The aim was to understand the relationship between anxiety, self-efficacy and motivation in relation to students' writing skills, which was achieved by collecting quantitative data from the students. Qualitative data was also collected from classroom teachers who observed and evaluated the students' writing processes, in order to shed light on these relationships. The quantitative phase was represented by a survey of 436 primary school students, conducted in the Turkish city of Mardin. Mediation analysis was employed to determine mediating role of anxiety via SPSS Process 4.0. The qualitative phase involved the analysis of interviews conducted with classroom teachers, which were used to interpret the quantitative findings. The results confirmed that motivation can be the dominant factor in taking action in writing, supporting the notion that anxiety partially mediates the relationship between motivation and self-efficacy. In addition, the findings were illustrated by classroom teachers' statements explaining that both motivation and self-efficacy decrease as students' anxiety about writing increases. Assessing students writing skills is crucial for policymakers, researchers, and families. The study's key findings demonstrate the practical benefits for primary school students of providing opportunities to write on topics of interest to increase their writing motivation (WMO), addressing concerns about dissatisfaction with their writing, and providing activities to sustain writing activity at school and at home.
The interplay of slow spin relaxation (long τS) and fast radiative recombination (short τR) is essential for using spin-polarized excited states in lead halide perovskites towards spintronics and quantum-optics technologies. Herein, we report on the observation of simultaneously long τS (59.8 ps) and short τR (3.4 ns) in the colloidal nanocrystals of high-entropy perovskites, Cs(PbMgZnCd)Br3, which enables the optical access and spin manipulation of excited states at room temperature. The incorporation of non-Pb metals spatially separates the [PbBr6]4- framework into smaller domains below the Bohr radius of excitons, and the size confinement leads to blue-shifted bright photoluminescence from short-lived photoexcitation species. Moreover, the distortion of [PbBr6]4- lattice is significantly enhanced in high-entropy structures, which enlarges the Rashba spin splitting and consequently prolongs τS over an order of magnitude. Optical write-in and read-out of spin states via circularly polarized light are achieved for both photoluminescence and amplified spontaneous emission from Cs(PbMgZnCd)Br3. Optical Hanle effect is demonstrated and allows for very efficient spin manipulation (positive/negative polarizations ~25.8%) under a perpendicular magnetic field, showing the great potential of high-entropy perovskites for opto-spintronic applications.
Patient and Public Involvement (PPI) is a continually growing component of health and social care research in the UK and internationally, ensuring that research is conducted with and by the public rather than simply about them. Doctoral research represents a critical opportunity to embed meaningful PPI early in researchers' careers, yet practical recommendations tailored to this context remain limited. Existing studies often focus on individual case reflections or programme-level evaluations, with few capturing the collective experiences of doctoral researchers, PPI contributors, and coordinators. This paper aims to co-produce practical recommendations to support meaningful patient and public involvement in doctoral health and social care research. This paper presents co-produced reflections and recommendations to support PPI in doctoral research. The writing process was approached collaboratively, with a team incorporating public contributors, doctoral researchers, and a public involvement coordinator working together through iterative discussion and revision. The approach aligns with the principles of authentic co-production, creating both "space to talk" through open, respectful dialogue and "space to change" through mutual adaptation. The team's experiences highlighted both shared benefits and challenges within the process. PPI enriched doctoral research by refining study design, questions, enhancing recruitment, and improving accessibility of outputs, while also offering PPI contributors opportunities for learning and impact. Challenges included managing emotional topics, balancing timelines, and recognising that not all suggestions could be implemented. The coordinator's role proved vital in bridging between researchers and public contributors, supporting communication, reimbursement processes, and continuity of relationships. Doctoral researchers emphasised the importance of building trust, using accessible language, and developing distinct relational skills alongside academic expertise. From these collective insights, the team developed practical recommendations for three key audiences: doctoral students, PPI contributors, and PPI coordinators. PPI in doctoral research offers mutual benefits for contributors and early-career researchers, strengthening both research quality and personal and professional development. Genuine co-production requires time, respect, and institutional support, but can foster strong partnerships and more relevant, impactful research. The recommendations presented here aim to help doctoral researchers, PPI contributors, and coordinators embed authentic, equitable, and sustainable involvement across health and social care research. Patient and Public Involvement (PPI) means that research is carried out with and by members of the public, rather than to or about them. It helps research to be more relevant, inclusive, and useful for the people it aims to benefit. This paper describes and examines the experience of involving patients and the public in doctoral (PhD) research. Doctoral projects often have limited funding and time, but they also offer opportunities for close, long-term collaboration between students and public contributors. The aims and content of the paper was developed collaboratively by doctoral researchers, public contributors, and a PPI coordinator who reflected together on what worked well and what could be improved. The process showed the importance of building trust, communicating clearly, and recognising that both researchers and public contributors bring valuable skills and knowledge. Having a PPI coordinator to support students and contributors, provide training, and manage practical arrangements such as payments was also found to be helpful. From these shared experiences, practical recommendations were developed for doctoral students, public contributors, and PPI coordinators. These focus on getting started, building relationships, communicating effectively, and ending involvement respectfully. Meaningful PPI during doctoral research was found to improve study quality and impact for patients, families, and the wider public, while helping new researchers to develop collaborative and inclusive ways of working that keep the focus on what matters to patients and the public.
