Search Results (23,589)

The escalating global threat of antimicrobial resistance (AMR) has intensified efforts to identify safe, effective, and sustainable alternatives to in-feed antibiotics in livestock production. The bovine gastrointestinal microbiome plays a central role in host immunity, nutrient utilization, and disease resilience, positioning microbiome-modulating interventions as promising candidates for antimicrobial stewardship. Despite growing experimental interest, a systematic synthesis of the available evidence in cattle is lacking. This systematic review aimed to evaluate the efficacy of microbiome-modulating interventions, including probiotics, prebiotics, postbiotics, phytogenic feed additives, essential oils, organic acids, and native rumen microbial supplements, as strategies to reduce antimicrobial use in cattle, and to characterize their effects on gut microbial diversity, fermentation characteristics, and host health and performance outcomes. A systematic search of Scopus, Web of Science, and EBSCOhost (including Academic Search Ultimate, MEDLINE with full text, and CAB Abstracts with Full text) was conducted in accordance with PRISMA guidelines. Studies were eligible if they used cattle (dairy cattle, beef cattle, calves, or mixed production systems), employed a microbiome-modulating intervention, and reported at least one microbiological or host outcome. Seventeen peer-reviewed studies published between 2010 and 2025 were included after full-text screening. Risk of bias was assessed using an adapted SYRCLE tool, which identified moderate overall study quality; the majority of included studies were randomized controlled trials or controlled experiments, though reporting of allocation concealment and blinding was inconsistent across studies. Across the 17 included studies, five broad categories of interventions were evaluated: probiotics (n = 5 studies), prebiotics (n = 2), postbiotics and organic acids (n = 4), phytogenic additives and essential oils (n = 4), and native rumen microbial supplements (n = 2). Animals spanned neonatal dairy calves, weaned Holstein calves, dairy heifers, lactating dairy cows, and Bos indicus feedlot beef cattle. Probiotics and organic acids most consistently improved growth performance: benzoic acid supplementation increased average daily gain by 8.4% (p < 0.05) and fructo-oligosaccharide prebiotics elevated body weight at weaning by 6.7% (p < 0.01). Native rumen microbial supplements improved energy-corrected milk yield by up to 3.1% without increasing dry matter intake. Polyphenols and bile acids demonstrated the strongest immunological and disease-preventive effects, reducing calf mortality by approximately 40% and disease severity by approximately 35%, respectively. Microbiome analyses revealed intervention-dependent increases in microbial diversity and shifts toward taxa associated with improved fermentation efficiency, including enrichment of propionate-producing Prevotellaceae, butyrate-associated Ruminococcus, and hindgut Bifidobacterium. Rumen fermentation outcomes included reductions in the acetate:propionate ratio and ammonia-N concentrations and improvements in fiber digestibility of 3.6–4.4 percentage units in dairy cows. Phytogenic additives preserved microbial diversity without inducing broad-spectrum suppression, functioning primarily as microbiome stabilizers rather than direct antimicrobial replacements. This systematic review provides evidence that gut microbiome modulation may enhance growth performance, improve fermentation efficiency, and reduce disease susceptibility in cattle, thereby supporting antimicrobial use reduction across dairy, beef, and mixed production systems. Effect magnitudes varied substantially across intervention categories and production contexts, and study quality was moderate, underscoring the need for larger, pre-registered trials with standardized outcome reporting and direct antibiotic comparator arms. Probiotics, prebiotics, and bile acid metabolites showed the greatest potential as components of integrated antimicrobial stewardship strategies in cattle production. Full article

Background: Hypertension (HTN) and type 2 diabetes mellitus are major global health challenges, and diabetic nephropathy (DN) is a critical complication of diabetes. Although observational studies link HTN to DN progression, causal evidence remains limited. We investigated the potential causal relationship between HTN and DN and quantified the global burden of HTN-attributable type 2 diabetic nephropathy (HTN-T2DN). Methods: We integrated two-sample Mendelian randomization (MR), Bayesian weighted MR, and sensitivity analyses with Global Burden of Disease (GBD) 2021 analyses. The burden of HTN-T2DN was assessed from 1990 to 2021 and projected to 2045. Results: MR provided genetic evidence supporting a potential causal role of HTN in DN (inverse-variance weighted odds ratio = 4.219, 95% CI: 1.807–9.853; p = 0.001). Globally, HTN-T2DN deaths increased to 50,689 and DALYs to 1,151,216 in 2021. Females had higher age-standardized mortality and DALY rates than males, and low-middle sociodemographic index (SDI) regions had the highest burden. By 2045, deaths and DALYs were projected to reach 162,392 and 4.04 million, respectively. Conclusions: HTN may play a potential causal role in DN development and progression. Strengthened blood pressure control, early screening, and tailored policies are essential, particularly for women, older adults, and populations in lower-SDI settings. Full article

