Search Results (383)

Sexual interactions are complex human exchanges that are further complicated in the digital domain. This is because the introduction of technology to sexual interactions has prompted change in not only sexual activity but also communication pertaining to consent. Challenges have emerged in defining, interpreting, and communicating sexual consent within a digital context. Accordingly, it is critical to understand how sexual consent is understood and communicated within digital contexts. Herein, the literature concerning digital sexual consent was reviewed and critically analyzed. This narrative review describes digital sexual consent practices, as well as critically analyzes the literature pertaining to sexual consent to identify similarities and differences between in-person and digital consent practices. It is suggested that digital sexual consent should be viewed as a subset of sexual consent rather than a separate sexual consent practice. Future directions pertaining to research and application are discussed. Full article

Background/Objectives: Online sexual violence is an increasingly prevalent form of gender-based harm facilitated by digital technologies, with significant consequences for the health, well-being, and rights of adult women. Despite growing attention to this phenomenon, women’s lived experiences remain underexplored, particularly regarding sexual consent and institutional responses. This study aimed to examine how adult women experience online sexual violence, how consent is negotiated or constrained in digital contexts, and how coping and institutional mechanisms are perceived. Methods: A qualitative study with a hermeneutic phenomenological approach was conducted. Data were collected through three focus groups with 23 women aged 21 to 42 years who were active users of social media. Results: Participants reported diverse forms of online sexual violence, including unsolicited sexual messages and images, persistent harassment, coercion, blackmail, and threats. Sexual consent was often undermined by emotional manipulation, social pressure, and fear, placing women in vulnerable positions. These experiences negatively affected well-being, contributing to anxiety, reduced self-esteem, fear, and difficulties in sexual and emotional relationships. Coping strategies were mainly individual, such as blocking perpetrators or reporting content, while social support was frequently perceived as insufficient. A generalized distrust of institutional responses emerged, with formal mechanisms viewed as ineffective or inaccessible. Conclusions: For the study participants, online sexual violence is increasingly normalized and concealed within digital environments, reinforced by anonymity and impunity. The findings highlight the need for continued research and the development of interventions that include early sexual and emotional education, awareness-raising initiatives, digital regulation, specialized professional training, and the strengthening of victim-centered support networks. Full article

Residential heating is a major contributor to atmospheric pollution, especially in populated areas. Traditional methods for measuring emissions, such as chimney probes, are limited due to the need for prior owner consent, which can compromise the reliability of results—particularly when detecting the illegal burning of materials like plastic or waste oil. This study introduces a mobile air pollution monitoring system using compact sensor modules installed on vehicles and drones. These autonomous modules are equipped with gas, particulate matter, and environmental sensors, along with Global Positioning System (GPS) tracking to record pollutant concentrations in real time and associate them with specific geographic locations. Field experiments conducted in Hungary and Uzbekistan demonstrated the system’s effectiveness in detecting elevated pollutant levels in rural areas with solid fuel heating and in urban zones affected by industrial activity and traffic. For instance, PM2.5 concentrations ranged from 15 μg/m³ in forested areas to as high as 160 μg/m³ in industrial zones, while CO₂ levels near chimneys exceeded background values by 15–25 ppm. Drone-based measurements enabled vertical profiling and direct analysis of emissions from individual chimneys, providing detailed spatial distribution data. The proposed mobile sensing approach allows for the accurate localization of pollution sources and the assessment of air quality variations within small-scale environments. This method overcomes limitations of stationary or pre-announced inspections and supports proactive environmental monitoring and enforcement. Full article

We prospectively evaluated whether cytotoxic T-lymphocyte (CTL) activation and T-cell receptor (TCR) Vβ clonality predict treatment-free remission (TFR) after tyrosine kinase inhibitor (TKI) cessation in chronic-phase chronic myeloid leukemia (CML). Forty-five patients with sustained deep molecular response (DMR) were enrolled (On-TKI, n = 38; Off-TKI, n = 7) and underwent one-year immuno-monitoring from consent. The primary endpoint was 12-month TFR, defined as retention of MR4. Overall, 32/45 patients (71%) maintained TFR at 12 months. Longer TKI exposure and stable DMR were associated with TFR; notably, patients fulfilling “≥7 years of TKI plus ≥1 year of DMR” and exhibiting CTL activation features—CD8 > CD4, memory > effector, and/or highly activated CTL clones on TCR Vβ repertoire—showed the highest likelihood of durable TFR. By contrast, NK cells, effector Tregs, and G-/M-MDSCs did not discriminate TFR status in this cohort. Although antigen specificity against CML stem cells was not directly tested, the memory-dominant CTL phenotype is consistent with immune control after antigen reduction. These findings suggest that a simple, clinically accessible strategy based on flow cytometric CTL profiling and TCR Vβ clonality may help inform TKI discontinuation decisions in CML. External validation is warranted to confirm transportability and refine clinical thresholds. Full article

