Conectar
by Forest W. Arnold, Leslie Wolf Parrish, Subathra Marimuthu, Jamie Findlow, Angela Quinn, Vidyulata Salunkhe, Daniya Sheikh, Phillip Bressoud, T’shura Ali, Dawn Balcom, Mohammad Ali, Ryan S. Doster, Deepti Deepti, Mohammad Tahboub, Fama Ndiaye, Jay Lucidarme, Stephen A. Clark, Ray Borrow, Paul Balmer, Steven Gootee, for the CERID study group
BackgroundNeisseria meningitidis is a cause of meningitis and outbreaks of it among young adults, especially college students. Rates of nasopharyngeal colonization and prevalence of specific capsular groups vary with age, geography as well as time, and may be influenced by meningococcal vaccination. The objective of this study was to measure the change in colonization rate, and define which meningococcal genogroups were present, in college students over a 3-month semester.
MethodsThis was a prospective, longitudinal cohort study with sequential oropharyngeal swabbing among college students at the University of Louisville (UofL) in Louisville, Kentucky from August to November 2022. Participants were ≥18 years of age and were enrolled within 48 hours of moving to campus-affiliated housing. Oropharyngeal swabs were collected at enrollment, one month and at three months. Samples were screened for N. meningitidis, and isolates were characterized using phenotypic and genotypic methods. Behavior questionnaires were obtained at each visit to identify risk factors for N. meningitidis colonization.
ResultsA total of 1047 participants were seen initially, of whom 821 attended all three visits. The baseline colonization rate was 3.5% followed by 3.9% after one month and 5.7% after three months. The genogroups of recovered isolates were capsule null (48%), B (38%; of which 11% were expressing capsule) and E (12%). No genogroup ACWY isolates were recovered. A total of 36% of participants had a history of receiving at least one MenB vaccine dose and 74% had a history of receiving at least one MenACWY vaccine. Risk factors for N. meningitidis nasopharyngeal carriage included being a second-year student, living on campus for the second year, smoking/vaping, kissing and sexual contact.
ConclusionsAn increase in N. meningitidis colonization over the 3-month semester was observed from 3.5% to 5.7%. The overall proportion of student carriers was significantly lower, and there were no genogroup A, C, W or Y strains isolated compared to studies conducted prior to the availability of meningococcal vaccines and the COVID-19 pandemic. However, genogroup B carriage, transmission and acquisition were almost identical to pre-COVID pandemic studies. This study reinforces the importance of periodic epidemiological monitoring of carriage as well as disease.
Keloids are chronic fibroproliferative skin disorders with high recurrence rates and limited treatment options, yet reliable diagnostic biomarkers are lacking. Current classification systems rely heavily on clinical observation, underscoring the need for objective, noninvasive tools. In this exploratory study, serum-based 1H nuclear magnetic resonance (NMR) measurement combined with short-time Fourier transform (STFT) for time-frequency analysis was performed, followed by principal component analysis (PCA), to investigate potential patient subgroups. Serum samples from 29 patients were analysed and PC1 scores suggested two potential patient subgroups. Retrospective analysis showed that these subgroups differed primarily in keloid aetiology: one group predominantly included cases arising from unclear or minimal causes (e.g., acne, folliculitis), whereas the other comprised cases following clear traumatic events (e.g., surgery). Although most clinical variables showed no significant differences, significant differences in aetiology and Japan Scar Workshop Scar Scale (JSS) scores support the biological relevance of this separation of subgroups. These findings suggest that the time-frequency features of NMR signals from serum samples capture systemic characteristics associated with keloid pathophysiology. If validated in larger cohorts, this approach may serve as a noninvasive adjunct to clinical assessment and lay the foundation for objective patient stratification and precision-guided treatment strategies.
by Oksana Kovtun, Olga Cheshun, Oksana Pashchuk, Kostyantyn Dumchev
BackgroundUkraine’s HIV epidemic remains concentrated among key populations, with sex workers (SWs) facing overlapping vulnerabilities, including a history of injection drug use. Although overall HIV prevalence has declined, prevention coverage remains below national and global targets. Accurate mapping of sex work hotspots is essential for effective outreach, yet existing data are fragmented and incomplete, especially in privatized and digitally mediated environments. This study aimed to systematically identify and characterize sex work venues across eight Ukrainian cities and assess their coverage by HIV prevention services.
