Search Results (412)

Background: The psychosocial needs of families involving a child with a life-limiting or life-threatening condition are well recognized. However, evidence-based interventions that address the needs of the entire family remain scarce, even though family health can be maintained and supported if interventions encompass each individual family member, as well as the family as a unit. The aim was to evaluate the family talk intervention (FTI), regarding family communication, and psychosocial health, for families involving a child with a life-limiting or life-threatening condition. Methods: This pre-post study without a control group involved families of children with a life-limiting or life-threatening condition receiving FTI at a pediatric hospital and a hospice in Sweden. The study is registered at clinicaltrials.gov (ID NCT05020158, date of registration: 23 August 2021). FTI is a family-based intervention with the goal of facilitating family communication about illness-related topics, e.g., prognosis, support parenting, and making all children’s needs visible. In total, 105 participants from 29 families were included. Surveys measuring self-assessed family communication and satisfaction, anxiety, resilience, parenting skills, and children’s mental problems were answered at three time points: baseline (before intervention), at the end of the intervention, and six months later. Changes over time were analyzed using linear mixed-effects models. Results: Significant improvements were reported in family communication, family satisfaction, parenting skills, and levels of anxiety over time. Children’s mental health problems were reduced over time regarding emotional symptoms, conduct problems, peer relationship difficulties, and hyperactivity. No changes were found regarding resilience. Conclusion: The results suggest that FTI contributes to improved family communication and psychosocial health for families involving a child with a life-limiting or life-threatening condition. This highlights the value of a systemic approach that actively involves all family members. Full article

On 9–10 December 2025, the Coalition for Epidemic Preparedness Innovations (CEPI) and the International Vaccine Institute (IVI) convened a workshop in Seoul under CEPI’s Disease X Program. The primary objective was to identify existing gaps needing to be filled and streamline vaccine development and preparedness for Severe Fever with Thrombocytopenia Syndrome (SFTS). CEPI’s partners and experts discussed a multifaceted agenda, ranging from understanding the evolving epidemiology to the refinement of animal models and immunological assay harmonization. Key outcomes included the refinement of Target Product Profiles (TPPs) specifying use cases for both peacetime and outbreak contexts, alongside a recommendation for a core immunoassay panel aimed at harmonizing evaluation frameworks and mitigating the challenges posed by low SFTS prevalence. Integration of the One Health approach emerged as a critical strategy for SFTS prevention, complemented by proactive regulatory engagement to compress vaccine development timelines. This report summarizes these key insights from the workshop, delineating a strategic framework for delivering safe, effective, and accessible vaccines for SFTS and broader Disease X threats. Full article

Background/Objectives: Social rejection during the latency stage is a significant risk factor for children’s emotional and social development. Whereas earlier research focused primarily on individual characteristics of rejected children, contemporary perspectives emphasize peer-group processes, including norm formation, hierarchies, and social status structures. Although autonomy has been widely examined as an individual developmental construct, less attention has been given to its possible collective expression within the classroom peer group. This study aimed to explore how children understand and experience group autonomy and to clarify its role in social status and peer rejection. Methods: Twelve classroom-based focus groups were conducted with 140 fifth-grade children from five public elementary schools in Israel. Discussions were initiated using a projective narrative describing ambiguous peer exclusion. Data were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Coding was conducted independently by two researchers and refined through iterative comparison and reflexive procedures. Results: Three themes emerged: (1) a shared longing for classroom-based group autonomy and collective decision-making; (2) group autonomy as an implicit hierarchical criterion shaping social status, whereby reduced reliance on adults and alignment with peer norms were associated with higher status, while adult dependence was linked to marginalization; and (3) an ambivalent structure of autonomy, as children valued peer independence yet expressed fear of adult punishment and responsibility. Conclusions: Findings suggest that during the latency stage autonomy shifts toward a collectively organized peer-group process. Recognizing group autonomy as a developmental dimension may deepen understanding of social status and peer rejection within classroom contexts. Full article