In collaboration with various stakeholders, including learners, parents, teachers, district administrators, and community organizations, school social workers (SSWs) can positively influence the school ethos, reduce risks and barriers to learning, and increase learners’ resilience. This collaboration is particularly crucial in low- and middle-income countries, where psychosocial well-being support structures are lacking, significantly affecting learners’ well-being. This exploratory qualitative study aimed to explore the nature of collaboration in the practice of school social work in South African public schools in Gauteng province. Semi-structured interviews were conducted with 17 SSWs who provided informed consent. Reflexive thematic analysis confirms that SSWs actively promote and participate in interdisciplinary and inter-organizational collaboration to support learners. These collaborations were crucial for addressing complex issues such as child protection, substance abuse, mental health, and poverty. However, the identified challenges include limited participation by experts, key stakeholders, and parents, as well as poor coordination between the social development and education departments. These challenges hinder SSWs’ ability to address learners’ diverse needs effectively. Therefore, the study argues for a shift toward more formalized, uniform partnerships and proposes operational strategies to strengthen collaboration and the practice of school social work within the broader school system. Full article

Background: Human granulocytic anaplasmosis (HGA) is a tick-borne zoonotic infection caused by Anaplasma phagocytophilum and transmitted by Ixodes species. In temperate regions, HGA is considered seasonal, with most cases occurring during late spring and summer. We describe two cases of HGA diagnosed in January during a winter period with episodic temperatures exceeding thresholds for tick activity, highlighting atypical seasonal presentation and diagnostic challenges. Methods: This report details the clinical course, diagnostic reasoning, and management of two patients evaluated at a tertiary care hospital in Suffolk County, New York. Data were derived from direct clinical care and the electronic health record. The institutional review board determined this work did not constitute human subject research. Written informed consent was obtained from both patients. Results: Both patients presented with acute febrile illness and characteristic laboratory abnormalities. Due to winter season, tick-borne infection was not initially suspected, resulting in delayed consideration. PCR testing confirmed A. phagocytophilum infection in Case 1, meeting CDC criteria for confirmed HGA. Case 2 met CDC criteria for probable HGA based on serologic testing showing elevated IgG (1:320) in the appropriate clinical context. Treatment with doxycycline led to rapid clinical improvement and complete recovery. Conclusions: These cases demonstrate that HGA can be diagnosed during winter months in endemic regions. Although the precise timing of infection cannot be determined, these observations occurred during a period when episodic temperatures exceeded thresholds for tick activity. The cases highlight limitations of season-based diagnostic assumptions and suggest maintaining clinical suspicion for anaplasmosis year-round in endemic areas. Full article

Introduction: End-of-life (EOL) HIV cure-related research offers a unique opportunity to advance scientific discovery while honoring the values, dignity, and legacy of people with HIV. However, participation remains demographically skewed, mirroring long-standing inequities in who is informed, invited, and supported to take part. Synthesizing eight years of experience, published literature reviews, and community engagement from the University of California San Diego’s Last Gift program, we propose strategies to embed justice, equity, diversity, inclusion, and accessibility (JEDIA) throughout the design and implementation of EOL HIV cure-related studies. Discussion: Using intersectionality as a structural analytic framework, we examine how interlocking systems and social determinants shape access, consent, and participant experience, and we translate ethics into action across three themes and eight domains. As examples, we facilitate equitable access by implementing solutions that address gaps limiting awareness and feasibility of participation. We establish ongoing consent through multi-session consent processes with teach-back methods, clear healthcare proxy pathways, and explicit separation of research activities from clinical care. We center lived experiences by partnering with people with HIV and community groups, customizing participation, and honoring cultural and spiritual needs. We enable real-time course correction by using a dashboard that monitors enrollment patterns and representation. Conclusions: An intersectionality-informed, participant-centered approach is both feasible and essential to ensure HIV cure-related research advances with fairness, trust, and global relevance. Programs such as the Last Gift show that scientific rigor, integrity, and participant dignity can coexist, establishing a model for equitable HIV cure discovery. Full article

