery.
This study is the first scoping review specifically focused on the health literacy of caregivers of patients with chronic obstructive pulmonary disease (COPD). It aims to summarize the current state of research in this field and provide guidance for the implementation of targeted health education and care support in clinical settings. Guided by the scope review methodology, the system searched 10 Chinese and English databases, including PubMed, Web of Science, the Cochrane Library, CINAHL, Embase, Scopus, CNKI, Wanfang Database, VIP Database, and the Chinese Biomedical Literature Database. The search period spanned from the inception of each database to March 16, 2026. Two researchers independently screened, summarized, and extracted data from the search results. A total of 7 studies were ultimately included, covering 4 countries: China, South Africa, the Netherlands, and the United States. The overall health literacy of caregivers of patients with COPD was found to be relatively low. The main influencing factors included sociodemographic factors, caregiving-related factors, patient-related factors, medical information and education, and the caregivers' physical and psychological factors. Assessment tools lack caregiver-specific instruments, and caregiver education focuses primarily on practical caregiving skills, with learning styles dominated by auditory and literacy-based approaches. The health literacy levels of COPD caregivers are generally low and influenced by multiple factors, creating an urgent need to develop caregiver-specific health literacy assessment tools. Clinicians should design personalized health education models based on caregivers' needs and learning preferences. Moving forward, high-quality intervention studies are needed to improve caregivers' health literacy and the quality of care, thereby enhancing patient outcomes.
Triplet therapy with androgen deprivation therapy (ADT), docetaxel, and androgen receptor pathway inhibitors (ARPIs), either darolutamide or abiraterone, is one of the standard treatments for metastatic hormone-sensitive prostate cancer (mHSPC); however, no randomized trial has directly compared both ARPIs within this regimen. Given practical and financial constraints, a head-to-head randomized trial directly comparing these ARPIs may be unlikely. To compare the real-world effectiveness of darolutamide- versus abiraterone-based triplet therapy in patients with mHSPC. Retrospective cohort study using a multinational electronic health record network. We conducted a retrospective cohort study using the TriNetX research network. Patients with mHSPC treated with darolutamide- or abiraterone-based triplet therapy were identified and balanced using propensity-score matching. The primary outcome was overall survival (OS), and the secondary outcome was time to next treatment (TTNT), defined by treatment switch. Prespecified subgroup analyses focused on age, cardiometabolic comorbidities, and polypharmacy-related medication use. Among 1607 eligible patients, 1252 were included after propensity score matching (626 per group). Darolutamide-based triplet therapy was associated with longer OS compared with abiraterone (hazard ratio (HR) 0.42). A favorable difference in TTNT was also observed (HR 0.66). These associations were consistent across clinically relevant subgroups, including patients aged ⩾65 years and those with ischemic heart disease or diabetes mellitus. In polypharmacy-enriched subgroups, darolutamide-based therapy was consistently associated with more favorable OS and TTNT. In this large real-world analysis, darolutamide-based triplet therapy was associated with longer OS and TTNT compared with abiraterone-based triplet therapy in patients with mHSPC, particularly among older individuals and those with comorbidities. These findings are hypothesis-generating, suggesting that ARPI selection within triplet therapy may have clinically relevant implications, supporting the need for prospective studies. Comparing two three-drug treatment options for advanced prostate cancer: results from a large real-world study Advanced prostate cancer is often treated with a combination of three drugs: hormone therapy, chemotherapy, and a hormone-blocking medicine. Two commonly used hormone-blocking drugs are darolutamide and abiraterone. Although both are recommended treatments, no clinical trial has directly compared these two options when used together with chemotherapy. In this study, we used a large international health database to compare these two treatment approaches in real-world clinical practice. We included over 1,200 patients and used statistical methods to make the two groups as similar as possible. We found that patients treated with darolutamide lived longer and had a longer time before needing another treatment compared with those treated with abiraterone. These benefits were also seen in older patients and in those with other medical conditions, such as heart disease or diabetes. However, because this was not a randomized clinical trial, other factors that we could not fully measure may have influenced the results. In addition, the follow-up period was relatively short. Overall, our findings suggest that darolutamide may be a more effective option than abiraterone when used as part of three-drug therapy for advanced prostate cancer. Further studies are needed to confirm these results.