Perforator flaps represent an effective and versatile option for the reconstruction of soft tissue defects around the knee. However, interindividual variability in perforator origin, course, and pedicle characteristics often complicates flap selection and increases intraoperative uncertainty. This study aimed to evaluate the role of computed tomography angiography (CTA) in guiding perforator selection and supporting individualized preoperative planning for knee soft tissue reconstruction. Between August 2014 and March 2024, we retrospectively evaluated 16 patients who underwent 17 flap procedures after preoperative CTA for reconstruction of soft tissue defects around the knee. The location, course, and length of candidate perforators were evaluated using the Picture Archiving and Communication System (PACS). Based on comparative preoperative assessment, the most suitable perforator was selected for flap design. Seventeen flaps were harvested in 16 patients, including 16 CTA-selected perforator-based flaps and one random-pattern local flap selected after CTA showed no suitable perforator. All 16 CTA-selected target perforators were identified intraoperatively as anticipated, yielding a target-perforator identification discrepancy rate of 0/16. Complete skin-paddle survival was achieved in 15 of 16 CTA-selected perforator-based flaps and in 16 of 17 flaps overall. One CTA-selected perforator flap developed partial distal necrosis and healed conservatively; no total flap loss occurred. The random-pattern local flap survived completely without complications. CTA provided a practical decision-support method for preoperative assessment of perforator anatomy around the knee. In this proof-of-concept retrospective Level IV case series, the structured CTA-guided workflow was feasible and showed qualitative concordance with intraoperative findings, supporting individualized flap planning according to defect characteristics and perforator anatomy. Because no Doppler-only, non-CTA, or historical control group was included, these findings demonstrate feasibility and anatomical concordance rather than measurable clinical superiority over other mapping modalities.
Cerebral tuberculoma is an infrequent but life-threatening manifestation of tuberculosis whose diagnosis and treatment are uniquely complicated by pregnancy-related physiological changes. Evidence to guide clinicians remains fragmented and largely anecdotal. We systematically searched MEDLINE, LILACS and grey literature to May 2025 for reports of cerebral tuberculoma in pregnant or postpartum women. Twenty-seven studies (24 case reports, 2 descriptive studies, 1 case series) from 20 countries met inclusion criteria, yielding individual-level data on 33 patients. Demographics, clinical features, diagnostics, management and maternal-fetal outcomes were extracted and synthesized. Median maternal age was 26 years (IQR 23-29). Diagnosis occurred ante-partum in 45% and post-partum in 55%, at a median gestational age of 31 weeks. Headache (59%), fever (56%) and seizures (48%) predominated; cranial-nerve palsies (54%) and focal paresis (50%) were common neurologic signs. Magnetic resonance imaging (MRI) revealed solitary or multiple contrast-enhancing lesions, chiefly supratentorial but infratentorial in 35%. Cerebrospinal fluid (CSF) showed proteinorrachia (n = 10/15) and mononuclear pleocytosis (n = 8/12, 66.67%); positivity of CSF or biopsy interferon-γ release assays (100%, n = 3/3) outperformed CSF culture (33.3%, n = 3/9) and CSF polymerase chain reaction (PCR; 12.5%, n = 1/8). Standard four-drug therapy plus corticosteroids was administered in 97%, typically > 12 months; 60% underwent neurosurgical biopsy or resection. Maternal mortality was 4.6%, and persistent neurological sequelae occurred in 33.3% of cases (n = 7/21). Among 26 live pregnancies, preterm delivery occurred in 72%; neonatal complications affected 50%, including congenital tuberculosis (17%) and neonatal death (17%). Although cerebral tuberculoma during pregnancy is rare, delayed recognition contributes to substantial maternal morbidity and adverse neonatal outcomes. Our synthesis underscores the diagnostic value of advanced imaging and CSF interferon-γ assays, supports prolonged first-line therapy with adjunctive steroids, and highlights critical gaps in evidence-based guidelines. Multicentre prospective registries are urgently needed to refine diagnostic algorithms and optimise maternal-fetal care.
