Search Results (3,079)

Background/Objectives: Recognizing workforce shortages and adverse impacts of trainee emotional exhaustion, we aimed to measure baseline levels of wellness, resilience, and burnout among pediatric rheumatology fellows as well as to understand the feasibility of implementing a narrative medicine intervention in this population. Methods: This study involved pre- and post-participation questionnaires for pediatric rheumatology fellows in the United States and Canada who participated in a narrative medicine intervention. Survey components included the Mini Z Burnout Survey, the Mayo Well-being Index and the Connor-Davidson Resilience Scale (CD-RISC), baseline demographics and self-reported burnout-related factors. Results: All sixteen invited fellows completed the pre-participation survey, and 15 of the 16 participants completed the narrative intervention. The median (range) baseline CD-RISC resilience score was 73.5 (44–88), and the baseline Mini-Z Burnout Survey showed high levels of burnout with a median (range) of 34 (17–44). The median (range) score of the baseline Mayo Well-being Index was 3 (0–7), with scores of ≥4 associated with physicians at risk of suicidal ideation and/or serious thoughts of leaving medicine. Following participation in the narrative medicine intervention, surveys showed a shift toward feelings that work is meaningful, as well as a shift toward feelings of having time for personal and family life. Conclusions: In this pilot study, baseline levels of wellness, resilience, and burnout among pediatric rheumatology fellows highlighted target areas to mitigate burnout and maximize resilience among fellows. Narrative medicine is a feasible and acceptable intervention, and future larger studies should investigate the possible impact of narrative medicine on burnout among pediatric rheumatology fellows. Full article

Notable discrete probability laws appear as posterior distributions in the estimation of the common mean with heterogeneous variances. These probabilities, which are defined by an arbitrary set of distinct real numbers, also arise in seemingly unrelated areas of polynomial approximation and statistical physics. The corresponding orthogonal polynomials possess an interesting self-duality property, which invites the study of statistical distributions based on data parity. These distributions provide novel, intriguing formulas for the classical hypergeometric function along with several combinatorial identities. Full article

Background: Telerehabilitation has grown with the advances of modern communication technologies, but it experienced its greatest surge during the COVID-19 pandemic. Our department also wanted to offer our patients with chronic neurological conditions (specifically, multiple sclerosis (MS)) the opportunity to exercise with a physiotherapist remotely during pandemic restrictions. We continued with telerehabilitation afterwards, but for further development of telerehabilitation programs we sought feedback from participants. Methods: People with multiple sclerosis (MS) who participated in any form of telerehabilitation offered at our MS centre between January 2021 and June 2024 were invited to complete a brief semi-structured interview to assess their feedback. To ensure unbiased responses, the feedback was obtained from a therapist other than the one with whom they had completed the online session. Results: A total of 95 multiple sclerosis (MS) patients (14 of whom were male) participated in telerehabilitation programs during the study period, with a mean age of 46.5 years. Of these, 82 agreed to participate in short interview. Patients particularly valued the ability to avoid commuting and the time flexibility in scheduling sessions. They perceived the limited opportunities for hands-on correction and the lack of personal interaction with the therapist and other patients as the most significant disadvantages. Conclusions: Telerehabilitation appears to be a viable complement to in-person physiotherapy for some patients with chronic conditions. In our experience, it is feasible to deliver telerehabilitation to people with multiple sclerosis who do not have severe disability, without the need for complex equipment. Full article

Background/Objectives: Clomiphene citrate (CC) is widely used off-label for male infertility despite limited evidence and inconsistent guideline recommendations. Although previous studies suggest variability in clinical practice, real-world data on prescribing patterns, patient selection, monitoring, and treatment success definitions remain limited. This study assessed CC prescribing patterns among urologists and identified factors associated with its use. Methods: A national, cross-sectional, web-based survey was conducted among urologists in Türkiye between November and December 2025. Of 1558 invited participants, 421 responded (27.0%), and 402 were included in the final analysis. The questionnaire was based on European Association of Urology and American Urological Association guidelines, refined through expert consensus, and pilot-tested. Multivariable logistic regression identified factors independently associated with CC use. Results: CC was used by 39.3% of respondents and was independently associated with private practice (odds ratio [OR] = 2.90, p < 0.001), greater professional experience (OR = 2.18, p = 0.002), and higher infertility case volume (OR = 2.27, p = 0.001). Substantial heterogeneity was observed in patient selection, dosing, monitoring, and success definitions. Treatment goals and perceived success definitions most frequently focused on laboratory-based endpoints, including semen parameters and testosterone levels, which were more frequently selected than pregnancy-related endpoints. However, spontaneous pregnancy was also commonly reported as a perceived success definition, whereas live birth was not separately assessed. An apparent indication paradox was observed for hypogonadotropic hypogonadism, which may reflect differing interpretations of functional versus irreversible hypogonadotropic states, and 31.6% of clinicians reported not routinely providing risk counseling. Conclusions: CC prescribing for male infertility remains heterogeneous among responding urologists and was associated with clinician experience, practice setting, and infertility case volume rather than standardized protocols. The predominance of laboratory-based endpoints, together with the frequent inclusion of spontaneous pregnancy as a perceived success definition and the absence of separate live-birth assessment, underscores the need for clearer terminology, standardized prescribing frameworks, structured risk counseling, and future studies incorporating clinically meaningful reproductive endpoints. Full article