Modulating the physical crosslink architecture of gelatin methacryloyl (GelMA) hydrogels without altering total polymer concentration or introducing exogenous components remains a central challenge in biomaterial design. Here, we present a source blending strategy in which porcine skin gelatin (PG) and salmon skin gelatin (SG), two gelatins with markedly different proline and hydroxyproline contents, are combined at seven compositional ratios (PG weight fractions 0–1.0) and subsequently functionalized to GelMA under standardized conditions (8% v/v methacrylic anhydride, 60 °C, 3 h). Near-complete degrees of substitution (95–98%) were achieved across all formulations, as confirmed by both TNBS and ¹H-NMR analyses. In the parent gelatin mixtures, increasing PG fraction progressively increased viscosity, elastic modulus (G′), gelation temperature (Tgel), and compression modulus at 4 °C, with DSC revealing independent SG (0–15 °C) and PG (20–40 °C) endothermic transitions that suggest partial hindrance of PG triple-helix formation by high SG fractions. These composition-dependent trends were preserved after functionalization to GelMA, albeit with attenuated physical crosslinking due to steric impairment by the methacrylate groups. Photocrosslinked GelMA hydrogels fabricated after pre-incubation at 4 °C exhibited systematically higher compression moduli and lower swelling degrees with increasing PG content, demonstrating that the PG/SG ratio provides an effective means for independently tuning hydrogel mechanics and mesh architecture. In vitro release assays using Rhodamine 6G further demonstrated that pre-incubation at 4 °C prior to photocrosslinking effectively modulates transport kinetics in SG-PG GelMA hydrogels. This strategy delayed characteristic release times and constrained Weibull shape parameters to the anomalous-transport regime (0.75 < β < 1), where diffusion is governed by network chain relaxation. This effect was most pronounced in the 0.4SG:0.6PG formulation, where lower SG content permitted unhindered triple-helix formation, as corroborated by DSC and compression studies. Ultimately, adjusting the pre-incubation temperature and gelatin source combination provides a straightforward, processing-additive-free strategy to achieve programmable release profiles via controlled matrix tortuosity. Full article

This study evaluated the effects of dietary supplementation with 25-hydroxyvitamin D₃ (25-OH-D3), canthaxanthin (Cx), copper (Cu), and gluco-oligosaccharides (GO) on performance, egg quality, fertility, and hatchability of broiler breeder hens during early production (30 to 41 weeks of age). A total of 210 breeder hens and 21 males were allocated to three dietary treatments. Birds were fed a standard broiler breeder diet (control) or the same diet in which 0.5 kg/MT of an additive premix replaced sand. This premix supplied 16.6–17.7 mg/kg canthaxanthin (Cx) and 3700–4700 IU/kg 25-OH-D3 in Treatment 1, and 9.2–11.1 mg/kg Cx and 4100–4700 IU/kg 25-OH-D3 in Treatment 2. Treatment 2 also included Cu and GO (≥44 mg/g within the additive), with Cu provided at industry-standard levels. Each treatment consisted of seven replicates, with birds housed in floor pens containing 10 females and 1 male per replicate. Hen performance was recorded weekly, while egg quality was assessed at 30, 35, and 41 weeks. Fertility and hatchability were evaluated at 30 and 41 weeks. Treatment 2 improved lay rate, albumen height, Haugh unit, and feed conversion ratio (FCR) at selected time points. Both supplemented diets consistently produced darker yolk color compared with the control. Supplementation consistently enhanced yolk color, whereas effects on albumen height, Haugh unit, shell thickness, and FCR were observed only at specific ages or weeks. Lay rate differed among treatments only at week 40, with a trend observed at week 41. Fertility and hatchability were not significantly affected by dietary treatment. Full article