Allogeneic hematopoietic stem cell transplantation remains critical for treating high-risk hematological malignancies like leukemia. Despite advances in treatment, early mortality remains clinically significant, with approximately 6-11% of patients dying within the first 100 days after transplantation. This highlights the need for dynamic monitoring strategies beyond static pre-transplant risk assessments. This study introduces a novel, interpretable, real-time proof-of-concept monitoring framework that continuously assesses individualized mortality risk during treatment using routinely collected clinical data. The framework employs deep learning models to predict seven-day mortality risk based on 22 laboratory parameters from the previous 14 days and five demographic features. The framework incorporates an explainability method that provides time-resolved insights into predictions, which can be aggregated across time intervals or patient groups for broader interpretation. We evaluated the approach on data from 891 patients treated at the University Hospital of Düsseldorf (UKD; 2004-2019), as well as on an independent cohort derived from the MIMIC-IV database. Our experiments demonstrate that the predicted mortality risk aligns with observed outcomes, achieving a patient-level AUROC of 0.95 in the primary (UKD) cohort. Preliminary expert evaluation suggests that the predictions and explanations are intuitive and clinically relevant, supporting awareness of complications and highlighting potential for timely intervention.
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Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare, genetic disorder mainly characterized by progressive heterotopic ossification (HO). Flare-ups in FOP, involving soft tissue swelling, pain, warmth, and stiffness, often precede HO. We report development of the FOP-FLEX-R© questionnaire (Ipsen, 2026), providing clinical researchers with a comprehensive tool to assess patient experiences during flare-ups, and address the limitations of existing patient-reported outcome measures (PROMs). The FOP-FLEX questionnaire was developed through: a targeted literature review to identify signs, symptoms, and impacts of FOP; concept selection and questionnaire development activities; validation of content and readability in expert consultations and patient interviews; revisions to create the FOP-FLEX-R© questionnaire. The literature review identified 42 'sign and symptom' and 28 'impact' concepts. Ten concepts were selected for inclusion in the initial FOP-FLEX: swelling, pain, skin warmth, stiffness, skin redness, impaired daily activities, frustration, bother, fatigue/tiredness, and appetite loss. Consultations with clinical experts (n = 5) and interviews with patients (n = 12) affirmed these concepts. Cognitive debriefing with the same patients indicated the FOP-FLEX was understandable and easy to complete, though some revisions were made, including those to enable the assessment to be completed by younger patients and to remove non-flare-up items. The FOP-FLEX-R© questionnaire offers a comprehensive, content-validated PROM for use in clinical trials, to understand the lived experience of flare-ups in FOP and evaluate the benefit of new therapies.
Functional ionic liquids (ILs) have been effectively used as probe materials to detect numerous targets, including heavy metal ions. Yet, their application for real-time, visual detection of trace levels of Hg2+, a key heavy metal contaminant, remains rare. In this study, we have prepared a fluorescent room-temperature ionic liquid, trihexyltetradecylphosphonium 2-(naphthalen-1-yl)-1H-phenanthro[9,10-d]imidazolate (BTNP), and its low-dimensional material (nBTNP) via a reprecipitation approach and characterized them using various spectroscopic and microscopic techniques. Neat BTNP showed potential as a solvent-free fluorescent ink, performing well as a secure writing medium. The nBTNP system served as a highly selective fluorescent chemosensor for detecting mercury ions (Hg2+), achieving detection and quantification limits in the nanomolar range, which compare favorably with those of previously reported sensors and reflect the probe's high sensitivity towards Hg2+. Utilizing its strong fluorescence response, the system enabled highly sensitive and selective quantification of Hg2+ ions in environmental soil samples. Moreover, the nBTNP-Hg2+ ensemble serves as a promising probe for I- ion detection through fluorescence-based assays. We have additionally demonstrated low-cost test strips for Hg2+ detection. Overall, the present report outlines a practical, robust strategy for designing IL-mediated fluorescent probes tailored for environmental monitoring.