MethodsIn 2021, we conducted a two-stage, multi-informant mapping study across eight Ukrainian cities, interviewing 1,212 secondary and 2,277 primary key informants, including SWs. Hotspots were characterized by type, perceived safety, access modality, operating schedule, and presence of SW subgroups. We used descriptive statistics, exploratory factor analysis, and multivariable mixed-effects regression to identify factors associated with HIV prevention service coverage.
ResultsOf 2,581 identified hotspots, 2,118 (82.1%) were validated as active. Apartments (43.2%), virtual platforms (11.7%), and street-based sites (11.1%) were the most common. Only 13.7% of hotspots were registered in the national HIV service registry, while 34.1% received prevention service delivery and 18.9% were reached by mobile vans. Coverage was highest at street-based and office-type venues and consistently lowest in private, virtual, and pimp-mediated settings. Service coverage was positively associated with 24/7 or daytime operation, higher perceived safety, open access, and the presence of SWs who inject drugs.
ConclusionsThis study provides comprehensive mapping of sex work hotspots in Ukraine, revealing persistent gaps in HIV prevention for less visible and harder-to-reach SWs. Community-led mapping achieved high validation rates (86.8%) and identified substantial unmet needs in digital and concealed hotspots. Routine hotspot mapping, combined with engagement with SW communities, is essential for data-driven, equitable, and adaptive HIV responses in rapidly changing contexts.
by Guohui Wang, Lu Liu, Hanshu Zhang, Panpan Mao, Saijuan Lu, Xiaofang Zhang, Xingde Li, Cangsang Song
BackgroundLiver transplantation (LT) is an effective treatment for patients with end-stage liver disease. In recent years, more and more evidence has supported the association between gut microbiota dysbiosis and the pathogenesis and progression of liver diseases.
MethodsThe study included 36 patients who received tacrolimus treatment after liver transplantation. Patients were stratified into subgroups according to three key variables: tacrolimus treatment duration, whole-blood tacrolimus concentration, and tacrolimus concentration-to-dose (C/D) ratio. Fecal samples and whole-blood specimens were collected from all participants. The Illumina HiSeq X platform was used to detect the gut metagenome, analyzing the composition and characteristics of the gut microbiota. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology was employed to detect metabolites of the gut microbiota, revealing their metabolic profiles.
ResultsAs the duration of tacrolimus use increased, the diversity of the gut microbiota also increased, and the abundance of Escherichia coli_D and Bacteroides stercoris rose. Additionally, the abundance of Brunovirus and Uetakevirus tended to decrease. The abundance of gene functions related to chemical carcinogenesis and bacterial invasion of epithelial cells significantly decreased. In the gut microbiota metabolites, 16 substances like Astragaloside A and Acetyl-L-carnitine significantly increased, while 108 substances like Capsaicin and TLK significantly decreased. Within a certain range, as the concentration of tacrolimus in whole blood increased, the diversity of the gut microbiota increased. The abundance of Phocaeicola and Klebsiella increased, and the abundance of Peduovirus among viruses also rose. However, excessively high concentrations may lead to a decrease in the diversity of the gut microbiota and a decrease in the abundance of Phocaeicola. With respect to the C/D ratio, increased ratios were linked to significantly higher levels of 57 fecal metabolites (e.g., PC 34:2, 5-Methyl-2’-deoxycytidine), whereas 13 metabolites (e.g., FAHFA 2:0/16:0) showed substantial declines.
