Feminism is culturally salient for adolescent girls and may be psychologically protective. Despite adolescence being a key period of identity development, little is known about how adolescent girls perceive and orient toward feminism. Using a diverse sample of 586 adolescent girls from across the US (32% Black, 28% white, 11% Latina, 5% Asian American, 21% multiracial), a mixed methods analysis was conducted to explore (1) girls' rates of feminist orientation, (2) their beliefs about feminism, and (3) the psychosocial factors related to a feminist orientation. Nearly half of girls considered themselves to be feminists and qualitative responses revealed considerable diversity and nuance in girls' beliefs about feminism, including varied praises and criticisms. Quantitative analysis showed feminist orientation to be correlated with more frequent experiences with gender discrimination, as well as indices of gender identity, including gender identity centrality and self-perceived similarity to boys (though not similarity to girls). These findings provide important insights into the ways a feminist identity can support adolescent girls' well-being.
Atrial functional mitral regurgitation (AFMR) characterizes a high-risk phenotype in heart failure with preserved ejection fraction (HFpEF). Although sacubitril/valsartan reduces functional mitral regurgitation (MR) in HF with reduced EF (HFrEF), its impact on exercise hemodynamics and the dynamic burden of AFMR in HFpEF remains to be elucidated. This multicenter, randomized, open-label trial with blinded primary endpoint assessment assigned 84 patients with symptomatic HFpEF and at least moderate AFMR within the previous year to sacubitril/valsartan (n=41) or standard-of-care (SOC; n=43). The primary outcome was the 6-month change in the exercise mean pulmonary arterial pressure to cardiac output (mPAP/CO) slope, assessed using cardiopulmonary exercise testing with simultaneous echocardiography (CPETecho). Secondary outcomes included changes in peak oxygen consumption (peak VO2), Kansas City Cardiomyopathy Questionnaire (KCCQ), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, left atrial (LA) volume and function, and AFMR severity in rest and during stress. At 6 months, sacubitril/valsartan significantly improved the mPAP/CO slope compared with SOC (adjusted between-group difference in change, -0.93 mm Hg/L/min; 95% CI, -1.80 to -0.07; P=0.035). This hemodynamic benefit was accompanied by improvements in peak VO2 (mean change, +0.9 versus -0.6mL/kg/min; P=0.002) and KCCQ (median increase, 10 versus 2 points; P=0.002). Significant reductions in NT-proBNP and LA volume were observed (P<0.001 for both), alongside a significant blunting of the dynamic MR increase during exercise (P=0.020). Target dose was achieved in 60% of patients, with symptomatic hypotension as the primary titration-limiting factor. In HFpEF and AFMR, sacubitril/valsartan was associated with improvements in exercise hemodynamics and peak VO2, along with attenuation of the exercise-induced increase in AFMR. These findings suggest a phenotype-specific benefit, warranting confirmation in larger, placebo-controlled, clinical outcome trials. URL: https://www.clinicaltrials.gov; Unique identifier: NCT05991284. EudraCT: 2023-506634-70-00.
Anaglyphs are displays in which the left and right eye images are presented in different colours, such as red and cyan, and they are viewed through filters of the same colours so that each eye sees a different image. They have typically been used to present slightly different images to each eye so that they are seen in relief - stereoscopic depth. Anaglyphs have become increasingly popular as a means for printing and projecting stereoscopic drawings and photographs. The general standard now is for red/left eye, cyan/right eye filters for viewing similarly coloured printed or projected images and these are recommended for viewing the anaglyphs in this article. Despite the disdain for anaglyphs in visual science, they have been used extensively in visual art and education. However, anaglyphs can be constructed that yield displays that would be difficult to produce for refracting or reflecting stereoscopes.
