Search Results (369)

The leading cause of post-surgical hospital readmission is the emergence of hospital-acquired infections (HAIs), where surgical site infections (SSIs) constitute a substantial negative impact on patient outcome and contribute annual direct costs estimated to range from $28.4 billion to $45 billion in the U.S. To address the need for novel antimicrobial coating strategies, previous research has demonstrated that certain microbes can degrade poly(aspartic acid) (PAA)-based coatings, suggesting potential limitations of single-compound approaches that must be considered when designing antimicrobial surfaces. In this proof-of-concept study, we investigated whether ordered sequential coatings combining thermally synthesized PAA (tPAA) and oleic acid (OleA) might produce enhanced antimicrobial effects compared to individual compounds. Despite concerns regarding PAA biodegradability, the benefits of using PAA include low cytotoxicity and an ability to chelate metals such as calcium and facilitate bone mineralization and growth post-surgery. Using simple yet effective methods of surface coating applications which utilize tPAA and OleA, we investigated the potential of these ordered coatings to attenuate planktonic and sessile (biofilm) growth and development in Pseudomonas aeruginosa and Escherichia coli in vitro. Application of these ordered coatings resulted in up to 62% reduction in bacterial carrying capacity for P. aeruginosa and up to 43% reduction in biofilm mass relative to untreated controls. Further, confocal imaging via immunohistochemical labeling revealed methods for evaluating the impact of treatments targeting biofilm development through extracellular DNA quantification. Additionally, these coatings show dose-dependent cytotoxic effects against 3T3 mouse fibroblast cells. These preliminary findings, along with results derived from cytotoxicity assessment and physicochemical characterization via dynamic light scattering, suggest that ordered tPAA-OleA coating systems warrant further investigation as potential antimicrobial strategies, though additional validation, including testing against diverse clinical isolates, mechanistic studies, and in vivo evaluation, would be required before clinical application. Full article

Background: Healthcare burnout is pervasive, necessitating more efforts to reduce it. Objective: To evaluate the effectiveness of well-being leadership training in reducing healthcare burnout. Design: The Clinician Wellness Council (CWC) leadership training consisted of 15 months of educational and small group sessions (September 2023–November 2024) with pre–post-training burnout survey comparison. Setting: Primary and specialty departments across a Pacific Northwest community-based hospital system. Participants comprised 22 clinicians from primary and specialty departments. Participants identified an intervention group where they would focus their leadership efforts. Those groups contained 549 clinicians, and 5439 non-intervention clinicians were controls. Intervention: Well-being leadership training. Measures: The Maslach Burnout Inventory (MBI) and the turnover intent questions before and after training. Results: Of the 22 CWC participants, 15 (68%) completed the surveys before and after training. Burnout reduction was seen (47% to 13%; p = 0.0253), primarily driven by decreased emotional exhaustion (EE). Among 549 intervention group clinicians, 173 completed both surveys compared to 359 of 5439 clinicians in the control group. Intervention practitioners (N = 173) showed reductions in EE items (e.g., feeling burnout, working too hard, working with people is stressful) and turnover intent. Multivariable regression analyses showed that EE reductions were associated with co-workers’ intent to leave. Limitations: We obtained pre- and post-training MBI measures on a subset of the intervention group co-workers rather than a majority. Conclusions: Participation in a well-being leadership training program consisting of education, coaching, and community building reduced burnout, increased confidence to improve their workplace, and their leadership decreased co-worker EE and turnover intent. This training creates a blueprint for reducing burnout in clinician leaders and co-workers. Primary Funding Source: A PPMC foundation grant sponsored 10 local participants. Central division funding came from system and local funds. Participants received $1000/month training reimbursement. Full article

Background/Objectives: Obstructive urosepsis mandates rapid source control, yet actionable time-to-decompression (TTD) thresholds and the influence of diversion route remain debated. This review synthesized evidence on TTD, early outcomes, and predictive biomarkers. Methods: Following PRISMA-2020, ten studies met eligibility: three large administrative cohorts and seven clinical series/trials comparing outcomes by TTD and/or initial decompression (retrograde stent [RUS] vs. percutaneous nephrostomy [PCN]) and reporting biomarkers. Results: Delays were consistently harmful. In a national cohort, a TTD of ≥ 2 days increased in-hospital mortality (adjusted OR, 1.29; 95% CI, 1.03–1.63). Another analysis showed mortality of 0.16% with ≤48 h vs. 0.47% when delayed (derived OR, 0.43; p = 0.044). Absence of decompression yielded the highest mortality (19.2% vs. 8.82%; OR, 2.6; 95% CI, 1.9–3.7). Septic shock remained frequent despite low crude mortality in clinical series: 20.8% and 33.3% across two cohorts. Post-decompression urosepsis occurred in 18.7% in a randomized study and was associated with pyonephrosis and higher procalcitonin (PCT). An ED cohort showed that earlier stenting reduced length of stay (≤6 h: 35.6 h vs. 71.6 h, p = 0.01; ≤10 h: 45.7 h vs. 82.4 h, p = 0.04). Modality effects were modest; one cohort reported higher ICU use with PCN vs. RUS (OR, 3.23; 95% CI, 1.24–8.41), likely reflecting confounding by indication. Conclusions: Across designs, timeliness—not device choice—was the dominant determinant of early outcomes. Biomarkers (notably, PCT) and imaging features can prioritize ultra-early decompression. Full article