ConclusionsTacrolimus treatment is associated with distinct alterations in gut microbiota and metabolites among LT recipients. These findings provide a preliminary framework for future investigations aimed at optimizing immunosuppressive regimens, although their clinical translational potential requires validation in larger-scale, prospective cohort studies.
Mindfulness-Based Interventions (MBIs) have gained traction in various healthcare settings, particularly for stress reduction among healthcare professionals. This meta-analysis aimed to evaluate the effectiveness of MBIs on reducing stress and depression in obstetrical nurses.
A comprehensive literature search was done across multiple databases, including Cochrane Library, PsycINFO/PsycNet, PubMed/MEDLINE, Web of Science, and Google Scholar. The risk of bias for each included study was assessed using the Cochrane Risk of Bias Tool. Subgroup analyses were done according to intervention time (less than 8 weeks, 8 weeks, more than 8 weeks) and population. Meta-analysis was done using random-effects models. Effect sizes were calculated using standardized mean differences (SMD). Heterogeneity was assessed using the I 2 statistic.
The sample size in 55 studies was 4612 nurses and midwives (2904 in the intervention group and 1708 in the control group). The meta-analysis showed a significant overall effect of MBIs on reducing stress levels (SMD = −0.71; 95% CI [−0.97, −0.44]; p < 0.001), and depression (SMD = −0.74; 95% CI [−1.35, −0.13]; p < 0.001) among midwives and nurses. Subgroup analysis showed that the effects of intervention duration on reducing stress (X 2 = 3.01, p = 0.220) was not significant, but its effect on depression (X 2 = 61.46, p = 0.000) was significant.
Healthcare organizations should integrate structured MBIs into staff wellness initiatives to promote mental well-being. Nursing education programs can include mindfulness components to strengthen coping skills. Future work should also examine combined mindfulness–CBT programs (e.g., MINDBODYSTRONG) and address organizational factors contributing to burnout for a more comprehensive approach.
To assess the association between ambient ozone (O3) exposure and semen quality among men with unhealthy behaviours and low income.
A case-control study was conducted from February 2024 to January 2025, in which male participants aged 18–45 years were recruited from Foshan, and following propensity score matching, a total of 820 participants were included in the final analysis.
The evaluated the association between O3 exposure during the 70–90 days, 10–14 days, 0–9 days and 0–90 days prior to semen collection and semen quality using stepwise conditional logistic regression analyses, and restricted cubic splines were incorporated into the models.
O3 exposure during the 70–90 days and 0–90 days preceding semen sample collection was significantly associated with an increased risk of low semen quality, with ORs of 1.020 (95% CI 1.003 to 1.039) and 1.056 (95% CI 1.008 to 1.108), respectively. Additionally, O3 exposure during the 0–90-days period showed a significant positive association with abnormal sperm concentration. A non-linear relationship between O3 exposure and sperm concentration was also observed. Notably, O3 exposure during the 0–9 days before semen collection was inversely associated with the risk of low semen quality. Subgroup analyses across age, lifestyle factors and socioeconomic strata revealed no significant effect modifications.
This study found that O3 exposure during the 70–90 days and 0–90 days before sampling was associated with reduced semen quality in men with unhealthy behaviours and low income.
Positive aspects of caregiving among family carers of persons living with dementia not only benefit the carers' health, but also enhance the quality and sustainability of invaluable informal care resources. To better inform the development of carer support intervention to optimise positive aspects of caregiving, this paper tested the integrative theoretical model based on stress coping and meaning-making paradigms.
Longitudinal exploratory study.
From January 2018 to August 2021, 390 Chinese family carers of persons living with dementia were recruited from the geriatric clinics in Hong Kong. The criterion variable was measured by the Positive Aspect of Caregiving Scale at baseline and 6 months thereafter. The predictors were measured using the Dementia Management Strategies Scale, the Caregiving Self-Efficacy Scale, the Meaning-Focused Coping Scale, the Medical Outcome Study Social Support Survey, the Duke University Religion Index, the Positive Affect Index and the Intrinsic Motivations to Care. Path analysis tested the hypothesised model.