The increasing global demand for food and the progressive constraints on natural resources underscore the need for advanced remote sensing frameworks to monitor, manage, and analyze agricultural systems. This study aimed to identify dominant crop-rotation patterns and quantify their spatiotemporal dynamics in an agricultural region of Shush County, Khuzestan Province, Iran. We utilized a three-year Sentinel-2 Level-2A time series (2023-2025) and implemented a supervised classification based on the Support Vector Machine (SVM). Training samples were derived from field surveys, NDVI time-series analysis, and the local cropping calendar. Final rotation maps were generated by layer-intersection operations in ArcMap. Accuracy assessment demonstrated stable, high precision across years: overall classification accuracies for rotation class's wheat-wheat-wheat, wheat-rice-wheat, and wheat-canola-wheat were 98.55%, 98.33%, and 98.58%, respectively, confirming the algorithm's strong capability for crop discrimination and temporal consistency. Spatiotemporal analyses indicated that the three-year rotations wheat-rice-wheat and wheat-wheat-wheat occupied the largest shares of cultivated area, whereas wheat-canola-wheat represented a minor proportion. The integration of Sentinel-2 time-series, SVM classification, and GIS spatial analysis provides an accurate and operational framework for regional crop-rotation monitoring. These findings highlight the method's potential to support sustainable agricultural planning and decision-making through reliable multi-year rotation mapping.
Urothelial carcinoma, the predominant form of bladder cancer, represents a global public health challenge due to its high rates of recurrence and progression. At the molecular level, microRNA-21 (miR-21) has been characterized as an "oncomir" because of its ability to negatively regulate tumor suppressor genes, thereby promoting tumor survival and progression. In this context, the CRISPR/Cas9 system has emerged as a precise genome-editing tool. To investigate the biological effects of miR-21 modulation using CRISPR/Cas9-mediated genome editing in the T24 high-grade invasive urothelial carcinoma cell line. The CRISPR/Cas9 system was delivered as a ribonucleoprotein (RNP) complex. Editing efficiency was assessed using quantitative reverse transcription PCR (RT-qPCR). Functional effects were evaluated through gene expression assays, cell migration assays, as well as Matrigel invasion assays. The presence of the Cas9 protein was confirmed by immunofluorescence. CRISPR/Cas9 treatment targeting miR-21 showed a trend toward reduced miR-21 expression (p = 0.0563), although this did not reach statistical significance. A statistically significant increase in MASPIN (p < 0.0001) and PDCD4 (p = 0.0239), as well as a trend toward increased PTEN expression (p = 0.055), was observed following treatment. Functionally, a significant reduction in the migratory capacity of edited cells was observed after 48 h (p = 0.0334). The presence of Cas9 was successfully confirmed in transfected cells. These findings suggest that CRISPR/Cas9-mediated modulation of miR-21 may influence tumor suppressor pathways and reduce the migratory potential of urothelial carcinoma cells.
The Norwegian public-private partnership, CONNECT, identified the reimbursement submission case of selpercatinib-a first-line targeted therapy for RET fusion-positive non-small cell lung cancer (NSCLC)-as a unique opportunity to assess the role of structured expert elicitation (SEE) in conjunction with phase II evidence. This study aims to compare the potential of using SEE and other sources of external evidence with phase III clinical trial results to explore the possibility of facilitating earlier (conditional) reimbursement decisions. We conducted a series of cost-effectiveness analyses, grouping different sources of evidence (i.e., published clinical evidence and SEE) to estimate the long-term health and economic consequences of selpercatinib versus pembrolizumab plus pemetrexed and platinum-based chemotherapy for patients with advanced RET fusion-positive NSCLC in Norway. We developed a probabilistic partitioned survival model to estimate and compare costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) associated with evidence potentially available early in the product lifecycle, including SEE, with those using phase III evidence. ICERs consistently ranged between $8257 and $19,819 per QALY gained when we used SEE, either alone or in combination with additional external evidence, or when we used the phase III randomized controlled trial (RCT) evidence. The consistent cost-effectiveness results between pre-submission and post-submission phases support the potential of SEE to complement health technology assessment (HTA) and potentially inform earlier (conditional) reimbursement decisions for this single case study. However, future research should focus on refining SEE protocols for continued methodological development and validation to improve generalizability and applicability.