The evolution of the mHealth era offers the possibility of behavioral interventions to promote changes in lifestyle habits with prevention relevance. These tools are considered digital therapeutics (DTx) and follow the MDR 745/2017 for testing, validation, and certification. In the frame of the ACTIVE3 project, we developed a platform composed of a mobile app, a wearable device, and a cloud backend to support healthy aging intervention in a population of 60–80-year-old subjects. This paper describes the clinical trial protocol and the baseline data of the recruited population. The explored parameters describe the effect of the DTx in the physical, nutritional (and metabolic), and cognitive domains, leveraging the Walking Group initiatives coordinated by ATS Brianza that are active in the Lecco area; in addition, system usability and acceptance were analyzed. The study started on 1 September 2024, and the analyzed baseline data are presented here. With respect to an expected population of 200 subjects, we received interest and consent to participate from 237 subjects: over-enrollment was allowed and all these subjects were accepted into the study. The characterization of the study population at the initial time of the trial was carried out, and the outcomes are presented here. The population is generally more active than Italian people of the same age. According to the outcome of the 6MWT, the population was divided into three groups: trained participants (42 subjects), active participants (142 subjects), and sedentary participants (58 subjects). The tests at month 12 were recently competed, and the final results will be available in winter 2025–2026. Full article

The goal of antiretroviral therapy (ART) is to achieve viral suppression and improve the quality of life in people living with HIV (PLWH). Targeting the determinants of self-rated health in virally suppressed PLWH could significantly contribute towards sustaining the quality of life and health gains from ART. A qualitative study was conducted to investigate the determinants of excellent self-rated health in PLWH who are virally suppressed in the Eastern Cape province. A descriptive cross-sectional study using qualitative approach was conducted among 26 consenting adults living with HIV who have achieved viral load suppression in the rural province of the Eastern Cape using in-depth interviews. Themes were generated from the qualitative data using thematic analysis in NVivo 13^®. All participants described what they perceived as excellent quality of life as mostly determined by self-system (downward counterfactual thinking and pain discounting), perceived improved health, and adherence to recommended healthy behaviours (ART, diet, physical activity, and non-use of tobacco and alcohol products). Income/financial support availability and good healthcare access emerged as indispensable prerequisites for achieving and maintaining good health or adherence to healthy behaviours. Targeting the determinants of Self-Rated Health (SRH) has the potential to greatly improve physical and mental well-being of PLWH beyond viral suppression. Interventions can be more effective by drawing from evidence generated from context-based research. Full article

Effective dentist-patient communication underpins care, empowering informed decisions, reducing anxiety, improving efficiency, and fostering trust through clear, accurate, cohesive exchanges. This narrative review used a structured Medline search of literature, employing key terms to select and synthesize relevant English-language publications on dentist-patient communication without strict inclusion criteria. Key strategies include active listening, empathetic dialogue, patient-centred approaches, and the use of plain language and visual aids to demystify complex information. Additionally, integrating technology for appointment reminders, virtual consultations, and feedback mechanisms can streamline interactions. Crucially, cultural competency and sensitivity to individual needs ensure inclusivity and personalized care. Building on these findings, the study outlines ten actionable pillars for effective communication: (1) Initial Consultation: Establish rapport and gather comprehensive medical/dental histories. (2) Treatment Explanation: Simplify diagnoses and options using layman’s terms. (3) Informed Consent: Transparently discuss risks/benefits and invite questions. (4) Patient Education: Clarify oral hygiene practices and post-treatment expectations. (5) Anxiety Management: Address fears through reassurance and tailored coping strategies. (6) Follow-Up Care: Maintain post-treatment engagement to resolve concerns. (7) Feedback Systems: Leverage patient insights for service improvement. (8) Cultural Sensitivity: Adapt communication to diverse backgrounds. (9) Non-Verbal Cues: Employ positive body language and active listening. (10) Technology Integration: Utilize digital tools for efficiency and accessibility. By prioritizing empathy, clarity, and adaptability, clinicians can transform dental visits from anxiety-inducing encounters into collaborative partnerships. This approach not only elevates patient satisfaction and adherence but also redefines the standard of care, aligning clinical practice with the evolving needs of modern dentistry. Full article