Insulin acts in the brain to promote satiety. Aging individuals may have brain insulin resistance and altered appetite perceptions. However, it is unclear if exercise impacts cerebral reward centers and appetite perception in middle-aged to older individuals. Purpose: To assess whether a single exercise bout alters cerebral blood flow (CBF) in reward centers in relation to appetite perceptions. Methods: Fifteen sedentary adults (12F; ~56 ± 2y; ~31 ± 1 kg/m²) completed a control and acute exercise condition (70% maximal oxygen consumption) in a randomized, counterbalanced order in the evening. Following an overnight fast, CBF in the accumbens, thalamus, and amygdala (pCASL MRI) was evaluated before and after intranasal insulin spray (INI, 40 IU) administration. Plasma glucose and insulin as well as an appetite visual analog scale (VAS) were assessed at fasting, 30, and 90 min post-INI, as well as at 30 min intervals of a 120 min 75 g oral glucose tolerance test (OGTT). Total area under the curve (tAUC) was calculated. Results: Exercise tended to lower blood glucose (p = 0.072) and plasma insulin (p = 0.007) tAUC, compared with rest. Exercise also raised right thalamus (p = 0.029) and left amygdala CBF (p = 0.023). The rise in fasting CBF in these regions, and the accumbens, correlated with reduced insulin tAUC (r = −0.55 to −0.73, p < 0.050). Although there was no difference in hunger, satisfaction, fullness, or prospective food consumption after exercise, changes in INI-stimulated thalamus CBF related to fullness tAUC after exercise (r = −0.57, p = 0.044). Conclusions: A single exercise bout might increase fasting CBF in some brain regions associated with appetite perception through a potential insulin-related mechanism. Full article

Agricultural heritage is a cultural pillar of the Mediterranean region, where durum wheat plays a central role in traditional landscapes and food systems. Projected climate change is expected to alter crop productivity and place additional pressure on water resources. This study assesses future variability in durum wheat productivity and related implications for water resource management in Sardinia, Italy, where durum wheat is a major rainfed C3 crop. The AquaCrop-OpenSource model was calibrated to local conditions and applied to simulate historical (1950–2023) and near-future (2024–2050) scenarios using projections from seven climate models. Results indicate a modest increase in average yields under future conditions, accompanied by a higher frequency of crop failures. Elevated atmospheric CO₂ concentrations emerge as the primary driver of yield increases, while changes in precipitation represent the main limiting factor. The role of aid irrigation as an adaptation strategy to stabilize yields and enhance productivity was evaluated. Scenario analysis shows that aid irrigation aimed at preventing crop failure remains sustainable in the near future, requiring approximately 14–17% of current agricultural water use in Sardinia. In contrast, irrigation used to maximize productivity would increase water demand by more than 40%, intensifying competition for water resources. Full article

Botulinum toxin type A (BoNT-A) is an established preventive therapy for chronic migraines; however, uncertainty remains regarding its comparative efficacy and safety. Thus, we aimed to summarize current evidence from high-quality systematic reviews of the therapeutic effects of BoNT-A in migraine management. An umbrella review was conducted following PRISMA guidelines and registered in PROSPERO. High-quality systematic reviews with meta-analysis evaluating BoNT-A efficacy were identified through five databases up to August 2024. Primary outcomes included monthly headache frequency and severity. Methodological quality and risk of bias were assessed using the umbrella review checklist. Fourteen articles were included. Overall, quantitative evidence indicated favorable effects of BoNT-A compared with placebo for chronic migraines, across headache frequency, headache severity, and acute medication use, but less efficacy than topiramate and the CGRP monoclonal antibodies (CGRPmAbs) galcanezumab and fremanezumab. Though the adverse events were frequent, BoNT-A was generally well-tolerated. Comparative data suggested superior tolerability versus topiramate and a safety profile like CGRPmAbs. Although botulinum toxin type A is widely used as a preventive treatment for chronic migraines, the available evidence supports its efficacy at a moderate level. Further head-to-head and long-term analyses are needed to clarify its comparative role alongside newer biologic treatments. Full article

This paper presents findings from an interview study conducted in seven different industrial manufacturing companies in Sweden. The purpose was to understand how industrial manufacturing companies currently work with the reduction in their environmental footprint and the transition into the circular economy. The operational sustainability and circular economy actions in the companies were investigated in relation to the sustainability reporting of the companies, particularly those aligned with the Greenhouse Gas Protocol scopes 1–3. The results showed that the reductions in Scopes 1 and 2 were well underway, while circular economy actions remained at an early stage, with most initiatives still being implemented on a limited scale. The paper discusses the reasons behind this. A key finding is that both corporate reporting and the scientific literature rarely differentiate between CO₂ reductions achieved through operational sustainability actions and those resulting from circular economy strategies. Full article

A global decline in students’ motivation and academic performance poses a serious threat to future competence supply, particularly in knowledge-driven economies such as Sweden. Despite higher education’s growing importance for economic and social mobility, the number of students pursuing such education continues to fall. This study employs a mixed-methods design using an explanatory sequential approach to explore how teachers’ leadership identity influences their aspirational engagement in shaping students’ beliefs and intentions to pursue higher education and future career opportunities. The results show that teachers who identify strongly with their leadership role exhibit a type of leadership that influences aspirational engagement with students. This, in turn, may promote students’ beliefs in their potential and intentions to pursue higher education through (1) aspirational engagement in individual dialogues with students, (2) aspirational engagement when introducing new subject areas in whole-class communication, and (3) aspirational engagement related to practical work experience (PRAO). This study demonstrates an understanding of the important potential of teachers’ contributions to elevate society’s future competence supply. Full article