Despite efforts to characterize the psychotherapeutic strategies used in routine children's mental health services and develop pragmatic assessments of evidence-based practice (EBP) strategy delivery, research on the associations between EBP strategies and child outcomes is very limited. The Evidence-based Concordant Care Assessment (ECCA; Brookman-Frazee et al., 2021) is a measure designed to assess therapist delivery of evidence-based strategies in children's mental health services. Previous research on the predictive validity of the ECCA indicates that a subset of ECCA Technique strategies are associated with child mental health outcome trajectories across presenting problems. The current study extends analyses to identify ECCA Content strategies associated with caregiver-reported outcome trajectories for children with specific presenting problems, and for distinct age groups. Data were obtained from 1,380 sessions with 248 children being served by 76 therapists in two county systems. Child primary presenting problems included: depression (32%), externalizing problems (27%), anxiety (22%), trauma (14%), and other concerns (5%). Children were, on average, 11.8 years old (SD = 3.7). Therapists reported their delivery of EBP strategies at the session-level using the ECCA (Brookman-Frazee et al., 2021) which includes 25 Content strategies (e.g., Time-Out, Cognitive Restructuring). Caregivers reported symptoms on the Brief Problem Checklist (BPC; Chorpita et al., 2010) at baseline, weekly over two months of treatment, and again at four months. Multilevel models examined whether the frequency and/or the extensiveness of ECCA Content strategy use were associated with child outcome trajectories in subgroup analyses by primary presenting problem and age group. Fourteen ECCA Content strategies were significantly associated with decline in child symptoms for at least one presenting problem, and/or age group. Specifically, delivery of Cognitive Restructuring was significantly associated with symptom improvement in the full sample, and for subgoups including externalizing, trauma, and depression subgroups. Additional Content strategies were associated with outcomes for specific subgroups: Following the Child's Lead, Praise, and Differential Reinforcement for 8-12 year olds, Distracting & Redirecting for externalizing, depression, and 8-12 year olds; Timeout for depression; Behavioral Contracting for depression; Exposure for trauma; Relaxation for trauma, Youth Education Support/Activities for trauma; Assertiveness training for externalizing, and Safety Skills for trauma. The ECCA study is the first to demonstrate the associations between therapist reported use of individual EBP strategies and child outcomes within children's mental health services. The findings support the potential of scalable therapist reports of EBP content delivery as a pragmatic quality indicator in systems of care.
Prostate-specific antigen (PSA) is a widely available and analytically robust biomarker, but its role in prostate cancer (PCa) screening remains controversial due to concerns regarding limited specificity, overdiagnosis of indolent tumors, and the downstream risk of overtreatment. This review provides a critical analysis of the main randomized trials, systematic reviews, and meta-analyses that have shaped current recommendations against PSA-based screening, highlighting the substantial methodological heterogeneity that complicates interpretation of aggregated outcomes. Key limitations identified across studies include variability in PSA thresholds and screening intensity, insufficient follow-up in some cases to detect long-term mortality benefits, non-comparability of PSA assays, and extensive contamination of control groups - particularly in the PLCO trial - which undermines estimates of screening efficacy. Recent updates from the ERSPC and CAP trials show that mortality reductions associated with screening increase with longer follow-up, supporting the need to reassess earlier conclusions. Parallel to the evolving evidence base, European initiatives such as the PRAISE-U consortium and several regional pilot programs following the European Council's recommendations are implementing risk-adapted pathways that combine baseline PSA stratification with multiparametric MRI triage and selective biopsy. These programs aim to minimize overdiagnosis while improving detection of clinically significant PCa and generating real-world evidence for organized screening. Additionally, the variability among PSA assays underscores the need for greater harmonization and standardized reporting. Overall, emerging data suggest that intelligently targeted, risk-stratified PSA screening may offer a more balanced approach than the traditional dichotomy of screening vs. no screening.
Artificial Intelligence (AI) is seen as a potential solution to alleviate workforce demands arising from growing use of magnetic resonance imaging (MRI) in prostate cancer (PCa) screening. We aimed to synthesize the evidence on use of AI in prostate MRI readings in asymptomatic men in PCa screening settings. We conducted a rapid scoping review following PRISMA-ScR guidelines and Cochrane rapid review methods performing the systematic search of major databases supplemented by grey literature search with no restrictions in study design and time-duration. We considered various aspects of utilization of AI in MRI interpretations and biopsy indications in the screening setting. Anticipating limited evidence on AI implementation in screening settings, we extended the review from 'what is known' to discussion on 'key considerations for expected expansion'. We identified 284 records with 47 studies assessed for eligibility and two studied met the inclusion criteria. Both evaluated commercially available ProstateAI software tool to interpret prostate MRI. Agreement between deep learning-based algorithm of AI and expert radiologist ranged from poor to moderate (kappa 0.17-0.42). AI demonstrated high tendency of over-detection and low specificity, leading to discordance with expert radiologists. Current evidence on use of AI in prostate MRI interpretation is limited, but this review highlights several important directions for future research and implementation. Generating robust evidence base in the coming years will be crucial to ensure that AI integration enhances the effectiveness and acceptability of future prostate cancer screening programs. In this study, we examined whether Artificial Intelligence (AI) tools can accurately read prostate MRI scans of apparently healthy men for early detection of prostate cancer. We found that deploying current AI tools that are trained and tested in hospital referred patients may not be optimal to read MRI performed in asymptomatic men. We conclude that AI needs much more training and testing in real screening populations before it can be safely used in prostate cancer screening programs.