Background: Infective endocarditis (IE) is a severe and multifactorial condition historically linked to dental procedures. Current evidence shows that most cases arise from complex host–microbe interactions and biofilm colonization on damaged endothelium or intracardiac/prosthetic material, while the inappropriate use of antibiotics in dentistry promotes antimicrobial resistance. Objectives: To provide a narrative synthesis of contemporary evidence on (i) the relative contribution of dental procedures versus daily oral inflammatory burden to bacteremia and IE risk, (ii) the role of periodontal disease and the oral resistome in AMR, and (iii) the clinical and medico-legal implications of antibiotic prescribing and guideline adherence in dental practice. Materials and Methods: A narrative review was conducted using PubMed, Scopus, ResearchGate, and Google Scholar, complemented by manual screening of reference lists and relevant guideline documents. The search covered approximately the last decade (2015–2025) and included ESC 2023 and AHA 2021 guidance on IE prevention. Search terms combined concepts related to “infective endocarditis”, “antibiotic prophylaxis”, “dentistry/dental procedures”, “periodontitis/periodontal disease”, “bacteremia”, “biofilm”, “oral microbiome/oral resistome”, and “antimicrobial stewardship/antibiotic resistance”, using Boolean operators. Eligible sources included clinical studies, systematic reviews/meta-analyses, consensus statements and guidelines, and selected medico-legal literature relevant to dental decision-making and documentation. Editorials and non-peer-reviewed items without retrievable full text were not considered for evidence synthesis. Results: The reviewed evidence supports that spontaneous bacteremia associated with active periodontitis and daily oral activities may be more frequent than procedure-related bacteremia, suggesting that inflammation control and biofilm management represent a major preventive lever. Antibiotic prophylaxis should be reserved for a limited subset of high-risk cardiac patients as per contemporary ESC/AHA recommendations, whereas routine “defensive” prescribing in low-risk contexts provides minimal expected benefit and carries individual and societal harms (adverse events, microbiome disruption, AMR selection). Integrating periodontal care pathways with risk stratification and targeted antibiotic stewardship can improve patient safety and support public health. Conclusions: Dentistry plays a strategic preventive role in IE and AMR primarily through periodontal inflammation control, asepsis, and prudent antibiotic use. From a medico-legal standpoint, professional liability should be assessed on a process-based standard (risk assessment, adherence to updated guidelines, causal local treatment, informed consent, and traceable follow-up) rather than on outcome-driven hindsight. Full article

Genome editing (GE) has transformed medicine by allowing precise changes to DNA, offering potential treatments for a range of inherited and acquired disorders. Several technologies support these advances, including zinc-finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and clustered regularly interspaced short palindromic repeats (CRISPR)-based systems, of which the latter has emerged as the most accessible, versatile, and popular. While GE holds great promise, its clinical use requires careful attention to safety, ethics and regulatory standards. Inadvertent on- and off-target DNA alterations and unintended modification of non-target cells pose major technical challenges, while bioethical considerations and the need for harmonized safety standards create regulatory challenges. The Food and Drug Administration (FDA) and European Medicines Agency (EMA), as regulatory agencies for key advanced therapy markets, provide detailed guidance on these aspects, emphasizing rigorous preclinical testing, patient monitoring, ethical consent, and compliance with legal frameworks. This concise review summarizes what is currently published in the scientific literature and recommended by regulatory agencies, providing an overview of the responsible clinical application of GE, with emphasis on patient safety, adherence to regulatory guidance, and ethical practice. Full article

Background: Patellofemoral pain (PFP) is a prevalent overuse injury among recreational cyclists worldwide. Despite its ubiquity, little is known about the lived experiences of people with PFP, especially in Saudi Arabia, where healthcare and cultural factors may have a specific impact on how the condition is managed. The aim of this study was to explore the lived experiences of recreational cyclists with patellofemoral pain in Al Madinah, Saudi Arabia. Method: A qualitative, descriptive design using reflexive thematic analysis was employed. Eleven male recreational cyclists aged 28–44 years diagnosed with PFP were purposely recruited from Al Madinah Physical Therapy Centre. Female participants were excluded due to cultural constraints regarding sports participation. The participants consented to participate in the study and to be audio recorded. Data were collected through semi-structured interviews using an interview guide. The interview data were transcribed verbatim and thematically analysed using Atlas.ti, version 24. Results: The thematic analysis revealed six themes highlighting the multidimensional impact of PFP. The participants described localised mechanical impairment with rapid onset during activity and persistent symptoms lasting up to two weeks. Pain was exacerbated by eccentric loading and cycling-specific stressors, such as uphill riding, leading to significant anxiety and avoidance behaviours. To maintain activity, these cyclists employed adaptive strategies, including bike modifications and self-management. Notably, PFP imposed substantial cultural and social burdens, hindering spiritual practices, specifically Salah (prayer) postures, professional duties, and family caregiving. While the participants demonstrated resourcefulness through a hybrid of physiotherapy and independent research, pharmacological relief was viewed as a transient solution. Conclusions: Patellofemoral pain imposes significant multidimensional burdens on recreational cyclists in Al Madinah, which are exacerbated by cultural practices. Physiotherapy offers targeted interventions for pain relief, functional restoration, and participation enhancement, necessitating the need for culturally sensitive management programmes. Full article