Allostatic load is a physiological measure of chronic stress, and stress is implicated in disrupting appetite regulation. Individuals with obesity and type 2 diabetes have higher allostatic load compared to lean counterparts. However, whether allostatic load differs across prediabetes phenotypes and relates to appetite is unknown. Purpose: Test whether prediabetes phenotypes differ in allostatic load in relation to altered appetite regulation. Methods: Individuals with obesity were recruited, and prediabetes was determined using American Diabetes Association (ADA) criteria (75 g OGTT) for this cross-sectional study. After an overnight fast, appetite hormones (ghrelin and PYY), insulin, and glucose were measured every 30 min up to 120 min of the OGTT. Perception of hunger and fullness as well as desire for sweet and fatty foods were assessed using a visual analog scale. Allostatic load was calculated from physiologic markers. Aerobic fitness (VO₂max), body composition (DXA), clinical labs, and quality-of-life questionnaires were also collected. Results: Participants with impaired fasting glucose (IFG) + impaired glucose tolerance (IGT) had a higher allostatic load, obesity, and insulin resistance compared with IFG or IGT (all p < 0.05), independent of fitness. IFG + IGT also had lower fasting ghrelin (p < 0.05) and no difference in fasting PYY. Hunger, fullness, and sweet ratings were comparable across groups, but fatty food ratings tended to be higher in IFG + IGT than NGT. Conclusions: Allostatic load was associated with altered fasting ghrelin levels in individuals with IFG + IGT, along with elevated body weight and insulin resistance. These findings suggest stress is a potential mechanism underlying appetite dysregulation in different forms of prediabetes. Full article

Background: The elementary school years are a critical period for children’s social development, during which interactions with peers play a central role. While previous research highlights the importance of integration into the peer group, this study investigated the From “Me” to “We” school-based intervention, designed to enhance peer acceptance by encouraging children to move from an individualistic “Me” perspective toward a more group-oriented “We” mindset. Methods: Participants were 594 fourth- and fifth-graders (Mage = 9.57 years; 46% male, 54% female) from four schools in Israel. Students were assigned to an intervention group (N = 270) or a control group (N = 324). The From “Me” to “We” intervention, led by teachers with psychologist support, spanned three months and included six classroom sessions. Peer acceptance was evaluated using pre- and post-test social status questionnaires that assessed children’s actual social interactions with classmates. Results: Analyses revealed a significant interaction between the intervention and children’s acceptance within the group, such that among the intervention group, children’s social status significantly increased, whereas the control group showed no significant change. Conclusions: The From “Me” to “We” intervention led to a small but statistically significant increase in children’s peer acceptance. While these findings highlight the potential of group-oriented approaches to support social development in elementary school, future research is needed to examine the long-term effects and generalizability of the intervention across diverse classroom and cultural contexts. Full article

Lafora disease is a fatal neurodegenerative disorder caused by loss-of-function mutations in the EPM2A or EPM2B genes, which encode laforin and malin, respectively. These mutations lead to the accumulation of intracellular inclusions of abnormal glycogen, known as Lafora bodies, the hallmark of the disease. Symptoms typically begin in early adolescence with seizures and rapidly progress to cognitive and motor decline, ultimately resulting in dementia and death within a decade of onset. Disruption of Epm2a or Epm2b in mice causes neuronal degeneration and Lafora body accumulation in the brain and other tissues. Epm2a^−/− and Epm2b^−/− mice exhibit motor and memory impairments, epileptic activity, and molecular and histological abnormalities. We previously demonstrated that intracerebroventricular delivery of a recombinant adeno-associated virus carrying EPM2A significantly improved pathology in Epm2a^−/− mice. In this study, we tested recombinant adeno-associated virus-mediated delivery of the human EPM2B gene in Epm2b^−/− mice. The treatment partially improved neurological, molecular, and histopathological outcomes, although some pathological features persisted. Importantly, our findings reveal differences between EPM2A- and EPM2B-based gene therapies, highlighting the need to better understand their distinct mechanisms. Despite limitations, our study provides new insights into the complexity of targeting EPM2B mutations in Lafora disease. Full article