Effective clinical communication is essential for medical practice, with standardized patients (SPs) being a reliable standard training method despite resource limitations. While large language models (LLMs) show strong role-playing abilities, current virtual patients (VPs) based on single LLMs face fidelity and interaction challenges. Recent advances in multiagent frameworks, which have demonstrated considerable potential in handling complex tasks, offer a new perspective for creating VPs in medical education. This study aimed to develop and evaluate a novel multiagent VP framework that simulates SPs through a collaborative agent design, thereby enhancing human-like fidelity and interaction performance in clinical communication training-oriented VP simulation. Our multiagent framework constructed 5 specialized subagents by simulating the functional partitioning of brain regions, collaboratively simulating the entire process, from case reception to interactive consultation scenarios, designed for medical students. To enhance the interaction performance of VPs, we incorporated retrieval-augmented technology, while deep character reasoning was used to improve response richness and realism. We evaluated the proposed framework through a 2-phase experiment in which the metrics of response quality, role-playing performance, interaction efficiency, information accumulation, and perceived educational utility were applied consistently: first, to compare different base models, and second, to benchmark the complete framework against a single-LLM baseline. The multiagent framework outperformed single-LLM baselines across multiple evaluation settings, achieving high information accuracy and role-playing scores under standardized dialogue conditions. Specifically, the GPT-4o-based implementation achieved peak factual consistency of 0.769 (SD 0.04), while all configurations maintained >94% clinical accuracy. The Qwen3-32B-based framework achieved the lowest misleading rate of 1.28% (SD 1.20), compared to 4.72% (SD 1.53%) for single-LLM scoring. In assessments using standard dialogue scripts, the Qwen3-32B-based framework attained the highest role-playing competency score of 39.67 (SD 0.71) and received high expert praise. However, limited discriminative power against specific leading questions on low-quality inquiries indicated that while these findings specifically establish high fidelity under structured conditions, further adaptation is required for authentic student interactions. Interaction efficiency remained practical with acceptable latency (~3 s) based on Qwen3-32B while maintaining a stable information pace during multiturn dialogues. Furthermore, a preliminary exploration of factual consistency and role-playing ability across 5 clinical departments demonstrated potential scalability. The multiagent framework offers a viable simulation of SPs through the coordinated interaction of multiple LLM-based agents. This approach enhances the performance of VP simulation, providing a customizable and scalable solution for medical communication training, without compromising patient confidentiality. The framework holds substantial potential for advancing medical education approaches.
Bovine viral diarrhea virus (BVDV), a major pathogen in the global bovine industry, causes diarrhea, fever, and reproductive disorders, leading to substantial economic losses. Developing the methods for rapid and accurate detection of BVDV is crucial for epidemic control. Current detection methods have notable limitations. PCR-based nucleic acid amplification techniques rely on sophisticated instruments and complex procedures. CRISPR-Cas13a systems, despite their high specificity, still require nucleic acid pre-amplification, which results in cumbersome workflows and contamination risks. To establish a simpler and more efficient on-site detection method for BVDV, this study integrated the CRISPR-Cas13a system characterized by specific recognition with electrochemical sensing praised for efficient signal transduction to establish a novel nucleic acid amplification-free method for the detection of BVDV. Through optimization of key parameters, including CRISPR RNA (crRNA) combination, buffer components, and Cas13a/crRNA concentration ratio, the biosensor achieved a detection limit of 3 090 copies/μL-representing a 4-5 order of magnitude improvement in sensitivity compared with conventional Cas13a fluorescence-based detection-and completed the entire process from sample loading to result output within 35 min. Specificity tests demonstrated that the sensor exclusively detected BVDV without cross-reactivity to other common bovine viruses (bovine parainfluenza virus type 3, bovine respiratory syncytial virus, bluetongue virus, and foot-and-mouth disease virus). Clinical validation with 22 samples demonstrated 100% specificity and sensitivity. The developed CRISPR-Cas13a-based electrochemical biosensor offers the advantages of being nucleic acid amplification-free and operationally simple, serving as a powerful new tool for rapid on-site BVDV detection with significant potential for veterinary diagnostics and epidemic prevention and control. 牛病毒性腹泻病毒(bovine viral diarrhea virus, BVDV)是危害全球养牛业的重要病原体，可导致腹泻、发热及繁殖障碍，造成严重经济损失。建立快速、精准的BVDV检测方法对疫情防控具有重要意义。现有检测方法存在明显局限:PCR等核酸扩增技术需精密仪器且操作复杂;而CRISPR-Cas13a系统虽特异性强，却仍需核酸预扩增，导致检测流程繁琐和污染风险。为开发更简便高效的BVDV现场快速检测技术，本研究将CRISPR-Cas13a系统的特异性识别能力与电化学传感技术的高效信号转换特性相结合，建立了一种免核酸扩增的BVDV检测新方法。通过优化CRISPR RNA (crRNA)组合、反应缓冲液组分及Cas13a/crRNA浓度比等关键参数，该传感器检测限达3 090 copies/μL，较传统Cas13a荧光检测方法灵敏度提升4-5个数量级，可在35 min内完成从加样到结果输出的全过程。特异性实验表明，该方法仅对BVDV产生特异性检测信号，而对其他常见牛源病毒(包括对牛副流感病毒3型、牛呼吸道合胞病毒、蓝舌病病毒和口蹄疫病毒)均未产生可检测的交叉反应信号。22份临床样本验证结果显示，该传感器的特异性和灵敏度均达到100%。本研究建立的CRISPR-Cas13a电化学生物传感器具有免核酸扩增、操作简便等优势，为BVDV的现场快速检测提供了新型高效工具，在临床诊断和疫情防控中具有重要应用价值。.