In solid organ transplant recipients receiving long-term immunosuppression, persistent or progressive pancytopenia is often initially attributed to infections or drug toxicity, thereby potentially delaying the recognition of clonal myeloid disorders and germline predispositions. We report the case of a kidney transplant recipient who had predominantly maintained tacrolimus-based immunosuppression and presented with progressive pancytopenia and marked reticulocytopenia. Bone marrow evaluation revealed severe hypocellularity with suppression of granulopoiesis and erythropoiesis, as well as prominent dysmegakaryopoiesis. Flow cytometry showed a small population of immunophenotypically aberrant myeloid blasts, supporting a diagnosis of hypocellular myelodysplastic syndrome. Myeloid gene next-generation sequencing detected a FANCA missense variant (c.3630C > A; p.F1210L; variant allele frequency 47.2%), prompting consideration of germline-associated marrow failure or genetic susceptibility and the need for confirmatory testing in nonhematopoietic tissues. During hospitalization, the patient developed severe opportunistic infections that rapidly progressed to respiratory failure and hemodynamic instability. This case highlights the need for early marrow evaluation and genetic risk stratification in transplant recipients with unexplained cytopenia and for the dynamic balancing of hematopoietic rescue against preservation of allograft function to reduce diagnostic delays and subsequent complications.
Cross-regional cooperation is essential when responding to large-scale disasters, yet it is not always easy to achieve. Empirical evidences reveal that regions facing similar disaster pressures may have different performances, i.e., either sharing resources or engaging in competition. Meanwhile, policymakers often lack a clear understanding of when cooperation is needed, why it emerges or fails, and how it can be sustained. To solve the problems, we identify two critical factors in cross-regional cooperation: disaster demand (which reflects shortage risk and response pressure) and disaster propagation (which generates spillover risks and cross-regional externalities). Based on them, we develop a propagation-based and demand-driven evolutionary cooperation (PDEC) framework to examine how disaster propagation, disaster demand, and governance structure jointly shape cooperation dynamics. We then classify disasters into three propagation types and construct evolutionary game models under decentralized and centralized governance settings. Our analysis indicates that cooperation is conditional on the interactive effects of shortage risk and spillover risk. Centralized governance further reshapes the outcome structure, lowering outcome volatility, reducing inefficient competition, and broadening the cooperation conditions. In summary, this study provides a conceptual and explanatory framework for assessing cooperation feasibility, cooperation failure risk, and the need for central coordination, thereby offering the risk community guidance for more proactive risk assessment, coordination design, and resilient disaster response.
This study aimed to develop and develop and preliminarily validate a scale for assessing marital anxiety among patients with breast cancer. Guided by Social Ecological Theory, we employed an exploratory sequential design within a mixed-methods research framework. The initial draft of the scale was developed through a systematic literature review, in-depth qualitative interviews, and expert consultations. A convenience sample of 509 patients with breast cancer was recruited for this study. Participants were randomly divided into two independent sub-samples for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). A total of 509 valid questionnaires were collected. The final scale comprised three first-level dimensions, nine second-level dimensions, and 25 items. The Cronbach's α coefficient for the entire scale was 0.865, with test-retest reliability of 0.902 and split-half reliability of 0.780. The item-level content validity index (I-CVI) for individual items ranged from 0.88 to 1.00; scale-level content validity index (S-CVI)/Ave = 0.987, and S-CVI/Universal Agreement (UA) = 0.81. Convergent validity was confirmed by average variance extracted values exceeding 0.5 and composite reliability values exceeding 0.7 across all dimensions. Several CFA fit indices met acceptable criteria; however, RMSEA and GFI suggested marginal fit, indicating that further validation is needed. The scale demonstrated preliminary reliability and validity after preliminary verification and can provide a reference tool for assessing marital anxiety among married patients with breast cancer who are of childbearing age. Nevertheless, follow-up studies need to verify its structural stability and applicability to a wider population.