The carers aged 56.2 (SD = 12.2); about two-thirds being female and adult-child caregivers. The hypothesised model showed an unsatisfactory model fit. The model was optimised by modification index with consideration of the theoretical plausibility in making the changes (CFI = 0.971, RMSEA = 0.057, SRMR = 0.027). After adjusting the baseline PAC, the 6-month PAC was predicted by self-efficacy in controlling upsetting thoughts and obtaining respite as well as meaning-focused coping. Various contextual factors strengthened the self-efficacy and meaning-focused coping, indirectly increasing PAC. Whereas carers' intrinsic motivation towards care and good dyadic relationships increased the carer's self-efficacy in emotional regulation, social support and religiosity played indispensable roles to facilitate meaning-focused coping.
PAC in dementia context is evolved from an integration of stress coping and existential meaning-making paradigms. Enhancing emotion and role regulation as well as meaning-focused coping are crucial to enhance the positive experience of the family carers.
This project has generated a theory-driven and evidence-based predictive model to explain the manifestation of positive aspects of caregiving in dementia caregiving. The findings provide precise directions on how to empower family caregivers to create a fulfilling and meaningful caregiving adventure.
Substantial evidence indicates the role of positive aspects of caregiving in enhancing the carers' health outcomes in the context of dementia. However, inadequate theorization of this phenomenon delimits the momentum to develop proactive strategies to optimise such a positive caregiving experience. This longitudinal study indicated that positive aspects of caregiving are evolved from an integrative stress coping and existential meaning-making paradigm. More specifically, a sense of self-efficacy in emotional and role regulation as well as the use of meaning-making coping predict a higher level of positive aspects of caregiving. A context, which is characterised by high religiosity, good intrinsic motivation of care and a good dyadic relationship, also favours the cultivation of this positive experience during life adversity. This study facilitates a paradigm shift in supporting family carers in a dementia context and advances the theorization of positive human experience in facing life adversity.
The reporting method complies with the STROBE, stands for observational study.
Family carers of persons with dementia actively shared their experience in family caregiving.
To explore the relationship between sleep and cognitive frailty in older adults.
A systematic review and meta-analysis.
The Web of Science, Cochrane Library, CINAHL, Embase, PsycINFO and PubMed databases were searched from inception to October 28, 2024.
Two investigators independently conducted literature screening, data extraction and quality assessment. The Joanna Briggs Institute Critical Appraisal Tool and Newcastle–Ottawa Scale were used to evaluate methodological quality. This review followed PRISMA guidelines.
This review included 13 articles involving 14,223 individuals, and 10 studies included in the meta-analysis. Across 13 studies, the overall prevalence of cognitive frailty was 25%. Sleep problems were categorised into four categories; the results reported that poor sleep quality, long sleep time and insomnia were correlated with the presence of cognitive frailty. However, the relationship between short sleep time and cognitive frailty was not significant.
This review quantitatively suggested that sleep parameters such as long sleep time, insomnia and poor sleep quality were correlated with the presence of cognitive frailty. Future research should adopt longitudinal designs and use validated instruments to measure both quantitative and qualitative aspects of sleep, thereby facilitating a thorough examination of the strength of the relationship between sleep and cognitive frailty, as well as the direction of causality.
The review highlights the need to integrate comprehensive sleep assessments and targeted interventions into nursing care plans for older adults to enhance their sleep health. The findings will provide support for the development of effective interventions to prevent and manage cognitive frailty in the older population.
No patient or public contribution.
To investigate diabetes family involvement, including supportive and nonsupportive family behaviours in China, and explore the relationships among opposite forms of family involvement, diabetes self-management and glycaemic control.
A cross-sectional study.
Type 2 diabetes patients were recruited from hospitals in Nanjing, Shanghai and Jinan, and communities across China, between April 2023 and August 2023. A total of 1648 patients completed questionnaires regarding diabetes family involvement, diabetes self-management, perceived glycaemic control and patient characteristics. Data analysis was conducted using SPSS 26.0 and PROCESS macro.