Text generation approaches in health care communication have evolved along 2 major paths. The first path involves generative adversarial networks, progressing from basic architectures to specialized variants like Text-to-Text Generative Adversarial Network (TT-GAN) and Time and Frequency Domain-Based Generative Adversarial Network (TF-GAN), which address challenges in discrete text generation through techniques such as Gumbel-Softmax and reinforcement learning. The second path emerges from transformer-based architectures, particularly Generative Pretrained Transformer-2 (GPT-2), which uses extensive pretraining and self-attention mechanisms to generate contextually appropriate text. GPT-2's transformer architecture enhances persuasive health communication by generating personalized messages using various strategies like task support, dialogue support, and social support for effective health interventions. This study aimed to use GPT-2 as a generative method to construct persuasive text in a dataset and compare the performance of sentiment analysis and emotion detection analysis. We combined sentiment analysis tools (VADER [Valence Aware Dictionary and Sentiment Reasoner] and TextBlob) with emotion detection methods (Text2Emotion and NRCLex [National Research Council Lexicon]) to analyze health coaching messages across different persuasive types: reminder, reward, suggestion, and praise. TextBlob and VADER achieved accuracies of 57% and 69%, respectively, while RoBERTa (robustly optimized BERT approach)-sentiment outperformed them with an accuracy of 88%. Emotion detection showed a high prevalence of "joy" and "happy" labels (93.69% positive skew). While transformers excel in accuracy, lexicon-based models like VADER offer a better performance-efficiency balance for real-time health communication systems. For emotion detection, all categories showed perfect accuracy (1.0), while trust showed mixed results, with precision, recall, and F1-score values ranging from 0.81 to 0.96. The emotion detection analysis revealed varying success rates across different emotions, with some categories, such as anger and neutral, showing reasonable performance and others, such as trust, showing mixed performance. This research contributes to understanding the emotional dynamics of persuasive health communication and highlights both the capabilities and limitations of current natural language processing tools in analyzing health-related persuasive messaging. This proof-of-concept study using synthetically generated data establishes a methodological framework for multimodal sentiment and emotion analysis. The findings require validation with real-world health coaching messages before clinical deployment.
This paper examines the use of praise in the care of people living with dementia (PLWD) in the acute hospital. Perceptions of praise vary. 'Excessive' praise is typically classified as elderspeak, with attendant debates over whether this is patronising and/or infantilising. However, some sources suggest praise may serve useful structural functions in conversation, or should be used for encouragement of PLWD, reflecting the pervasive person-centred care ideology of supporting PLWD's existing abilities. Conversation analysis was used to examine 85 video and audio recordings of interactions involving PLWD and healthcare professionals in acute UK hospital wards. Findings suggest that although context sensitive, praise: 1) works as a supportive action to aid orientation to tasks and activities; and 2) has implications for the preservation of agency and face. Findings demonstrate the importance of sensitivity to individual interactional circumstances and have implications for healthcare practice, training and wider care of PLWD.