Electronic medical record (EMR)-based quality improvement (QI) tools for cirrhosis care require accurate patient identification. Combining administrative and EMR data may enhance cirrhosis identification. This study aims to validate the Alberta code set (a hybrid code set using both administrative and EMR data) for identifying patients with cirrhosis. Twelve high-performing ICD-10 codes (Alberta code set) were evaluated using a cohort of 719 chart review-confirmed cirrhosis patients. Validation was performed in an independent cohort of 913 consecutively admitted patients at four Albertan hospitals (two tertiary and two non-urban). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were obtained with a 95% CI. Two other code sets (Shearer and SoLiDaRity-10) were also validated using administrative-only, EMR-only, or hybrid data. Using administrative data alone, the Alberta code set showed a sensitivity of 78.9%, specificity of 97.4%, PPV of 80.4%, and NPV of 97.2%. With hybrid data, sensitivity improved to 87.2% and NPV to 98.2%, while specificity (96.5%) and PPV (77.2%) remained similar. Urban sites showed higher sensitivity (86.2% and 91.7%) than non-urban sites (70% and 82.1%), likely attributed to coding practice variability. The Shearer and SoLiDaRity-10 code sets also demonstrated high sensitivity (86.2% and 83.5%, respectively) and similar specificity (96.6 and 97.1, respectively) when using hybrid data rather than either admin data or EMR data alone. A hybrid administrative and EMR-based approach effectively identifies in-patient cirrhosis cases across health care settings and holds promise to support QI and research for cirrhosis patients. Cirrhosis is a serious medical condition that needs regular medical care and often leads to repeat hospitalizations for patients. To treat and study it effectively, hospitals need to accurately identify patients who have cirrhosis. However, this can be challenging because there is no single test to diagnose cirrhosis and given patient information is stored in different places, such as administrative databases (for billing and hospital records), while other details are stored in electronic medical records. This study tested whether combining both types of information better identifies patients with cirrhosis as compared with just one of these methods. We tested the accuracy of a set of 12 medical codes for cirrhosis used in Alberta to determine how accurate they were at identifying patients with cirrhosis. The codes were tested in a random group of patients admitted at four hospitals across the province to see how well each method worked. We found that using both hospital and medical record data together gave the most accurate results, especially in big-city hospitals where record-keeping is more detailed. This combined approach helps doctors and researchers track patient care, improve treatments, and provide better care for people living with liver disease.
Spondyloarthritis (SpA) is a group of chronic inflammatory diseases encompassing axial and peripheral forms, with up to 20% of patients developing symptoms before age 16. Despite this substantial pediatric burden, treatment options for juvenile-onset SpA (JSpA), particularly those with axial disease (axJSpA), remain limited. This gap underscores the need for evidence-based approaches to extend effective therapies to children. This review highlights the strong parallels between adult axial SpA (axSpA) and axJSpA, supporting the appropriateness of extrapolating efficacy and target drug exposure data from adults to children. Adult- and juvenile-onset axSpA (axJSpA) share key clinical and pathogenic features, including overlapping clinical symptoms, genetic susceptibility, and treatment approaches. Classification systems also align: adult axial SpA is classified according to the Assessment of Spondyloarthritis International Society (ASAS) criteria, while children are classified using the recently validated axJSpA criteria, which closely mirrors the adult framework. Treatment paradigms further reinforce these similarities. Non-steroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor inhibitors (TNFi) are standard therapy in both adults and children, and emerging mechanisms, such as inhibition of IL-17A/F and JAK, are relevant across age groups. However, the absence of approved agents for axJSpA underscores the importance of leveraging data from adults. Given the shared biology, clinical phenotype, treatment response patterns, and the availability of shared outcome measures such as the Spondyloarthritis Research Consortium of Canada (SPARCC) MRI inflammation and structural scores, extrapolating efficacy and target drug exposure data from adults with axSpA to children with axJSpA is scientifically justified and critical for addressing the unmet therapeutic needs in affected youth.