The mean scores for supportive and nonsupportive family behaviours were 19.14 out of 40 and 12.47 out of 30, respectively, resulting in an overall family involvement score of 6.67. Overall family involvement, especially supportive family behaviours, was positively related to diabetes self-management and perceived glycaemic control, whereas nonsupportive family behaviours were not. Diabetes self-management partially mediated the relationships between both overall family involvement and supportive family behaviours with perceived glycaemic control.
Diabetes family involvement was suboptimal. Overall family involvement, especially supportive family behaviours, could not only directly improve glycaemic control but also indirectly enhance it through promoting diabetes self-management.
The findings highlight the importance of promoting supportive family involvement and patient self-management in diabetes management.
This study endorses the necessity for healthcare professionals to integrate the family unit into diabetes management and implement interventions at the family unit level, to address the neglect of families in current interventions. It also advocates for promoting supportive family involvement rather than all family involvement in future interventions. Promoting supportive family involvement and patient self-management can better improve patients' glycaemic control and alleviate the burden on medical and social systems.
This study adheres to the STROBE guideline of reporting.
No Patient or Public Contribution.
To elucidate the essential strategies used by home-visit nurses to support the independence of individuals with dementia who live alone.
Qualitative interview study employing the Interpretive Description methodology.
Purposive sampling was conducted across three home-visit nursing offices in Tokyo. Individual semi-structured interviews were conducted with 14 home-visit nurses between June and August 2022. The interviews explored the strategies the participants employed while caring for individuals with dementia living alone. The transcribed data were analysed using reflexive thematic analysis.
Four strategies were identified: Strategy 1. Cultivating a relationship of trust to manage client refusal, Strategy 2. Fostering a balance between client and practical realities, Strategy 3. Optimising limited support resources and Strategy 4. Educating and advocating for a lack of understanding among supporters.
Home-visit nurses incorporate their standard practices into four strategies at both the direct care and support network levels to support independent living of individuals with dementia living alone. These strategies address the challenge of balancing autonomy with safety and health protection, which is a key consideration in supporting this population.
The findings provide guidance for home-visit nursing practice and inform the development of educational programmes to enhance their training.
This study advances understanding of how home-visit nurses navigate the challenges of autonomy, safety and health for people with dementia living alone, offering insights to inform future research and educational initiatives.
This study adhered to the Consolidated Criteria for Reporting Qualitative Research.
This study did not include patient or public involvement in its design, conduct, or reporting.
To explore the role transition journey of spousal caregivers of people living with dementia based on transition theory.
A meta-synthesis.
This review employed a directed content analysis approach to systematically synthesise qualitative evidence. The findings were reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines and the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis.
A comprehensive search was conducted in eight electronic databases for studies published from the inception of each database to November 2024.
This review ultimately included a total of 31 studies. Three themes were identified, including role stage, role transition properties and role transition conditions of spousal caregivers of people living with dementia. Role stage of spousal caregivers of people living with dementia encompassed seven sub-themes; role transition properties of spousal caregivers of people living with dementia included five sub-themes; role transition conditions of spousal caregivers of people living with dementia involved six sub-themes.
This review synthesises evidence to explore the role transition journey of spousal caregivers of people living with dementia. The role transition properties highlight the impact of critical points and events, as well as caregivers' awareness, engagement, change and difference and transition time span during their role transition journey. The role transition conditions emphasise that personal meanings, cultural beliefs and attitudes, socioeconomic status, preparation and knowledge, as well as community and society simultaneously influence the role transition journey of the caregivers.
The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guided the reporting of the study.
No patient or public contribution.