The application of Internet of Things (IoT) technology to Digital Twin (DT) in smart manufacturing has opened significant opportunities for real-time monitoring, predictive maintenance, and closed-loop control; however, the inherent latency that exists in these architectures (the temporal gap between a physical event and its reflection in a digital model) remains one of the most significant and least systematically understood barriers to fulfill its full potential. This paper aims to propose a formal four-layer taxonomy of latency sources in IoT-based Digital Twin systems for smart manufacturing and to review the current approaches and tools that are available for their measurement. The PRISMA protocol has been used to perform a systematic literature review, where 58 primary survey studies published between 2020 and 2026 were extracted from IEEE Xplore, Elsevier Scopus, Google Scholar and arXiv, with all the studies being coded along six dimensions (architectural layer, application domain, latency metrics reported, evaluation methodology, quantitative impact, and enabling technologies). The proposed taxonomy presents 28 different types of latencies under four layers: (L1) network, (L2) compute, (L3) data, and (L4) end-to-end (E2E), whose magnitudes vary from 0.1 ms for local network propagation to tail latencies above 500 ms in production (P99). Three categories and three cross-layer interaction patterns are formalized here and are absent from prior partial taxonomies. Among the most promising results is the finding that several high-impact interventions require no infrastructure investment: a protocol migration from Modbus to WebSocket reduces telemetry latency by 32%, while Age of Information-aware synchronization and clock drift correction deliver substantial data layer gains through software updates alone, yet remain underutilized. The review identifies a systematic under-reporting of tail-latency percentiles across the corpus, the lack of a cross-protocol jitter benchmark, and a predominance of simulation-based evaluation over real-hardware measurement. The systematic review contributions of this paper (the formal four-layer taxonomy, the proportional metric audit across the 58 papers, and the formalization of three cross-layer interaction patterns) are derived from cross-corpus analysis. The investigation also identifies three open research directions (a standardized manufacturing IoT-DT benchmark, cross-layer joint optimization frameworks, and wireless TSN validation on real manufacturing testing grounds) that together form a well-organized and practical basis to advance both the science and the application of ultra-low-latency Digital Twin technology in the industrial field. Full article

Introduction: The declining efficacy of standard triple therapy for Helicobacter pylori (H. pylori) eradication, largely driven by increasing antibiotic resistance, has highlighted the need for alternative treatment strategies. Vonoprazan–amoxicillin dual therapy (VDT) has emerged as a promising regimen due to the potent and sustained acid suppression provided by vonoprazan. This meta-analysis aims to compare the efficacy and safety of VDT versus clarithromycin-based standard triple therapy (STT) for H. pylori eradication in adults. Methods: A systematic search of PubMed, Scopus, and the Cochrane Library was conducted from inception to 15 March 2026 for randomized controlled trials (RCTs) comparing VDT (vonoprazan plus amoxicillin) with STT (proton pump inhibitor, amoxicillin, and clarithromycin) for H. pylori eradication (PROSPERO “CRD420261357715”). Heterogeneity was assessed using the I² statistic and Cochran’s Q test. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using the Mantel–Haenszel method within a restricted maximum-likelihood random-effects model. Results: Five RCTs were included with 1363 patients (VDT: 680, STT: 683). VDT demonstrated a significantly higher H. pylori eradication rate compared with STT (RR 1.17; 95% CI [1.07; 1.27]; p = 0.007; I² = 11%). Conclusions: This meta-analysis suggests that VDT may be associated with higher H. pylori eradication rates than clarithromycin-based STT. Further large, well-designed RCTs are needed before firm first-line recommendations can be made. Full article

Offshore renewable energy is widely recognised as a critical pathway for decarbonising electricity systems, but the integration of floating offshore wind turbines with wave energy converters remains technically challenging. This paper presents a structured literature review of hybrid wave–wind offshore energy platforms, drawing on 114 reviewed sources published between 2000 and 2026. The review classifies hybrid concepts using a three-axis framework based on floating platform type, wave energy converter (WEC) integration approach, and energy-dominance category. It then compares representative configurations, including point absorbers, oscillating water columns, flap-type devices, and heaving torus concepts, with emphasis on hydrodynamic response, energy contribution, structural complexity, mooring implications, validation status, and optimization suitability. The findings show that no single hybrid configuration can be ranked as universally superior because reported performance depends strongly on platform geometry, WEC scale, site wave climate, modelling assumptions, and validation maturity. Point absorber systems offer modularity and lower integration complexity, oscillating water column (OWC)-based systems provide protected power take-off (PTO) integration and moderate hydrodynamic interaction, flap-type systems can provide stronger motion-control potential but impose higher structural and mooring demands, and spar–torus concepts remain geometrically compatible with spar platforms but are generally wind-dominated. The review further shows that optimization method selection should depend on problem class: gradient-based methods are most suitable for local PTO tuning, evolutionary methods for non-convex multi-objective layout problems, surrogate-based methods for high-cost coupled simulations, and data-driven methods for adaptive control. The paper concludes that future progress requires standardized benchmark models, transparent evidence-level reporting, multi-physics co-optimization, techno-economic assessment, and systematic experimental or field validation before definitive concept ranking or commercial-readiness claims can be made. For decision-makers, industry stakeholders, and policymakers, the framework supports early-stage concept screening, identification of technology-specific risk factors, prioritisation of validation and investment pathways, and alignment of hybrid-platform development with site conditions, infrastructure constraints, and policy objectives. Full article