Atopic dermatitis (AD) is associated with microbial dysbiosis and impaired skin barrier function. Topical therapies, such as moisturisers and antimicrobial fragrance compounds, may modulate the skin microbiome and support disease management. The objective was to evaluate how a moisturiser and a fragrance compound (farnesol) influence skin microbiome composition in individuals with AD and healthy controls. In a randomised, controlled, operator-blinded study, 15 AD patients and 15 healthy controls applied a moisturiser, farnesol, moisturiser + farnesol, or no treatment to defined skin areas over 7 days. Microbiome composition, alpha/beta diversity, and core taxa were analysed using shotgun metagenomics. At baseline, AD patients exhibited distinct microbial profiles, including elevated Staphylococcus aureus and Micrococcus luteus. Neither moisturiser nor farnesol significantly altered richness, beta diversity, or core taxa in either AD patients or controls. However, moisturiser use in healthy individuals modestly increased Shannon diversity, reflecting improved microbial evenness. Despite clear microbiome differences between AD and healthy skin, short-term topical treatment did not markedly shift microbial composition. The observed stability underscores the resilience of the skin microbiome and suggests that longer interventions or more targeted formulations may be necessary to influence microbial dysbiosis in AD. Full article

Hypoxia-ischemia is a serious perinatal complication affecting neonates globally. Animal models have increased the understanding of its pathophysiology and have been used to investigate potential therapies. Exenatide, clinically used for the treatment of type 2 diabetes mellitus, also protects the rodent brain from hypoxia-ischemia. The rabbit brain has an earlier neurodevelopmental maturation than rodents, as well as similar postnatal maturation to humans. We hereby introduce a new, reproducible hypoxia-ischemia model in rabbit kits at postnatal day (P) 3–4. Following hypoxia-ischemia, rabbit kits received different exenatide concentrations: 170 μg/g (2-dose) or 500 μg/g (1- or 2-dose), or vehicle. The brains were collected seven days later for histological assessment showing that 500 μg/g exenatide, either as a 1- or 2-dose regimen, reduced brain tissue loss by 90% in hypoxia-ischemia experiments both at P3 and P4. A second cohort received a 1-dose 500 μg/g of exenatide or vehicle, and were sacrificed at different early time-points for glucose, ketone bodies, body weight, and temperature measurements. Our results showed a transient 2-fold increase in ketone bodies (0.6 to 1.3 mmol/L) at 6 h. Exenatide did not affect glucose, body temperature or weight gain and appears to be safe and well tolerated in the rabbit model of hypoxia-ischemia. Full article

Objectives: This study aimed to investigate the diagnostic performance of imaging-based biomarkers from computed tomography (CT) and magnetic resonance imaging (MRI) for prediction of malignant and borderline malignant ovarian tumours. Methods: 195 consecutive patients with suspected primary epithelial ovarian cancer were included from the retrospective “Prognostic and Diagnostic Added Value of Medical Imaging in Staging and Treatment Planning of Gynaecological Cancer” (PRODIGYN) study. The radiological stage, according to the International Federation of Gynaecology and Obstetrics system (rFIGO), magnetic resonance imaging (MRI)-based Ovarian-Adnexal Reporting and Data System (O-RADS-MRI) score, and the mean apparent diffusion coefficient (ADC_mean) were investigated for prediction of ovarian malignancy, with histopathology as reference. The same imaging biomarkers were applied to the borderline tumour cohort (n = 33) to predict malignant/adverse features, such as micro-invasion. Results: The rFIGO stage demonstrated high accuracy for ovarian malignancy, with an area under the curve (AUC) of 0.98 (95% confidence interval (CI) = 0.97–0.99). On lesion level, the sensitivity and specificity of the O-RADS-MRI score to predict ovarian malignancy, after adjusting for correlated data structure, was 1 (CI: 0.96–1) and 0.82 (CI: 0.70–0.90), respectively. The performance of ADC_mean to predict ovarian malignancy on lesion level was moderately high, with AUC = 0.78 (95% CI 0.68, 0.88). Discrimination of adverse features in borderline tumours was not improved. Conclusions: rFIGO and O-RADS-MRI showed excellent performance and outperformed ADC_mean as predictive tools for ovarian malignancy but could not predict adverse features in borderline tumours. Full article

Spatially fractionated radiotherapy (SFRT) is emerging as a powerful tool in cancer therapy for patients who are ineligible for treatment with clinically established irradiation techniques. Microbeam radiotherapy (MRT) is characterized by spatial dose fractionation in the micrometre range. This presents challenges in both treatment planning and dosimetry. While a dosimetry system with a spatial resolution of 10 µm and an option for real-time readout already exists, this system can only record dose in a very small volume. Thus, we are exploring dosimetry in an N-isopropylacrylamide (NIPAM) gel as an option for 3D dose visualization and, potentially, also three-dimensional dosimetry in larger volumes. In the current study, we have recorded the geometric patterns of single- and multiport irradiation with microbeam arrays in NIPAM gel. Data for 3D dose distribution was acquired in a 7T small animal MRI scanner. We found that the resolution of the gel is well suited for a detailed 3D visualization of microbeam patterns even in complex multiport geometries, similar to that of radiochromic film, which is well established for recording 2D dose distribution in MRT. The results suggest that a dose–response calibration is required for reliable quantitative dosimetry. Full article