Background: Voluntary Assisted Dying (VAD) legislation in Western Australia (WA) introduced new responsibilities for community pharmacists, including the safe disposal of unused VAD substances. Pharmacists may receive VAD-related enquiries; however, their preparedness, including their knowledge of VAD, remains largely unexplored. Aim: To explore Western Australian community pharmacists’ knowledge of VAD and their role as Authorised Disposers under the Voluntary Assisted Dying Act 2019 (WA). Methods: Community pharmacists in WA were invited to participate in an anonymous, online survey consisting of multiple choice and open-ended questions. Results: Of 143 respondents, 76% were aware that VAD is an end-of-life option; despite this, 64% were uncertain about its relevance to their role. Almost one-third had received VAD-related enquiries. Of these, 40% could not provide information, with half attributing this to insufficient knowledge. Among those yet to receive a VAD-related enquiry (n = 115), 75% felt ‘not confident’ to respond, with 76% attributing this to lack of knowledge. A total of 63% of participants were unaware that they may be requested to perform authorised disposal. Uncertainty surrounding the process and the legal and ethical aspects were frequently mentioned. Conclusion: WA Community pharmacists demonstrate awareness of VAD legislation but have gaps in knowledge, particularly regarding authorised disposal. Further training and resources are essential. Full article

Background: Inflammatory bowel disease (IBD) is a chronic condition characterized by persistent inflammation of the gastrointestinal tract. Sexual dysfunction is a common but often overlooked consequence of IBD, affecting approximately half of women and one-third of men living with the disease. Despite the significant role of sexuality in overall quality of life, discussions about sexuality frequently remain absent from clinical encounters between patients and healthcare providers. Purpose: This study aims to deepen understanding of how individuals with inflammatory bowel disease experience—and wish to approach—conversations about sexuality with healthcare professionals in specialist clinical settings. Method: A descriptive and exploratory qualitative design was employed, using semi-structured interviews with 12 individuals diagnosed with IBD, recruited from two outpatient clinics in Norway. The data were analysed using reflexive thematic analysis. Results: Our analysis generated three main themes: (1) sexuality as an overlooked dimension of IBD care, (2) unmet informational needs related to sexuality, and (3) relational prerequisites for discussing sexuality. Sexuality was seldom addressed in participants’ healthcare encounters. Only a minority had been invited into such discussions, and those experiences were typically brief. Some participants preferred not to engage in conversations about sexuality. Reported barriers included awkwardness, embarrassment, stigma, discomfort, and concerns about privacy. Participants also described limited access to reliable information and perceived some healthcare providers as insufficiently knowledgeable or dismissive when the topic was raised. Feeling safe, trusting the provider, and having an established therapeutic relationship were identified as essential conditions for discussing sexuality. Conclusions: Sexuality remains largely unaddressed in clinical encounters with individuals living with IBD. The findings reveal a gap between patients’ information needs and the support currently provided. Strengthening healthcare providers’ competence and ensuring access to appropriate resources may help create the trust and safety required for meaningful conversations about sexuality. Full article