According to data from the World Federation of Societies of Anesthesiologists, numerous countries across Asia and Africa have fewer than one anaesthesiologist per 100,000 people. Upskilling nurse anaesthetists in these regions is critical to improving clinical outcomes, and interactive virtual patient simulators offer a safe environment to explore complex clinical scenarios. This paper introduces an advanced general anaesthesia patient simulator engineered to bridge the accessibility gap left by existing platforms, which often require expert programming knowledge and restrict users to manual titration. Our simulator features an intuitive graphical user interface optimised for clinical education and natively supports both manual and closed-loop anaesthesia administration. The platform includes a suite of pre-designed controllers, specifically standard PIDs and two distinct fractional-order FO-PID variants, highlighting a novel robust FO-PID framework engineered to mitigate high patient variability. The deployment of these embedded controllers is demonstrated via a Depth of Hypnosis regulation case study and validated across a diverse cohort of 19 virtual patients. Closed-loop evaluation reveals that while the standard PID achieves a lower average mean squared error during the maintenance phase, the fractional-order alternatives deliver significantly superior robustness and inter-patient consistency. Ultimately, integrating this simulator into clinical training frameworks offers a viable pathway to reduce nursing workload and enhance patient safety through optimised automated drug delivery. Full article

Background/Objectives: Nanopore sequencing is increasingly used in mycobacterial diagnostics, where clinical microbiologists and diagnostic laboratories must decide when broad metagenomic next-generation sequencing (mNGS) or focused targeted next-generation sequencing (tNGS) is most appropriate. This review examined reported clinical and laboratory roles of nanopore mNGS and tNGS in tuberculosis (TB) and nontuberculous mycobacterial (NTM) settings. Methods: Targeted searches of PubMed/MEDLINE, Embase, Web of Science Core Collection, and Scopus were refreshed on 4 April 2026. Thirty-five records spanning original clinical studies, evidence syntheses, and guideline-context documents were included. Results: Nanopore mNGS is most useful for broad organism detection and diagnostic rescue in unresolved pulmonary and extrapulmonary presentations, particularly when first-line testing is negative, discordant, low-yield, or when mixed infection is suspected. Nanopore tNGS appears better aligned with predefined TB confirmation and resistance-focused workflows because targeted regions allow more standardized interpretation. Agreement is strongest for rifampicin- and isoniazid-related resistance targets. In NTM settings, evidence is stronger for detection and species identification than for disease-level diagnosis. Common implementation constraints include pre-analytical variation, contamination control, host-background interference, inconsistent bioinformatics, and limited workforce capacity. Conclusions: A practical tiered approach is supported in which mNGS is positioned mainly for diagnostic rescue and discovery, whereas tNGS is considered for predefined workflows requiring standardized target interrogation and resistance-associated mutation reporting under local validation and quality systems. Full article