PROSPERO registration number: CRD 42024623402
The aim of this study was to develop a predictive model of nutritional risk in elderly CAPI patients through retrospective cross-sectional data, to identify core predictors applicable to community/nursing home settings, and to validate the predictive augmentation of the combined Braden Score and Nutritional Blood Indicator in hospitalised patients, to provide a basis for stratified nutritional risk management. A retrospective study was conducted to include 424 elderly CAPI patients. They were divided into two groups according to NRS2002 score. Demographic parameters, physiological function parameters and blood parameters were collected. All above indicators of the patients with CAPI were analysed to explore their correlation with nutritional risk. Among 424 participants, 294 patients (69.34%) were at nutritional risk. Independent risk factors identified were aged ≥ 70 years, reduced intake in the last week, and decrease in BMI, Braden score, ALB (albumin), and PA (prealbumin) levels. The AUCs of the first four parameters mentioned above and all the above parameters were 0.816 and 0.872, respectively. The value of aged ≥ 70 years, reduced intake in the past week, BMI, and Braden score in combination to predict and assess nutritional risk is high, which can be used to predict nutritional risk for elderly patients with CAPI who are at home or in nursing homes. The combination of the above parameters combined with albumin and prealbumin has an even higher predictive value in elderly patients hospitalised with CAPI.
Surgical site infections (SSI) in vascular surgery have a huge impact on patients’ morbidity and mortality and healthcare systems worldwide. Dialkylcarbamoylchoride (DACC) is a synthetically produced material that can irreversibly bind and inactivate bacteria that exhibit cell-surface hydrophobicity (CSH). The DACC in the Reduction of Surgical Site Infection (DRESSINg) trial is a multicentre randomised controlled trial which aims to assess the effectiveness of DACC-coated post-operative dressings in the prevention of SSI in vascular surgery. Seven hundred and eighteen participants undergoing clean or clean-contaminated lower limb vascular surgery will be randomised in a 1:1 ratio to either DACC-coated dressings or standard dressings for their postoperative wounds. The primary outcome is the incidence of SSI defined by the Centers for Disease Control and Prevention (CDC) criteria or total ASEPSIS score of 21 or more within 30 days of surgery. The secondary outcomes include satisfactory wound healing with a total ASEPSIS score of 10 or less, quality of life pre and post surgery, Bluebelle wound healing scores, resource use and financial (£), and environmental (KgCO2e) cost analyses. This multicentre randomised controlled trial will provide level 1 evidence on the effectiveness of preventing SSI in lower limb vascular surgery.
Although caesarean section (CS) has been reported as one of the potential risk factors for postpartum depression (PPD), there is uncertainty about the association between repeat CS and the risk of developing PPD. We sought to explore whether repeat CS will further increase the risk of PPD compared with primary CS.
Observational cohort study.
A tertiary maternity hospital in Shanghai, China.
571 women, aged 20 years and older, full-term parturients with singleton scheduled for elective primary or repeat CS were enrolled between December 2020 and September 2021.
An increased risk of PPD was defined as the total scores of the Edinburgh Postnatal Depression Scale ≥11. The primary outcome was the risk of PPD at 6 weeks postpartum. Secondary outcomes included the risk of postpartum depressive symptoms at 48 hours after CS, pain situation at 48 hours after CS and 6 weeks postpartum.
Among the 571 women included in the final analyses, PPD at 6 weeks postpartum occurred in 41 women (24.0%) in the repeat CS group (n=171) versus 93 (23.3%) in the primary CS group (n=400). After adjusting for the confounders, repeat CS was not associated with higher odds of PPD at 6 weeks postpartum (adjusted relative risk (aRR), 1.04 (95% CIs 0.73 to 1.45); adjusted risk difference (aRD), 0.03 (95% CI –0.32 to 0.37), p=0.84). Compared with primary CS, women with repeat CS were more likely to report significant uterine contraction pain (NRS ≥4) at 48 hours after CS (aRR, 1.51 (95% CI 1.23 to 2.03); aRD, 0.41 (95% CI 0.12 to 0.71), p
Repeat CS was not associated with the increased risk of PPD at 6 weeks postpartum in comparison to primary CS. But women undergoing elective repeat CS were more likely to suffer significant uterine contraction pain in early postoperative stage.