Rapid, low-cost ethanol quantification is vital for beverage quality control, biofuel production, and pharmaceutical applications, yet current approaches are costly, reagent- or label-dependent, or rely on spectroscopy with substantial sample preparation. We introduce a purely cell-based, label-free biosensor that exploits temperature-gradient-induced spontaneous detachment of Saccharomyces cerevisiae from a chip surface. The readout is the detachment half-time, t_d50, derived from time-resolved changes in interfacial thermal resistance, R_th, at the solid–liquid interface. Cells were pre-exposed to ethanol (0–70% v/v) and the detachment kinetics monitored using the heat transfer method (HTM). Under these conditions, cells display a pronounced non-monotonic t_d50 response with a peak around 20% v/v ethanol. Overall, the t_d50 rises from ~45 min (0% ethanol) to ≳10 h (20%) and then decreases, with no detachment at 60% and beyond. Critically, cell quality gates the detachment window. Fresh yeast responds up to ~50%, whereas aged yeast ceases to detach above ~8%, demonstrating a dual-function assay. Complementary measurements show that ethanol decreases surface tension monotonically, as expected, while optical/SEM imaging reveals aggregation above the detachment window. Requiring only a heater and a temperature probe, this platform offers a compact and low-cost strategy for ethanol sensing. Its applicability in a complex matrix is further demonstrated using whiskey diluted to selected alcohol concentrations, which produced responses consistent with the ethanol calibration trend. Potentially, it also offers a thermal assay for real-time monitoring of microbial cell quality across biotechnology and bioengineering applications. Considering ethanol as a proxy for drugs, the strategy may also support label-free drug screening on cells. At a fundamental level, the non-monotonic effect of ethanol, and especially the sharp maximum at 20%, remains unresolved and invites further studies. Full article

The annual congress of the Italian Association of Plastic Aesthetic Surgery (AICPE), with more than 700 members, represents one of the most relevant conference meetings in Europe relating to Aesthetic Plastic Surgery due to the number of participants and due to the faculty of invited speakers chosen for their renowned scientific value. The 13th meeting was held in Rome (Italy) from 10 to 12 April 2026. Key focus areas of the scientific program concerned breast (reduction, lifting supported or not by mesh, implant surfaces, augmentation), face and neck (lifting, blepharoplasty, malar implants, feminization), body (abdominoplasty and torsoplasty, post-partum and ex-obesity surgery, body and limb contouring, complication treatments) and nose surgery combined with medical innovations in energy devices, threads and aesthetic medicine procedures. Special attention was also given to the theme of the therapeutic role of aesthetic surgery, which is increasingly becoming an integral part of a clinical pathway useful for restoring the patient’s psycho-physical balance. Presented here is a report of the abstracts accepted due to their innovative or cutting-edge content that were selected to be given as oral presentations during the congress sessions. The 2nd edition of the Saccomanno memorial award for the best abstract presented by a young surgeon has been organized with the endorsement of Surgical Techniques Development by MDPI. Full article

This paper examines how conversational daily deep dive news podcasts build journalistic authority and legitimacy through what we call the “journalist-as-guest” (JAG) format. Applying a deep analytical listening methodology that honors the aurality of the medium and positions listening as a core analytical method, we analyzed eight daily deep dive news podcasts from Canada and Australia, attending to how sonic elements interact with conversational performance to produce podcasting’s characteristic intimacy and parasocial listener bonds that support authority and legitimacy claims for journalism. Our findings expand on our previous identification of the JAG format as a key element of explanatory-type daily deep dive podcasts. Here, we reveal how it operates through three key mechanisms: recurring self-referential speech that reinforces journalistic cultural belonging; intentional unpacking of the reporting process to reveal behind-the-scenes work; and the careful construction of journalists as subject-matter experts. Together, these mechanisms transform performative conversation into metajournalism, creating a space in which journalistic expertise is displayed and validated through colleague-to-colleague dialogue. We term this dynamic “intimate authority.” We argue that the JAG format capitalizes on podcasting’s affordances for intimacy, parasociality, and extended metajournalistic conversation to invite audiences into the news-making process while positioning journalists as credible experts and sense-makers. In doing so, it functions as a mechanism for establishing authority and legitimacy claims in digital media environments. As daily news podcasting becomes increasingly central to remediation efforts aimed at restoring trust in journalism, both legacy and independent news podcasters appear to be counting on the JAG format as a strategic response to concurrent crises of news avoidance and relevance. Full article