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A growing body of research has sought to understand the contextual factors that influence emotion regulation (ER) strategy choice. As a process that is usually involuntary to start and difficult to end, perseverative thought (PT) can be an ongoing context that influences how individuals respond to emotions. This study investigated how different PT dimensions, captured through written language, predicted subsequent ER strategy choice, including engagement (i.e., reappraisal, acceptance, problem-solving) and disengagement (i.e., experiential avoidance, distraction, expressive suppression) strategies. College students (N = 413) completed an experimental paradigm once a day for ten days. Each night, they underwent a PT induction writing task and were instructed to regulate (to feel better) and report their ER strategy use (1 = selected; 0 = not selected). We used the Linguistic Inquiry Word Count program to construct PT dimensions and multilevel logistic regressions to examine links between each PT dimension and subsequent ER strategy selection. Within individuals, higher negative valence during PT predicted a higher likelihood of selecting distraction. Higher self-focus during PT predicted a greater likelihood of selecting experiential avoidance and expressive suppression. Higher situation certainty, more social words, and more past focus during PT predicted a lower likelihood of selecting problem solving. Overall, the findings support the role of PT dimensions as important contextual features for ER strategy selection and highlight the value of computational linguistics and a dimensional approach for studying PT. The online version contains supplementary material available at 10.1007/s42761-026-00357-w.
As new evidence on the evaluation and management of patients with acute ischemic stroke continues to emerge, the American Heart Association/ American Stroke Association released its latest guidelines for the early management of acute ischemic stroke. These guidelines, for the first time, incorporate evidence-based recommendations for assessment and interventional management of pediatric patients with acute ischemic stroke. This update emphasizes on the new pediatric-specific recommendations and also discusses key differences from other pediatric stroke guidelines.
Given the biopsychosocial shifts that often accompany aging, it is reasonable to expect changes in one's view of themself as a sexual being (i.e., sexual schemas), which then has important implications for sexual and overall well-being. Participants (N = 206) wrote essays describing their sexual schemas, and responses were analyzed using computerized text analysis to identify seven central themes. Next, we conducted analyses to examine group differences in theme prominence by age group (ages 30-45, referred to as the early-midlife group, and the late-midlife group, 51-78), as well as the impact of sexual function on theme prominence. Late-midlife, compared to early-midlife women, had a higher prominence of relationship progressions and past abuse themes. Late-midlife women had a lower prominence of sexual pleasure and changes to their sense of self in their writings, though accounting for sexual function reduced these differences. The impact of one's sexual debut and the importance of emotional connection to one's schema did not differ between groups. Sexual function was associated with some (i.e., emotional connection, relationship progressions, sexual pleasure) but not all themes in both groups. In summary, sexual schemas appear to evolve across time, and these shifts may shape or be shaped by sexual function.
The rapid growth of the global economy and rising energy costs have underscored the need for efficient energy utilization across various sectors. To address this, we developed a novel data-informed digital shadow framework, enhancing energy management within a closed-loop control system, particularly in wastewater treatment facilities. Our approach centers on reducing biogas consumption in the fluidized bed reactor, a crucial component of the incineration process. The digital shadow simulates the entire incineration section by extracting model parameters for key components, including the furnace, dryer, mixer, and heat exchangers, from both physical models and operational data. System-level simulation was performed in AnyLogic software, integrating analytical calculations with data from positioning sensors. The model was informed by operational plant data and validated against historical system data. Evaluation of five operating scenarios demonstrated the capability of the digital shadow to capture system behavior and support operational decision-making. The evaluation of dynamic energy performance identified the most effective scenario, achieving a 40% reduction in biogas consumption while maintaining furnace operation within the temperature range specified by European standards. These findings demonstrate the effectiveness of the digital shadow approach and highlight its potential to deliver substantial annual cost savings in wastewater sludge incineration systems.