Cancer is a major social, public health and economic problem worldwide, causing physical and psychological distress to patients. The emerging telemedicine model in healthcare delivery has garnered significant interest because of its potential effectiveness.
To assess the effects of telemedicine on distress, physical function, and self-efficacy in cancer patients.
This meta-analysis was conducted and reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 checklist.
Six databases were searched for relevant studies published from inception to October 2024. The literature search and data collection were conducted by two separate researchers. The quality of the methodologies in the studies included was evaluated using the Cochrane Risk of Bias Tool. Data analysis was conducted using Review Manager (version 5.4).
Compared with the control group, patients who received telemedicine experienced significant reductions in distress (SMD = −0.44, 95% CI: −0.62 to −0.25, p < 0.00001, I 2 = 46%) and significant increases in physical function (SMD = 0.11, 95% CI: 0.01–0.22, p = 0.04, I 2 = 0%) and self-efficacy (SMD = 0.46, 95% CI: 0.23–0.69, p < 0.0001, I 2 = 0%).
Telemedicine can effectively enhance the psychological health and physiological function of cancer patients, as well as their self-efficacy, suggesting a sustainable approach to the clinical care of cancer patients. Future studies are needed to further investigate the effectiveness of telemedicine interventions in different types of cancer patients and in different cultural contexts and to conduct long-term follow-up studies to evaluate their long-term effectiveness and cost-effectiveness.
This systematic review and meta-analysis provides evidence to offer effective and sustainable telemedicine care among cancer patients.
No patient or public contribution.
This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (Registration number: CRD42024604929) under the title ‘The effectiveness of death education on death anxiety, depression and quality of life in patients with advanced cancer: A meta-analysis of randomised controlled trials’. The full study protocol could be obtained at https://www.crd.york.ac.uk/PROSPERO/view/CRD42024604929
Diabetes is a leading cause of morbidity and mortality, contributing to complications such as cardiovascular disease, kidney failure and lower-limb amputations. Diabetic foot complications, such as structural deformities, ulceration and infection, present significant risks, necessitating early detection and intervention. This study explores the development and validation of artificial intelligence (AI) image analysis for diabetic foot screening, focusing on structural deformity identification which includes callus, hallux valgus and hammer toes, because they represent the earliest detectable visual risk markers for ulceration, preceding wound formation. Leveraging datasets comprising over 1000 healthy foot images and 215 diabetic foot deformity images, the model employed YOLOv5 for object detection, a convolutional autoencoder for anomaly detection, and DenseNet201 for anomaly classification. Initial internal validation yielded 91.1% anomaly detection accuracy, while anomaly classification accuracy improved to 88.57% following refinement. External validation using 27 participants achieved an overall accuracy of 85.2% and anomaly classification accuracy of 66.7%. Final evaluation on 35 unlabelled images demonstrated promising performance, with 88.57% accuracy, 90.47% precision and an F1 score of 86.11%. Integrated into the ‘Foot at Risk’ (FAR) mobile application, this AI-driven solution offers a scalable tool for early diabetic foot deformity detection. With larger dataset input for training and development, it can be utilised as an early screening tool for diabetic foot and integrated into existing community diabetic care model, facilitating timely intervention and improving patient outcomes.
To identify: (1) current evidence and gaps of PhD program components influencing PhD students' career outcomes; and (2) methods and tools used to assess the relationships between PhD program components and career outcomes.
PRISMA scoping review.
Search terms included PhD nursing students, PhD education, PhD-prepared nurse, PhD in nursing, nursing faculty, and assistant professor. Studies empirically assessing PhD program components and career outcomes (e.g., desires, attitudes, actual employment) were included. Two researchers conducted screening, data extraction, and inductive content analysis.
PubMed, Scopus, and CINAHL in October 2025, without year and geographic location restrictions.