The number of older adults with cancer, those who require complex needs and care, continues to increase. With limited learning opportunities, the healthcare workforce is unprepared to meet this growing need. This study examined the long-term impact of Geriatric Oncology: Cognition and Communication (Geri Onc CC), a multidisciplinary program developed and implemented to address this gap in care. Multidisciplinary healthcare providers (HCPs) were recruited from across the United States and internationally to participate virtually or in person at a comprehensive cancer center in the Northeast United States. The program included education about geriatric syndromes, unique and complex issues related to older adults with cancer, and tailored communication strategies. Knowledge, attitudes, and self-efficacy were assessed pre- and post-training and at 6- and 12-month follow-ups. Skill utilization and implementation practices were evaluated at 6- and 12-month follow-ups only. 282 HCPs participated. Initial gains in knowledge and self-efficacy were maintained at both 6 and 12 months post-training (p values <.01). More than 70% indicated using all skill categories "somewhat more" or "much more" at both follow-up periods. Most HCPs implemented changes in their clinical practice, teaching, and/or research based on what they learned. Geri Onc CC has demonstrated a sustained, positive impact in many areas, including knowledge and self-efficacy. It also led to greater usage of the skills learned and changes in clinical care, teaching, and research. The program addresses a critical gap in education and training of the workforce caring for older adults with cancer.
The growing integration of digital technologies into everyday life has reshaped how older adults engage with their social environments, access information, and navigate health and community services. Yet, limited research has examined these dynamics among Mandarin-speaking older immigrants in Canada, a rapidly expanding population facing intersecting challenges of ageing, migration, and linguistic adaptation. Drawing on qualitative data from the national Inclusive Communities for Older Immigrants project, this study explores how Mandarin-speaking older immigrants use smartphones in their daily lives and how these technologies contribute to adaptation, independence, and well-being. Data were obtained from 102 participants living in 7 cities across 4 provinces in Canada. The data were deductively and inductively coded with NVivo 15© and analyzed thematically. Findings reveal 3 interconnected domains of smartphone use in support of daily living: (a) access to community resources, healthcare, home, and community safety; (b) play and leisure, including digital gaming, music, and online reading; (c) empowerment, navigating unfamiliar environments, enhanced autonomy, and reduced dependence on family members. Despite these benefits, participants reported persistent barriers to smartphone use, including linguistic inaccessibility, inconsistent translation services, and fears of digital dependence. The study highlights the dual role of smartphones as both facilitators and barriers to digital inclusion, underscoring the need for culturally and linguistically responsive digital supports to promote equitable digital technological participation among Mandarin-speaking older immigrants in Canada.
Hypertension is the leading modifiable risk factor for cardiovascular disease and premature mortality worldwide. In Somalia, the national hypertension control rate is estimated at only 10%, yet antihypertensive medication adherence remains unstudied. This study determined the prevalence of medication adherence and its independent predictors among hypertensive outpatients in Mogadishu. A hospital-based cross-sectional study was conducted between January and April 2024 at Mogadishu Somali-Turkey Training and Research Hospital. In total, 373 adult hypertensive patients on antihypertensive treatment for at least six months were recruited by simple random sampling. Adherence was assessed using the validated 8-item Morisky Medication Adherence Scale (MMAS-8), a self-reported instrument; scores of 6-8 were classified as high or moderate adherence (adherent) and scores below 6 as low adherence (non-adherent). Multivariable binary logistic regression was used to identify independent predictors (p < 0.05). Of 373 participants (54.2% male; 45.8% aged ≥65 years), 63.5% demonstrated high or moderate adherence and 36.5% exhibited low adherence. Multivariable logistic regression identified four independent predictors of adherence. T2DM (AOR = 0.458; 95% CI: 0.279-0.752; p = 0.002) and high-salt diet consumption (AOR = 0.460; 95% CI: 0.271-0.780; p = 0.004) were independently associated with lower odds of adherence. Ischemic heart disease (IHD) was associated with 2.15 times higher odds of adherence (AOR = 2.151; 95% CI: 1.214-3.811; p = 0.009). Divorced marital status was also associated with higher odds of adherence compared with married status (AOR = 3.077; 95% CI: 1.211-7.817; p = 0.018). More than one-third of patients exhibited low adherence. T2DM and IHD showed opposing associations with adherence, reflecting the contrasting motivational dynamics of these comorbidities. High-salt dietary intake and divorced marital status were additional independent predictors. These findings, interpreted within the context of the observational design and self-reported measurement, underscore the need for patient-centred, integrated interventions addressing comorbidity burden and dietary behaviour to improve antihypertensive adherence in Somalia. Future prospective research using objective adherence measures is recommended.