As the U.S. population ages, the Older Americans Act (OAA) Title III-C senior nutrition program (SNP) must evolve to meet emerging needs. The National Resource Center on Nutrition and Aging (NRCNA) developed ican!, a free, online course designed to strengthen the capacity of SNP professionals. This article describes the theory-based development of ican! and evaluates its impact using a mixed-methods design. Quantitative data from survey respondents (n = 801) revealed positive course perceptions across several metrics (engagement, relevance, satisfaction, knowledge, skills, attitudes, and commitment). Qualitative interviews (n = 10) provided insight into how the course was utilized, including training staff or local service providers, advancing user knowledge, and informing organizational planning. Interviewees praised the course's user-friendly design, clear language, and flexible format. The findings suggest that ican! is a well-received, valuable training tool for SNP professionals. The study also highlights the importance of theory-driven design, audience input, and ongoing evaluation in developing impactful educational resources. These insights can inform future training efforts within the Aging Network and support broader goals of program sustainability and workforce development.
Parent training (PT) helps parents of children with neurodevelopmental disorders cope with anxiety and stress. Current PT evaluation relies on subjective self-assessment and lacks objective indicators. To provide professional support, objective indicators are needed to monitor parent-child relationship changes through PT. The aim is to develop an observation framework for supporters to objectively assess the changes and challenges of PT. An observational study was conducted on one pair using Group Triple P, a Level four program of the Positive Parenting Program (Triple P). Ten observational aspects were established as objective evaluation indicators. Nine aspects were confirmed by two observers based on 10-min video recordings of parent-child free-play sessions before PT, after PT, and at follow-up. Confirmed data were coded every 10 sec, and reliability and validity were analyzed using kappa coefficients. The remaining item, parent-child utterances, was counted using video footage and verbatim transcripts. Eight observational aspects were adopted, and seven (speaking for and empathizing with child's feelings, physical displays of affection, simple or specific praise, suggesting play, setting parental example, and responsiveness) showed high inter-observer reliability. By quantifying speaking frequency, we captured changes in parent-child interactions, demonstrating effectiveness. These eight observational perspectives capture changes in parent-child interactions. Using these perspectives, it is possible to objectively evaluate PT effectiveness and identify future challenges. This method could improve by increasing cases, providing concrete examples of observational perspectives, and considering a pre-training program.
This commentary responds to arguments presented in Caspi et al.'s (see record 2026-80066-001) viewpoint article. I endorse the authors' overall argument but note that exactly how many mental disorders one needs to study at a time will likely depend on the specific research question. I also describe how transdiagnostic research requires strong norms of data and credit sharing. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Global tobacco control efforts, influenced substantially by the World Health Organization Framework Convention on Tobacco Control and the MPOWER package, have lowered smoking prevalence in some populations but have failed to address the lived realities of the people who continue to smoke. These individuals increasingly come from communities marked by socioeconomic disadvantage, lower educational attainment, and limited access to healthcare, contexts where structural constraints, chronic stress, and reduced opportunity shape tobacco use far more powerfully than individual "choice." Yet tobacco control frameworks continue to prioritize abstinence-only strategies, punitive measures, and restrictive regulatory environments that rarely reflect the perspectives or needs of the people most affected. Countries are praised for adopting increasingly restrictive policies, with little attention given to the actual reductions in smoking rates. This editorial argues that further decreases in smoking rates can be achieved if the focus shifts from moralizing nicotine use in any form to empowering people who smoke with practical, science-based harm reduction tools. Noncombustible nicotine products that reduce toxicant exposure are often dismissed or prohibited despite growing evidence of their value for people unlikely to achieve abstinence. This disconnect widens health inequities and alienates those currently navigating stigma, misinformation, and limited cessation support. We propose a real-world EMPOWER framework that integrates evidence, pragmatism, risk-proportionate regulation, and person-centered communication. To reduce smoking-related harm more effectively, policy must move beyond ideology and prioritize autonomy, equity, and practical harm reduction.
Background/Objectives: Non-covalent nanocarrier-based systems have become a promising platform as they offer a strategy to improve the efficacy-safety profile of doxorubicin (DOX) without altering its chemical structure. Praised for biocompatibility and rich surface chemistry, nanodiamonds (NDs) have launched as nanocarriers of choice for advanced cancer therapy. By investigating DOX-ND physicochemical interactions, this work advances the structural understanding of a non-covalent potential anticancer system, which has not been quantitatively experimentally explored so far. Methods: To our knowledge, this is among the first studies combining ultraviolet-visible (UV-VIS) spectroscopy with spectral deconvolution to reveal the redistribution of different DOX species in the presence of NDs. Centrifugation-assisted analysis enabled differentiation between hypothetical labile and stable ND/DOX fractions. Adsorption kinetics was studied, and dynamic light scattering (DLS) measured particle size and zeta potential. In vitro screening was performed in non-malignant fibroblasts (MRC-5) and malignant melanoma (HS294T), glioblastoma (U251), and breast cancer (MCF-7) cells to evaluate ND/DOX combinations. Results: Centrifugation analysis revealed heterogeneous ND-DOX binding. Kinetic experiments showed fast multi-stage adsorption kinetics, best described by a bi-exponential decay function and the Weber-Morris model. DLS suggested stable systems with a particle size within 10-80 nm, predominantly around 20 nm, and positive zeta potential. Comparative in vitro screening demonstrated differential cellular responses across cell types, highlighting the relevance of ND/DOX interactions. Conclusions: The findings contribute to elucidating ND-DOX interactions relevant for the design and optimization of drug delivery systems, emphasizing the importance of spectroscopic insights for the design of nanodiamond-based drug delivery systems.