This study presents an integrated framework for agricultural drought monitoring in data-scarce regions, utilizing the Google Earth Engine (GEE) platform to analyze multisource Earth observation data over the South Wollo highlands, Ethiopia, from 2001 to 2024. The analysis was complemented by Mann–Kendall trend testing, Sen’s slope estimation, and Pettitt change-point detection to identify and quantify long-term trends and abrupt shifts in drought dynamics. The methodology integrates climatic and satellite-derived indicators within a hybrid analytical framework. It incorporates the standardized precipitation evapotranspiration index (SPEI), vegetation condition index (VCI), vegetation health index (VHI), temperature condition index (TCI), and land surface temperature (LST), which are derived from MODIS (NDVI, LST, PET) and CHIRPS precipitation datasets. The analysis focused on the main growing season (June–September) to capture critical crop growth and moisture-sensitive periods for agricultural production in the study area. The findings reveal pronounced interannual variability in drought occurrence and intensity across the study period. Severe agricultural drought conditions were most extensive in 2009 and 2014, with VHIs indicating 15% and 4% of the area under severe and extreme drought in 2009, respectively, and 2.6% and 2% in 2014, respectively. In contrast, 2001, 2005, 2020, and particularly 2024 were characterized by predominantly no-drought to mild-drought conditions, with no-drought coverage increasing from 86.7% (2009) to 98.0% (2024). Vegetation-based indices demonstrate that drought impacts are episodic rather than persistent and strongly controlled by rainfall timing and early-season moisture availability. The LST exhibited marked year-to-year variability (28.8 °C to 33.8 °C), with elevated temperatures coinciding with drought periods and suppressed evaporative cooling. Correlation analysis confirmed a strong positive relationship between the SPEI and VHI (r = 0.77), with moderate correlations for the VCI (r = 0.40) and TCI (r = 0.36), underscoring the sensitivity of integrated vegetation health to the climatic water balance. The study concludes that combining the SPEI with satellite-derived vegetation and thermal indices provides a robust, scalable approach for agricultural drought assessment in regions with limited ground-based observations. The integrated framework effectively captures both moisture deficits and thermal stress components, offering a scientific basis for improving drought early warning systems and climate-resilient agricultural planning in Ethiopia and similar environments. Full article

The immune response is essential in the protection of our body against pathogens; however, the inflammatory response caused by the immune system can become a disease itself. In fact, anti-inflammatory and immune-suppressive drugs are applied to limit the immune response to treat inflammatory diseases. Flavonoids are plant-derived polyphenols extensively investigated for their anti-inflammatory and antioxidant properties in inflammatory diseases. Studies applying isolated compounds as well as using supplements as nutraceuticals based on flavonoids have been conducted. Our review systematically analyzed the top five studied flavonoids between 2020 and 2025: quercetin (1742 articles), kaempferol (642), luteolin (589), apigenin (419), and epicatechin (354), highlighting their major therapeutic applications in diseases affecting the liver (12%), nervous system (11%), and lungs (10%). Mechanistically, these compounds act as multi-target agents mainly by inhibiting NF-κB and inducing Nrf2-dependent antioxidant programs. Application of advanced delivery systems, which increase oral bioavailability by up to 20-fold, overcomes pharmacokinetic bottlenecks. Clinical highlights demonstrated promising therapeutic effects, including reduced intrahepatic lipid accumulation in non-alcoholic fatty liver disease patients following quercetin supplementation (11.5% to 9.6%) and accelerated SARS-CoV-2 clearance after quercetin phytosome administration. The translation of flavonoids into standardized clinical therapies remains limited by the lack of large-scale, well-controlled clinical trials. Full article

The development of accessible and experimentally validated robotic systems for engineering education is a challenge, especially in academic environments where industrial manipulators are economically inaccessible. This paper presents the design, mechanical validation, and experimental evaluation of a robotic arm-based didactic module developed for the classification of objects according to color and morphology. The proposed system integrates a five-degree-of-freedom articulated configuration, a servomotor drive, motion planning with a trapezoidal speed profile, and a web-based control interface, enabling local and remote operation within an educational environment aligned with Industry 4.0 principles. The mechanical structure was designed using CAD modeling and validated through static structural analysis to ensure mechanical integrity and adequate safety factors. The selection of actuators was made considering the torque, angular velocity, and load requirements. A trapezoidal speed profile was implemented in order to ensure smooth trajectories and minimize positioning errors. Experimental validation was carried out through repetitive tests under controlled laboratory conditions, evaluating the accuracy and repeatability metrics. Statistical indicators such as mean error, standard deviation, and root mean square error (RMSE) were calculated. The results show the stable performance of the system, with low variability in multiple test cycles, confirming the viability of the proposed architecture for its implementation in automation and educational robotics laboratories. The integration of structural validation, motion control strategy, and experimental quantitative evaluation contributes to bridging the gap between theoretical teaching of robotics and its practical application, offering a scalable, low-cost platform for engineering training. Full article