Background: Population ageing increases the burden of chronic diseases, multimorbidity, and functional limitations, making nutrition and lifestyle important modifiable determinants of healthy ageing. Universities of the Third Age (U3A) provide an educational and social environment for older adults, but multidimensional relationships between nutrition knowledge, diet quality, lifestyle, and health status in this population remain insufficiently characterized. This study aimed to assess these associations among older adults attending U3A in Poland. Methodology: A cross-sectional online survey was conducted between January and April 2026 among community-dwelling older adults participating in U3A programs. Of 700 distributed invitations and 520 returned questionnaires, 450 complete and eligible responses were included. The questionnaire was based on the KomPAN^® framework and expanded with items on health, lifestyle, psychosocial resources, barriers to healthy eating, and sources of health information. Diet quality was assessed using the pro-Healthy Diet Index, non-Healthy Diet Index, and overall Diet Quality Index (DQI). Nutrition knowledge was measured using a 24-item scale. Analyses included distributional diagnostics, non-parametric group comparisons, FDR-corrected Spearman correlations, psychometric assessment, principal component analysis, multivariable regression with model diagnostics, and profile segmentation. Results: The mean age was 73.63 ± 5.73 years, and most participants were women. The median DQI was 15.59 [3.93–24.86], with a predominance of neutral diet quality. Nutrition knowledge was moderate, with a median score of 12.00 [9.00–15.00], and the scale showed very good internal consistency. PCA identified three dietary patterns: convenience/ultra-processed, prudent/health-promoting, and traditional meat-and-fat. Higher DQI was associated with better nutrition knowledge, greater physical activity, a more favorable sleep profile, regular meal timing, and lower disease burden. Participants with multimorbidity had significantly lower DQI. Segmentation distinguished a health-engaged/higher-resource profile and a lower-resource/nutritionally vulnerable profile. Conclusions: U3A participants in Poland are educationally and socially active but nutritionally heterogeneous. The predominance of neutral diet quality, moderate nutrition knowledge, and identifiable knowledge gaps indicates the need for targeted, practical, and behavior-oriented nutrition education supporting healthy ageing. Full article

Drug use, mental health, and gender identity are complex phenomena influenced by multiple social, psychological, and cultural factors. Previous research indicates that the university stage represents a period of vulnerability for mental health, especially among students whose gender identity differs from the traditional categories of man or woman. This study aimed to examine the association between gender identity, drug use, and symptoms of anxiety and depression among students at a public university in Mexico. A cross-sectional correlational study was conducted through a public invitation survey among undergraduate students enrolled in a public university in Mexico. Data were collected using the Drug Use Questionnaire for University Students administered through the LimeSurvey platform. Variables included sociodemographic characteristics, gender identity (man, woman, and other identity), drug use, and symptoms of anxiety and depression. The results indicate that students who identified with another gender identity showed a higher likelihood of using the substances analyzed compared with those who identified as women, particularly prescription drugs and marijuana. Additionally, they presented higher odds of reporting anxiety and depressive symptoms compared with those who identified as men. These findings highlight the need for targeted prevention and support strategies to improve mental health among students with diverse gender identities. Full article

The 9th National Congress of the Italian Society for Virology (SIV-ISV), entitled “One Virology—One Health”, took place in Turin at the Centro Congressi Lingotto from 22 to 24 June 2025. The meeting highlighted recent multidisciplinary and translational developments in virology, with a strong focus on the integration of the One Health perspective. Major themes included viral emergence and surveillance, genomic sequencing and bioinformatics, virus–host interactions, viral immunology and vaccines, structural and physical virology, environmental and food virology, zoonoses and animal infections, diagnostics and antiviral therapy, virus-based biotechnology and plant virology. The Congress aimed to: (i) bring together clinicians, basic researchers, veterinarians, environmental microbiologists, bioinformaticians, public-health professionals and industry to share methodologies and best practices; (ii) provide an interactive scientific environment promoting discussion and collaboration between senior investigators and trainees through plenaries, joint society sessions, invited talks, oral communications selected from abstracts, poster sessions, and mentoring panels; and (iii) identify priorities and inspire new research directions at the interface of human, animal and environmental health. More than 400 participants from national and international institutions attended the meeting, featuring distinguished plenary speakers, joint sessions with global networks, and numerous presentations of original unpublished data. This report summarizes the meeting’s scientific highlights, cross-disciplinary discussions, and proposed actions to strengthen One Health surveillance, computational infrastructures, and translational applications of viral biology. Full article