Adolescents experiencing psychiatric emergencies often require intensive interventions to prevent hospitalisation and support their return to education, employment or training. Intensive Community Care Services aim to provide an alternative to inpatient care. To evaluate the effectiveness of Intensive Community Care Services compared to treatment as usual in reducing the time to start or return to education, employment or training for young people with psychiatric emergencies. A multicentre, parallel-group, single-blinded, randomised controlled trial, including an internal feasibility phase, across seven NHS trusts in the United Kingdom. Adolescents aged 12-17 were randomised to receive either Intensive Community Care Services or treatment as usual. The primary outcome was the time to start or return to education, employment or training within a 6-month observation period. Secondary outcomes included clinical symptoms, functioning and service satisfaction. Process evaluation used semistructured visual interviews followed by thematic decomposition analysis. The impact of COVID-19 and the importance of continuity of care were explored in a series of cohort studies based in emergency departments. A consensus meeting was held to define the features of Intensive Community Care Services. Of the approximately 977 adolescents screened, 36 were randomised in a 1 : 1 ratio using a web-based randomisation system stratified by the NHS trust using variable block sizes to receive either Intensive Community Care Services or treatment as usual. A key reason for poor recruitment was the absence of an alternative to Intensive Community Care Services. The recruitment rate did not meet pre-specified progression criteria (n = 55 by the first 6 months of recruitment), and conducting a full evaluation trial was deemed not feasible. Thirty participants from the pilot sample (83.3%) returned to education, employment or training during the 6-month follow-up period, with a median time to education, employment or training of 9 days (interquartile range 1-49). The median time to education, employment or training was lower in the Intensive Community Care Services group (6 days) compared to the treatment-as-usual group (12 days), with a hazard ratio of 1.34 (95% confidence interval 0.63 to 2.86). Estimated effect sizes for secondary outcomes were also in the direction of a benefit under Intensive Community Care Services, with higher satisfaction with services and improvements in clinical symptoms and functioning. There was a greater total average cost for the treatment-as-usual group at £15,155 (standard deviation 31,560), compared to £7063 (standard deviation 10,605) for Intensive Community Care Services. Due to the small sample size, no inferences regarding Intensive Community Care Services effectiveness or cost-effectiveness can be drawn. Fourteen young people participated in the process evaluation. Inpatient care received both praise for effective diagnoses and therapeutic interventions and criticism for a sterile approach and inadequate staff attention. Intensive Community Care Services was valued for the personalised approach, exemplified by beneficial home visits. During COVID-19, there was a significant reduction in emergency presentations of young people, followed by a significant increase post pandemic. The follow-up attendance rate increased by more than three times if the follow-up appointment was offered by the same clinician who saw the young person in an emergency room (odds ratio 3.66, 95% confidence interval 1.65 to 8.13). Intensive Community Care Services teams should use the modified Dartmouth Assertive Community Treatment Fidelity Scale to assess their quality. Recruitment to a randomised controlled trial of this kind can be improved if all new Intensive Community Care Services teams are considered to be experimental services and an equipoise between Intensive Community Care Services and existing services acknowledged. Rigorous post-implementation research is warranted for those areas that choose to implement Intensive Community Care Services. An adequately powered randomised controlled trial is needed to confirm the pilot findings of the IVY study and explore the full potential of Intensive Community Care Services as an alternative to inpatient and other community-based services for young people with severe mental health needs. Clinicians' experience delivering Intensive Community Care Services should be explored in further qualitative studies. The most significant limitation of this pilot study is the very small sample size, which was a direct result of recruitment difficulties. As a result, we were unable to draw any inferences about the effectiveness or cost-effectiveness of Intensive Community Care Services relative to treatment as usual. It was not possible to blind participants to the intervention they were receiving. The 6-month follow-up period may have been insufficient to capture important long-term outcomes. No definitive conclusions can be drawn from this study. Preliminary results suggest that Intensive Community Care Services may support a faster return to education, employment or training than treatment as usual. Intensive Community Care Services may be cost-effective compared to treatment as usual. Additional mental health professionals should be deployed to Intensive Community Care Services during future lockdowns. The same Intensive Community Care Services professionals should offer assessments in emergency departments and provide community follow-up. Research with a larger sample is warranted to confirm these findings. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR127408. Adolescents in psychiatric crises often need intensive help to avoid hospital admission and get back into education, employment or training. Intensive Community Care Services aim to offer an alternative to hospital care for these young people. This study looked at how effective Intensive Community Care Services is compared to standard treatment, also called treatment as usual. We conducted a study across seven NHS trusts in the UK, where adolescents aged 12–17 were randomly assigned to receive either Intensive Community Care Services or treatment as usual. The main goal was to measure the time it took for them to start or return to education, employment or training within 6 months. We also looked at their clinical symptoms, daily functioning and service satisfaction. We used interviews to evaluate their experiences and also studied how COVID-19 and continuity of care affected outcomes. Out of 36 participants, 30 (83.3%) returned to education, employment or training within 6 months. The Intensive Community Care Services group returned faster (about 6 days) than the treatment-as-usual group (12 days), though the difference was not statistically significant. Still, Intensive Community Care Services showed some positive trends, like higher service satisfaction. Costs were lower for Intensive Community Care Services (£7063 on average) compared to treatment as usual (£15,155). Fourteen participants shared their experiences of using services; while hospital care was sometimes praised, Intensive Community Care Services was valued for its personalised approach. During COVID-19, fewer young people came to emergency departments, but this rose again afterwards. Follow-up attendance tripled when the same clinician was involved in emergency assessments and follow-up. Although the study did not provide conclusive results, Intensive Community Care Services shows promise in helping young people return to education, employment or training faster and maybe more cost-effective than treatment as usual. We recommend more mental health staff for Intensive Community Care Services in future lockdowns. The same clinicians should handle both emergency assessments and follow-up care. Further research with more participants is needed to confirm these findings.
Ginseng is widely praised for its benefits on cancer patients, often attributed to its metabolite compound K (CK). Here, we synthesized a derivative (CKD-4) that, compared with CK, exhibited enhanced cellular uptake, threefold greater cytotoxicity, and improved pharmacokinetics. CKD-4 induced significant growth inhibition on lung cancer patient-derived organoids, and on cell line-derived xenografts with minimal systemic toxicity. CKD-4 also suppressed orthotopic lung tumor growth in immunocompetent mice with enhanced antitumor immune infiltration. Using proteome integral solubility alteration and ProTargetMiner analyses, the mitochondrial phospholipid transfer protein PRELID3B was unbiasedly identified as a shared anticancer target of CK and CKD-4. PRELID3B is a potential pancancer therapeutic target and prognostic biomarker supported by cancer genetics and transcriptomics evidence. Both CK and CKD-4 stabilize PRELID3B in cellular thermal shift assay and bind PRELID3B with Kd of 23 µM and 5 µM, respectively, measured by biolayer interferometry. Multiomics analyses revealed that CK and CKD-4 share similar anticancer mechanisms, involving mitochondrial phospholipid depletion, integrated stress response activation, and immunomodulatory pathways induction associated with PRELID3B inhibition. This study provides the basis for the immunomodulatory and anticancer effects of ginseng metabolites through targeting PRELID3B, and illustrates the application of orthogonal proteomics in target identification of natural compounds.
To evaluate the accuracy and educational utility of Microsoft Copilot's (GPT-4, July 2025, closed-system version) responses to radiography questions through expert assessment, with a focus on strengths, limitations, and implications for radiologic science education. This qualitative descriptive study evaluated Copilot's responses to 15 open-ended radiography questions derived from the American Registry of Radiologic Technologists Radiography Examination Content Specifications. Seven subject matter experts with extensive clinical and teaching experience independently reviewed the artificial intelligence (AI)-generated responses for accuracy and educational utility. Feedback was collected using Microsoft Forms and analyzed inductively following a 6-phase thematic analysis framework. Thematic analysis revealed 6 overarching themes: accuracy and completeness of content, scope of practice and role clarification, outdated terminology and standards, formatting and presentation strengths, utility as a learning aid, and need for specificity and context. Experts praised the clarity, structure, and organization of responses and noted their potential as supplemental study aids. However, concerns were raised about incomplete or superficial content, attributions outside a radiologic technologist's scope of practice, outdated terminology and standards (including shielding and grid use), lack of specificity, and insufficient clinical context. Findings suggested that although Copilot might provide structured and accessible support for radiography learners, its limitations could result in outdated or inaccurate practices if used without a critical lens. The closed-system design further constrained educational utility by preventing transparent sourcing. For radiography education, these results highlighted the importance of embedding critical AI literacy skills into curricula so that students learn to evaluate, verify, and contextualize AI-generated outputs. Copilot demonstrated potential as a supplemental learning aid in radiography education, but outdated terminology, technical inaccuracies, and lack of sourcing constrained its reliability. Future research should compare multiple AI platforms, assess student learning outcomes, and explore strategies for embedding AI literacy and institutional safeguards to support safe, effective integration into health professions education.