The search yielded 379 studies. After title, abstract, and full-text screening, 13 studies were included. Analysis resulted in 10 factors spanning four categories: program preparation, readiness and satisfaction, impressions of the faculty role, and program support.
Experiences in the PhD program likely influence students' desire to pursue academia. While this review synthesized influential factors, given significant gaps in the literature, there are likely more factors influencing student career desires. A more robust understanding of the factors during the PhD program which influence career outcomes is needed.
This study did not include patient/public involvement in design, conduct, or reporting.
This study aimed to evaluate and rank the effectiveness of various acupoint stimulation therapies in alleviating cancer-related fatigue (CRF), a pervasive and distressing symptom among cancer patients.
CRF severely compromises patients' quality of life across treatment and survivorship stages. Despite growing interest in nonpharmacological interventions, comparative evidence on the efficacy of acupoint stimulation therapies remains limited.
A systematic review and network meta-analysis of 28 randomized controlled trials (RCTs) involving 2370 participants was conducted. Databases searched included MEDLINE, CINAHL, Embase, Cochrane, Web of Science, and Airiti Library. Interventions included acupuncture, acupressure, oil acupressure, moxibustion, and transcutaneous electrical acupoint stimulation (TEAS). Standardized mean differences (SMDs) were calculated using a random-effects model. Surface Under the Cumulative Ranking Curve (SUCRA) was used to rank therapies.
Oil acupressure (SUCRA: 73.6%), relaxing acupressure (73.4%), and acupuncture (72.7%) were the most effective interventions. Both professionally administered and self-administered therapies significantly reduced CRF, with no major differences in efficacy. Subgroup analyses revealed consistent effectiveness across cancer types, particularly breast and lung cancer, and treatment stages.
Acupoint stimulation therapies, especially acupressure and acupuncture, effectively reduce CRF and are suitable for integration into routine cancer care. Self-administered acupressure offers a practical, low-cost alternative, especially in resource-limited settings. Standardization of protocols and long-term studies are warranted to guide clinical implementation.
The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42024556455)
by Chao Feng, Guodong Chen, Yan Shu, Jing Chen, Wenxin Ye, Ligang Ren
IntroductionGiven the high recurrence rate of bladder cancer (BCa) and the significant adverse effects associated with conventional treatments, it is urgent to search for new clinical therapeutic targets and safer natural-derived compounds. Resveratrol (Res) has been demonstrated to exhibit cytotoxicity against various tumors. However, the signaling pathways and targets involved in inhibition of BCa cells still need further exploration. This study aims to investigate the mechanism of Res in Bca via suppression of the AURKA/STAT3 axis, providing important theoretical basis for subsequent further researches on Res for treating BCa.
MethodsDifferentially expressed genes were identified through bioinformatics methods and the binding sites of resveratrol were also identified. The cell survival rate was detected by the CCK8 method to calculate the concentrations of Res for 30% inhibition and for 50% inhibition. Then, flow cytometry was used to detect the cell cycle and apoptosis after treatment with different concentrations of Res. Immunofluorescence staining was used to detect the effects of Res and MLN8237 on the expression of STAT3. Western blot and qPCR analyses were used to verify the reliability of the effects of Res and MLN8237 on target proteins.
ResultsAURKA was identified as the potential target of Res by computational analysis. Further validation through CCK8 assays and flow cytometry demonstrated that Res could inhibit BCa cells and their cell cycle in a time- and dose-dependent manner. Immunofluorescence staining revealed both Res and MLN8237 suppressed STAT3 expression in BCa cells. Additionally, western blot and qPCR analysis confirmed that Res and MLN8237 inhibited the expression of AURKA and known target genes (VEGF, Bcl-2, and Cyclin D1).
ConclusionOur findings suggest that Res may regulate BCa cell expression through the AURKA/STAT3 axis, providing a theoretical foundation for the structural optimization of Res and the development of multi-target drugs for clinical application.
FreshRSS 