Amaranthin is a major red-violet betacyanin of Amaranthaceae and an increasingly relevant natural pigment for food, cosmetic, nutraceutical, and biotechnological applications. This review integrates knowledge from over 100 studies, addressing amaranthin as a chemically defined betalain, distinguishing it from other scientific uses of the term, and evaluates its natural sources, analytical methods, extraction strategies, in vitro production systems, biosynthetic regulation, and biological activity. Cultivated Amaranthus species are among the richest plant sources, with total betacyanins of 46.1–199 mg/100 g fresh weight and amaranthin constituting up to 80.9% of the pigment fraction. Reliable identification and quantification rely on high performance liquid chromatography coupled with a diode array detector (HPLC-DAD), liquid chromatography-tandem mass spectrometry (LC-MS/MS), and ultraviolet–visible (UV–Vis) spectrophotometry, while microwave-, ultrasound-, and green solvent-assisted extraction markedly improve pigment recovery and stability. While plant in vitro cultures, including callus, suspension, and shoot systems, have clarified biosynthetic regulation and offer controlled production platforms, engineered Yarrowia lipolytica CcAmaSy1 currently provides the highest reported yield, reaching 2.97 ± 0.029 g L⁻¹ in fed-batch fermentation. Amaranthin-rich extracts and purified pigments demonstrate antioxidant, anti-inflammatory, antimicrobial, and antiviral potential; however, mechanistic, bioavailability, and in vivo evidence remain limited. Standardized analytical protocols, further investigation of stable high-yield sources, physicochemical stability assessment, and structure–activity studies are identified as priorities for advancing future application-oriented research on this multipotential pigment. Full article

Background: Exercise plays a crucial role in the prevention and management of type 2 diabetes. During self-motion, optic flow provides visual information about heading direction and influences postural control. This study investigated postural responses and muscle activation in individuals with type 2 diabetes exposed to optic flow stimuli simulating self-motion, and examined whether these responses varied according to habitual physical activity over 12 months. Methods: Surface electromyographic (EMG) and stabilometric data were collected from 23 individuals during quiet standing under different visual motion conditions. Participants were classified as physically active or inactive based on standardized criteria. EMG activity was recorded bilaterally from the tibialis anterior and soleus muscles at baseline, 6, and 12 months. Center of pressure (COP) displacement was measured using two force platforms. Results: Stabilometric analysis revealed a significant effect of visual stimulus on COP displacement in both antero-posterior and medio-lateral directions, as well as on COP speed, indicating that optic flow modulates postural control. COP speed changes over time differed by sex, while medio-lateral sway showed time-dependent variations across sides and physical activity groups. EMG analysis showed a significant effect of visual stimulus on soleus activation, with no consistent effects for tibialis anterior. Conclusions: Optic flow significantly modulated postural control and lower-limb muscle activation in individuals with type 2 diabetes. Preliminary differences in response profiles associated with habitual physical activity level were observed, though these should be interpreted cautiously given the exploratory nature of the study. Larger, adequately powered studies are warranted to further investigate these associations. Full article

Introduction. Chronic non-cancer pain is highly prevalent and profoundly diminishes quality of life. While pharmacological and interventional treatments are central, its psychosocial and spiritual dimensions remain under-addressed. This pilot study assessed the feasibility of a therapist-led support group intervention for patients with chronic non-cancer pain and explored preliminary psychospiritual outcomes. Methods. A two-arm, non-randomized pilot feasibility study was conducted among 58 outpatients of a university pain management clinic in Poland. Feasibility was assessed through recruitment, retention, attendance, and safety, while preliminary psychological and spiritual outcomes were evaluated using validated self-report instruments. The intervention group (n = 29) participated in eight group sessions combining psychoeducation, mindfulness-based techniques, and supportive dialogue inspired by the Simonton Method. The control group (n = 29) received standard care. Participants completed the Numeric Rating Scale to measure pain intensity, the Satisfaction with Life Scale, the Positive and Negative Affect Schedule, the WHOQOL-BREF, the Spiritual Well-Being Scale, the Generalized Anxiety Disorder Scale, and the Patient Health Questionnaire-9. Results. The intervention was feasible in terms of physician workload; however, patients adherence varied significantly. At baseline, the control group showed a significantly higher positive affect and existential well-being than did the intervention group. In exploratory within-group analyses, participants in the intervention group showed improved positive affect and reduced anxiety (p < 0.05), whereas existential well-being showed a trend toward improvement (p < 0.06). However, the self-selection design limits causal inferences. Nevertheless, participants reported social connectedness, meaning-making, and enhanced vitality. Discussion. This pilot feasibility study provides preliminary evidence that a therapist-led support group intervention integrating psychoeducation, mindfulness, and supportive components is practicable within multidisciplinary pain management. Further research in a larger, randomized trial is needed to evaluate adherence and safety, as well as clinical effects, more rigorously. Full article