Adolescence is a developmental period marked by heightened sensitivity to social evaluation due to the ongoing maturation of brain regions involved in emotion regulation and social cognition. Adolescents may be more vulnerable to socially evaluative feedback, particularly criticism, than adults. Although previous studies have documented age-related differences in neural responses to social evaluation, it remains unclear how the dynamic interactions among brain regions differ between these two age groups during social evaluation. In this study, sixty-four adolescents (14-17 years) and fifty-nine adults (20-40 years) were exposed to criticism, praise, and neutral comments during fMRI scanning. Dynamic causal modeling (DCM) was used to examine functional interactions among key brain regions involved in social evaluation: the right pregenual anterior cingulate cortex (pgACC), left dorsolateral prefrontal cortex (DLPFC), and left precuneus. Compared to adults, adolescents were more sensitive to criticism as they reported higher perceived criticism and more task-induced mood disturbance following criticism. DCM results showed that adolescents had stronger excitatory DLPFC-to-pgACC connectivity, and weaker excitatory pgACC-to-DLPFC and DLPFC-to-precuneus connectivity during social evaluation in general, compared to adults. Moreover, when being criticized, adolescents showed less excitation of the DLPFC-to-pgACC connectivity, whereas when being praised, they showed less inhibition of the pgACC-to-DLPFC connectivity. These findings highlight age-related differences in the neural dynamics underlying social evaluation processing, providing insight into adolescents' heightened sensitivity to social evaluation and potential risk for developing affective disorders.
I examine how the teacher-as-hero trope, rooted in the Filipino concept of bayani, functions as a weaponized virtue. Although kabayanihan (heroism) traditionally signifies collective service to the bayan (community), it now operates as cultural hegemony, reframing systemic neglect as personal virtue and depoliticizing chronic underfunding and exploitative labour. Through neoliberal critique and structural violence frameworks, I trace how heroic narratives normalize invisible labour, intensify emotional demands, and sustain burnout as an institutional outcome rather than an individual failing. Political elites benefit most from this trope; they substitute symbolic praise for material investment and evading accountability for structural failures. I do not dispute teachers' dedication; I call instead for dismantling the ideological structures that convert admiration into exploitation. Genuine educational reform requires fair labour conditions and a shift from the hero trope to structural justice, a lesson relevant across the Global South. J'ai fait valoir que le cliché de l'enseignant‐héros, bien qu'inspirant en apparence, masque de profondes défaillances éthiques et structurelles dans le système éducatif. Dans le contexte philippin, ce cliché puise sa force dans le bayani(héros), mais il est de plus en plus utilisé comme une vertu instrumentalisée. Contrairement au « héros » occidental solitaire, un bayani agit traditionnellement en coopération avec les autres, au service du bayan (la communauté) plutôt que dans la recherche d'une reconnaissance personnelle. Pourtant, les enseignants sont loués comme des bayaniprécisément lorsqu'ils endurent la surcharge de travail, les bas salaires, les conditions de travail dangereuses, l'indifférence bureaucratique et l'obligation de subventionner eux‐mêmes leurs salles de classe. Cette élévation morale présente l’échec structurel comme une vertu personnelle, normalisant le sacrifice tout en excusant le sous‐financement chronique et la négligence de l’État. Je ne remets pas en cause le dévouement des enseignants; j'appelle plutôt à transformer l'admiration en soutien matériel et institutionnel. Un système éducatif durable nécessite des structures solides et des conditions de travail équitables. Il est essentiel d'aller au‐delà des récits héroïques, non seulement pour le bien‐être des enseignants, mais aussi pour mettre en lumière comment la vertu, le travail et les inégalités s'entrecroisent dans les pays du Sud, où les louanges symboliques remplacent trop souvent les réformes structurelles.