This prospective multicenter study aimed to compare the decision-making abilities of board-certified colposcopists and two commercially available large language models (LLM), ChatGPT-4o and ChatGPT-5, in cervical dysplasia management. Twenty-three anonymized real-life patient cases with multiple-choice (MC) questions regarding treatment decisions were used to assess answer quality. Ten board-certified colposcopists and the two LLMs addressed the MC questions. The gold standard was defined by two guideline authors. LLMs were prompted to justify their responses. Concordance rates were calculated and compared across all questions and histopathological subgroups, including cervical intraepithelial neoplasia (CIN), unspecific histopathological results, and cervical cancer cases. Clinicians and LLMs achieved similar overall concordance rates compared to the gold standard (69.6% for clinicians, 69.6% for ChatGPT-4o, and 65.2% for ChatGPT-5). ChatGPT-5 outperformed clinicians in precancerous lesions (81.8% vs. 66.4%), while clinicians excelled in complex cases with unspecific histopathology (86% vs. 60%). Clinicians showed a tendency to overtreat low-grade lesions (CIN I), opting for more intensive surveillance. ChatGPT-4o performed better than ChatGPT-5 in cervical cancer cases, though both models struggled with these scenarios. This study highlights the potential of LLMs as decision support tools in cervical dysplasia management, particularly for straightforward cases like precancerous lesions. However, clinicians remain superior in handling complex or ambiguous cases. The tendency of clinicians to overtreat low-grade lesions may offer the potential to test the implementation of a decision support tool for those cases. While LLMs show promise, exploring open-ended clinical scenarios and integrating retrieval-augmented generation could enhance their practical application.
Large language models (LLMs), such as ChatGPT, are rapidly transforming how patients identify and evaluate surgeons, marking the most significant shift in digital patient acquisition since the emergence of search engines. For decades, surgeon visibility online has depended on search engine optimization (SEO), a marketing strategy built around technical website performance, backlinks, and strategic content marketing designed to match keyword-based search behavior. This is in direct contrast to LLMs, which operate as "recommendation engines" and synthesize information across vast sources to generate personalized, conversational guidance in response to user queries. Rather than scanning ranked lists of links, patients increasingly can ask nuanced questions and receive narrative, context-sensitive answers. This shift fundamentally alters how expertise is recognized online. LLMs deemphasize traditional SEO signals and instead can emphasize more nuanced information ("language"), such as academic affiliation, peer-reviewed scholarship, institutional reputation, high-quality educational writing, and consistency across credible sources. This article outlines how LLMs form surgeon recommendations, why conventional SEO approaches are increasingly insufficient, and what practical steps surgeons can take to strengthen visibility in an artificial intelligence-mediated digital landscape. As generative artificial intelligence becomes embedded into everyday patient information-seeking, surgeons who adapt to this new recommendation paradigm can be best positioned for the next era of online discoverability.
To identify symptom phenotypes among breast cancer survivors using latent profile analysis (LPA) and examine differences in fear of cancer recurrence (FCR) and social support levels across phenotypes. A multicenter cross-sectional study recruited 357 breast cancer survivors through convenience sampling from three university-affiliated tertiary hospitals in Beijing between November 2024 and January 2025. Symptoms were assessed using the Memorial Symptom Assessment Scale (MSAS), while the Fear of Cancer Recurrence Inventory-Short Form and Social Support Rating Scale measured FCR severity and perceived social support. LPA was performed using severity scores of nine MSAS symptoms to determine the optimal symptom profile model. Three symptom phenotypes were identified: Emotion-reactive (33.9%), Somatic-burden fatigue-pain (13.2%), and Regulated low-symptom (52.9%). Significant differences among these phenotypes were observed in medical burden, treatment method, activities of daily living, and illness cognition (P < 0.05). FCR levels were significantly higher in the Emotion-reactive and Somatic-burden phenotypes compared with the Regulated low-symptom phenotype (p < 0.001, η2p = 0.199), with no difference between the two high-symptom phenotypes. After adjusting for covariates, differences in perceived social support across symptom phenotypes were not significant (p = 0.119, η2p = 0.012). Breast cancer survivors exhibit substantial heterogeneity in symptom phenotypes: those with Emotion-reactive and Somatic-burden fatigue-pain phenotypes experience higher FCR levels, whereas individuals with the Regulated low-symptom phenotype show better symptom control and comparatively lower FCR levels. Integrating symptom phenotypes with FCR may aid rapid identification of high-risk subgroups and support precision nursing in survivorship care.