Retreaded tires constitute a substantial segment of the commercial tire market and are an important source of tire wear particles (TWPs), yet the environmental risks of this major microplastic category remain uninvestigated. Here, we show that although the total additive mass is generally lower in TWPs from retreaded tires, these particles exhibit a markedly greater additive leaching potential, particularly for p-phenylenediamines (PPDs). Notably, the highly water-soluble additive N-isopropyl-N'-phenyl-p-phenylenediamine (IPPD), present at high concentrations in some retreaded-tire TWPs, is especially leachable. Correspondingly, leachates from retreaded-tire TWPs cause greater growth inhibition in Vibrio fischeri and Chlorella vulgaris than those from new or used tires. Furthermore, our numerical model projections under the Shared Socioeconomic Pathway 2 (SSP2) scenario show that global emissions of retreaded-tire TWPs could increase several hundred-fold by 2060. The substantial and growing risks identified in our study underscore the urgent need for broader investigations into the environmental impacts of these particles.
A calix[4]arene-functionalized BODIPY fluorescent probe (Calix-BODIPY) was developed for the selective detection of Fe3+ ions in aqueous media for the first time. The integration of a calixarene recognition unit with a BODIPY fluorophore enabled efficient fluorescence signal transduction, resulting in a rapid "turn-off" response (∼10 s) toward Fe3+ ions with high selectivity over competing species. The sensor platform exhibited a linear response in the concentration range of 332-3537 µM, with a limit of detection (LOD) of 87.65 µM. Spectroscopic studies revealed that the sensing mechanism is governed by combined static and dynamic quenching processes. The applicability of the proposed system was validated through the determination of Fe3+ ions in tap and well water samples, yielding satisfactory recovery values (75.17-121.12%) without the need for complex sample pretreatment. Compared to nanomaterial-based sensors, the Calix-BODIPY probe offers advantages such as a well-defined molecular structure, operational simplicity, and high selectivity. These findings demonstrate that calixarene-BODIPY hybrid systems represent a promising platform for the development of practical fluorescent sensors for metal ion detection.
As artificial intelligence (AI) integrates into healthcare, clinical nurses need digital resilience to adapt to technological changes. However, little is known about the digital resilience of practicing nurses. This study aimed to investigate the current status and influencing factors of digital resilience among clinical nurses. A quantitative, descriptive, cross-sectional study was conducted in two tertiary hospitals in Nantong City, China. A convenience sample of 460 clinical nurses completed questionnaires assessing general characteristics, AI literacy, organizational support, self-efficacy, and digital resilience. Multiple linear regression was used to identify influencing factors. The mean digital resilience score was 123.05 ± 11.80 (possible range 39-195), indicating a moderate-to-high level. Monthly income, number of night shifts per month, participation in AI-related training, AI literacy, organizational support, and self-efficacy were significant predictors (all P < 0.05). These variables collectively accounted for 78.9% of the variance. Digital resilience among clinical nurses is influenced by multiple factors. Nursing managers should implement systematic training, optimize shift schedules, enhance organizational support, and foster self-efficacy to improve digital resilience.