Background/Objectives: Alzheimer’s disease (AD) disproportionately affects women, who account for nearly two-thirds of affected individuals worldwide. This sex imbalance cannot be explained by longevity alone and likely reflects complex interactions among biological sex, endocrine aging, genetic susceptibility, and brain-specific mechanisms of vulnerability. Neuroimaging has played a pivotal role in characterizing these sex-related differences in vivo, enabling the assessment of amyloid-β deposition, tau propagation, neurodegeneration, cerebral glucose metabolism, and network reorganization. This invited review examines AD through a rigorously sex-specific neuroimaging perspective, with particular emphasis on implications for women’s brain health. Methods: We integrated evidence from structural MRI, FDG-PET, amyloid-PET, tau-PET, estrogen receptor PET, diffusion MRI, and fluid biomarkers, together with epidemiological, molecular, genetic, and endocrine studies. The review focuses on female-specific trajectories of AD initiation and progression, highlighting the contribution of neuroendocrine aging, menopause, metabolic dysfunction, and sex-modulated genetic risk factors. Results: Available evidence indicates that women exhibit distinct biological and neuroimaging signatures across the AD continuum. Menopause emerges as a critical neuroendocrine transition associated with metabolic decline, altered brain connectivity, increased amyloid and tau vulnerability, and progressive neurodegeneration. Female-specific patterns of tau propagation and sex-dependent interactions with genetic risk factors further contribute to differential disease trajectories. Advanced multimodal neuroimaging approaches have substantially improved the characterization of these mechanisms and their relationship with cognitive decline and clinical progression. Conclusions: A sex-specific neuroimaging framework is essential to improve understanding of AD pathophysiology and to advance precision medicine approaches tailored to women’s brain health. Recognition of endocrine aging and female-specific biological vulnerability may inform earlier identification of at-risk individuals and the development of targeted prevention and treatment strategies. Future research should prioritize sex-aware longitudinal studies and multimodal biomarker integration to optimize personalized interventions in AD. Full article

Meeting the physiological and psychological needs of shelter cats through appropriate care is critical to reducing stress and disease risk, as well as enabling positive homing outcomes. Shelter organisations across the British Isles provide care for many cats; however, little is known about the types of housing and husbandry approaches applied. This study, therefore, aimed to quantify current approaches to cat housing, husbandry, and general care practices, in addition to providing information relevant to local site capacity, considering reported practices against sector minimum standards where applicable. Nine hundred and sixty-one shelter organisations and/or sites caring for cats were identified and invited to complete an online survey including predominantly multiple-choice questions. A total of 393 unique responses were collected from employees and volunteers, and quantitative data were summarised descriptively. In most cases, the results provided evidence of majority alignment with sector standards, although substantial variations in reported practices were also consistently captured. While most responses described approaches supportive of meeting cats’ basic physiological needs (e.g., access to veterinary care and basic resources), psychological needs were addressed less consistently (e.g., general housing and husbandry approaches), potentially leading to poor welfare outcomes. Identified opportunities to better meet cats’ needs include more cat-friendly, low-stress approaches to pen cleaning and cat handling; greater and more consistent provisioning of within-pen resources; and improved approaches to multi-cat housing and associated decision-making. Additional opportunities to enhance both cat and human wellbeing include more structured intake and assessment processes and capacity management to support optimal cat-to-staff ratios, staff working hours, cat lengths of stay and more consistent access to isolation and emergency intake facilities. Full article

Background/Objectives: Antimicrobial resistance (AMR) is a major public health problem driven partly by inappropriate antibiotic use. Students of health studies represent future healthcare professionals with an important role in patient education, infection prevention, and antimicrobial stewardship. This study assessed knowledge, attitudes, and behaviours regarding antibiotic use and AMR among students of the Faculty of Health Studies, University of Mostar. Methods: An anonymous cross-sectional online survey was conducted in March 2025 using a self-selected convenience sample. The questionnaire was adapted from a previously published survey among Cypriot university students and distributed through student WhatsApp groups and by e-mail. Of 1113 invited students, 220 completed the survey, yielding a response rate of 19.8%. Results: During the previous 12 months, 39.5% of respondents reported antibiotic use. Most respondents reported adherence to medical instructions regarding dosage and duration of therapy, while 20.5% reported self-medication with antibiotics and 29.5% reported keeping unused antibiotics at home. Approximately 42% perceived antibiotics as easy or very easy to obtain without a prescription. Only 36.4% of respondents correctly distinguished antibiotics from other medications. Although most respondents recognised that bacteria can develop resistance, misconceptions persisted regarding humans and viruses. Differences between study programmes were observed for some attitudes and perceptions, whereas gender and year of study were not significantly associated with most responses. Conclusions: Health studies students demonstrated partial knowledge of antibiotics and AMR, together with behaviours that may contribute to inappropriate antibiotic use. Strengthened curricular content on rational antibiotic use, infection management, infection prevention, and antimicrobial stewardship appears justified. The findings are also consistent with the need to consider broader stewardship measures, including better enforcement of existing prescription-only dispensing requirements in Bosnia and Herzegovina. Full article