Background/Objectives: Older adults are disproportionately affected by traumatic brain injuries (TBIs), representing a significant portion of TBI-related hospitalizations and deaths. The objective of this study was to evaluate the feasibility and effectiveness of BrainCheck (Braincheck, Inc., Austin, TX, USA), a digital cognitive assessment tool, in detecting acute TBI-related cognitive deficits in the context of dementia-related cognitive impairment in older adult emergency department (ED) patients. Methods: From March 2020 to November 2023, participants aged 65+ with mild TBI, as defined by the American College of Rehabilitation Medicine (ACRM) diagnostic criteria, and individuals with isolated orthopedic injuries were recruited from 14 U.S. type 1 and 2 trauma centers. After informed consent, each subject was assessed by well-validated neurocognitive tests to characterize pre- and postinjury cognitive status. The Clinical Dementia Rating (CDR) and Functional Activities Questionnaire (FAQ) were used to assess cognitive impairment, with the informant sections used to classify preinjury status. The Rivermead Post-Concussion Symptoms Questionnaire (RPQ16) was used to assess injury-related symptoms, and the tablet-based BrainCheck Battery was tested as a diagnostic platform for injury-related deficits across several functional domains. Spearman’s correlation was used to assess BrainCheck’s internal validity and its relationship with self-reported cognitive symptoms. Technology familiarity was self-reported on a 1 (lowest) to 5 (highest) Likert scale. ROC curves evaluated the tool’s accuracy in identifying cognitive impairment associated with TBI in the context of pre-existing cognitive impairment. Results: For the 101 mTBI and 52 orthopedic trauma control patients, BrainCheck demonstrated strong internal validity, with significant correlations among its component tests, indicating its effectiveness in assessing cognitive impairment. However, low correlations with RPQ16 self-reported symptoms suggest that BrainCheck and the self-reported questionnaire assess different aspects of cognitive functions. Conclusions: While BrainCheck effectively identified cognitive impairment, the composite battery and scoring did not differentiate TBI and dementia. Technology familiarity did not affect test outcomes. BrainCheck is a useful tool for evaluating cognitive function in adults aged ≥ 65 years with and without TBI in ED settings. Full article

Background: Coronavirus disease 2019 (COVID-19) vaccines deliver mRNA packaged in lipid nanoparticles via intramuscular injection. This study investigated several factors influencing antibody production patterns and adverse reactions after vaccination with COVID-19 vaccines. Methods: Among the participants of the Iwaki Health Promotion Project (IHPP), 211 individuals who consented to this study were surveyed regarding antibody titers and adverse reaction symptoms following vaccination. A machine learning approaches such as ridge regression, elastic-net, light gradient boosting, and neural network were applied to extract the variables, and Bayesian network analysis was applied to explore causal relationships between health data and the multi-omics dataset obtained from the IHPP health checkups. Results: Females with lower levels of free testosterone experienced more adverse reactions than males. Moreover, the immune system is more active in younger individuals, causing adverse reactions and higher antibody production. The Spikevax vaccine induced adverse reaction symptoms with higher antibody production in cases of fever. Meanwhile, drinking 2–3 cups of green tea daily seemed to be effective in increasing antibody production. Factors increasing side effect risk include blood natural killer cell count and muscle quality in the vaccinated arm. Plasma metabolome metabolite concentrations, tongue coating bacterial colonization, and folate intake were also identified as factors influencing side effect risk. Furthermore, characteristics of participants at risk for fever symptoms included longer telomere length, higher antibody production patterns, and higher CD4-positive T cell counts. Conclusions: Further investigation of these identified influencing factors is expected to clarify the rationale for new vaccine development and identify lifestyle and dietary habits that enhance vaccine efficacy. Full article