Developmental theories of ethnocultural socialization (Incorporating the cultural value of respeto into a framework of Latino parenting. Cultural Diversity and Ethnic Minority Psychology, 16(1), 77-86; Traditional and culture-specific parenting of prosociality in U.S. Latino/as. Oxford handbook of parenting and moral development, Oxford University Press.) emphasize the importance of understanding how caregivers instill culturally grounded values adapted to specific cultural and environmental contexts to support positive youth development. Caregivers are deemed to transmit these cultural values to their youth via ethnic heritage practices, customs, rituals, and cultural experiences. Importantly, work based on these models has shown that specific cultural values significantly predict the health and well-being of Latine youth (Cultural values, empathy, and prosocial behavior among U.S. Latino/a youth: A mediation model. Journal of Social and Personal Relationships, 38(2), 521-540; Familism values and adjustment among Hispanic/Latino individuals: A systematic review and meta-analysis. Psychological Bulletin, 147(9), 947-985). Among the cultural values instilled by many Latine parents is bien educado, a concept that emphasizes the importance that youth be well-mannered, display positive social behaviors, and exhibit a strong moral character (Familismo, respeto, and bien educado: Traditional/cultural models and values in Latinos. Critical Cultural Studies of Childhood. Springer). While much of the prior research has focused on cultural values such as familismo and respeto, relatively little is known about the cultural value of bien educado. Indeed, no studies exist on how bien educado is conceptualized and taught by Latine mothers. To address this gap, focus group interviews were conducted to explore how Latine mothers of adolescents define and teach bien educado to their adolescents. Seventeen Latine mothers (Mage = 41.88 years, SD = 6.23) reporting on their adolescents (Mage = 14.97 years, SD = 3.55) participated. On average, mothers had two children and lived in the United States for approximately 21.6 years. The majority were of Mexican origin and predominantly Spanish-speaking (88%). Focus group interviews were conducted in Spanish and English using semi-structured questions designed to explore mothers' definitions, beliefs, and practices related to bien educado. The questions included: "What is your own definition of bien educado?" and "What are some things you do to teach your child to be bien educado?" All focus groups were audio-recorded, transcribed verbatim, and trained; bilingual coders analyzed the transcripts using inductive thematic analysis (Qualitative inquiry and research design: Choosing among five approaches. SAGE Publications). Mothers conceptualized bien educado as encompassing four main aspects: respect, consideration for others, humility, and being well-mannered. Furthermore, mothers emphasized their intentionality to foster these traits in their youth and viewed the concept as a strength-based approach that contributed positively to their youth's moral development. The findings reveal that bien educado is a multidimensional cultural value construct and a Latine culturally-relevant parenting goal. Specifically, the findings highlight the central elements of bien educado as respect, consideration for others, being well-mannered, and humility. Given the centrality of these four elements in prosocial and moral development (The development and correlates of prosocial moral behaviors. Handbook of moral development. Psychology Press.), the present findings situate bien educado as a Latine-grounded value that can further our understanding of U.S. Latine youth prosocial and moral development. Moreover, the findings demonstrate the need to incorporate this understudied core Latine cultural value into sociocultural- and ecological-grounded parental socialization models and future research in U.S. Latine youth.
Respiratory viruses such as influenza A virus (IAV), respiratory syncytial virus (RSV), and human metapneumovirus (hMPV) impose a persistent global health burden, yet current antivirals are often limited by toxicity and side effects. This highlights the urgent need for broad-spectrum antiviral agents that can safely block viral infections. Carbon dots (cDots) provide an ideal scaffold for this strategy due to their ultra-small size, tuneable surface chemistry, and inherent biocompatibility. Notably, we previously demonstrated that 2-aminophenylboronic acid (APBA)-derived cDots have virus-binding capabilities by inhibiting human immunodeficiency virus (HIV)-1 entry. Herein, we synthesize APBA-functionalized cDots via pyrolysis, yielding cDots densely decorated with boronic acid and boroxine groups. These non-toxic APBA-cDots demonstrate potent antiviral activity against RSV, IAV, and hMPV in vitro. Competitive inhibition by N-acetylglucosamine and molecular docking analyses are consistent with a proposed boronic acid-mediated interaction with glycan-rich viral surfaces, although this mechanism has not yet been definitively proven by direct loss-of-function chemistry. Overall, these findings identify APBA-cDots as a promising antiviral nanoplatform and provide preliminary support for a glycan-targeting mechanism that warrants further validation.
Antisynthetase syndrome (ASyS) is an autoimmune disorder that may be associated with hepatic involvement, such as nodular regenerative hyperplasia (NRH), a histologic manifestation of porto-sinusoidal vascular disorder, and complications such as variceal bleeding despite preserved liver function. We report a case of life-threatening variceal hemorrhage due to NRH-associated porto-sinusoidal vascular disorder in a patient with ASyS. This case highlights NRH as a cause of severe gastrointestinal bleeding in ASyS and underscores the need for diagnostic and management strategies distinct from those used in cirrhosis.