Background/Objectives: The Developing and Evaluating a Machine Learning Opioid Prediction & Risk-Stratification E-Platform (DEMONSTRATE) trial aims to assess the usability, acceptability, feasibility, and effectiveness of implementing a machine learning (ML)-based clinical decision support (CDS) tool—the Overdose Prevention Alert—which predicts a patient’s risk of opioid overdose within three months. Methods: This single-arm study uses a pre–post implementation design with mixed-methods evaluation in 13 University of Florida Health, Gainesville, internal medicine and family medicine clinics. Eligible patients are aged ≥18 years, received an opioid prescription within the year prior to their upcoming primary care visit, are not receiving hospice care, do not have a malignant cancer diagnosis, and are identified by the ML algorithm as high risk for overdose. The Overdose Prevention Alert triggers when a primary care provider (PCP) signs an opioid order in electronic health records. We will evaluate effectiveness by comparing pre- and post-implementation outcomes using a composite patient-level measure defined by the presence of any of the following 6 favorable indicators: (1) evidence of naloxone access; (2) absence of opioid overdose diagnoses and naloxone administration; (3) absence of emergency department (ED) visits or hospitalizations due to opioid overdose or opioid use disorder (OUD); (4) absence of overlapping opioid and benzodiazepine use within a 7-day window; (5) absence of opioid use ≥50 morphine milligram equivalent daily average; (6) receipt of referrals to non-pharmacological pain management. Additional quantitative metrics will include alert penetration, usage patterns, and clinical actions taken. Usability and acceptability will be assessed using a 12-item questionnaire for PCPs and semi-structured interviews. Expected Results: The trial will provide insights into real-world ML-driven CDS implementation and inform future strategies to reduce opioid-related harm. Full article

Purpose: This study aimed to examine post-traumatic growth, mindfulness, and quality of life in recipients after liver transplantation. Design and Methods: This study employs a descriptive and cross-sectional design. We collected data in an organ transplant center affiliated with a research and application hospital in Eastern Turkey. The sample in our study included a total of 292 liver transplant recipients. We collected data using a personal information form, the Post-Traumatic Growth (PTG) Inventory, the Mindfulness Scale (MS), and the Quality of Life Questionnaire (QoL) Short Form (SF-36). We performed data analysis using descriptive statistical methods and one-way analysis of variance. Results: Of the liver transplant recipients, 72.6% were between 45 and 64 years of age, 72.3% were female, and 56.5% had undergone liver transplantation more than 1 year prior. Liver transplant recipients scored between 64.89 and 97.85 on the negative subscales. Recipients scored between 32.70 and 44.72 on the positive subscales in QoL SF-36. The PTG and MS mean scores were 62.43 ± 20.31 and 62.35 ± 7.14, respectively. There was a positive correlation between positive QoL sub-dimensions and MS and PTG (p < 0.05). Conclusions: We found a positive and strong relationship between PTG and mindfulness; in addition, we found that an increase in both had the effect of improving QoL. We recommend developing strategies that increase PTG, and that mindfulness be performed to improve QoL among patients following liver transplantation. Full article

Background and Objectives: Reports of respiratory function in COVID-19 survivors are still rare, especially in children. This study aims to determine the prevalence and prognostic factors that influence long-term respiratory function in children after COVID-19. Materials and Methods: An observational analytical study with a retrospective cohort design was conducted between January and June 2024. The subjects were pediatric patients aged 5–18 years with confirmed history of COVID-19. Respiratory function was evaluated with spirometry. The analyzed prognostic factors included clinical classification of COVID-19, gender, age, comorbidities, history of ventilator support, history of hospitalization and persistent symptoms. Results: A total of 100 subjects were included in this study. The subjects were 53% female, 52% aged ≥ 12–18 years, and 76% had at least one comorbidity, the most common being obesity (27%). The majority (73%) had a history of mild COVID-19, and 78% were not hospitalized. The prevalence of impaired lung function was 47%, dominated by restrictive lung pattern. The prevalence of long COVID was 18%, with the most common symptom being fatigue (13%). The presence of persistent symptom is significantly associated with abnormal spirometry result (p = 0.03, RR 1.99; 95% CI 1.38–2.87). Undernourished status and moderate-to-severe and critical COVID-19 significantly influence long-term respiratory function with p = 0.002, aOR 5.64; CI 95% 1.89–16.85 and p = 0.006, aOR 5.18; and CI 95% 1.59–16.89, respectively. Conclusions: The prevalence of impaired lung function in children after COVID-19 was 47%. Persistent symptoms, undernourished status, and moderate-to-critical severity of COVID-19 were found to be associated with impaired long-term respiratory function in post-COVID-19 pediatric patients. Further prospective studies are needed to confirm these findings and clarify causal mechanisms. Full article

Background/Objectives: Psychiatric nurses are constantly exposed to physical and verbal violence from patients with mental illnesses, which can lead to post-traumatic stress (PTS). This study investigated the correlations among psychiatric nurses’ experiences of violence, cognitive-emotion regulation strategies, and PTS and sought to identify factors associated with PTS. Although workplace violence and its psychological effects have been examined among nurses, little is known about how cognitive-emotion regulation influences PTS in psychiatric nurses who are frequently exposed to violence. Understanding these mechanisms is crucial for developing interventions to support their mental health. Methods: This was a cross-sectional, descriptive correlational study. Participants were 140 psychiatric nurses with more than one year of clinical experience working in psychiatric wards at university, general, and psychiatric hospitals in South Korea. Collected data were analyzed using SPSS/WIN 25.0. A hierarchical regression analysis was performed to identify factors influencing the nurses’ PTS. Hierarchical regression analysis was performed in three steps: demographic variables were entered first, followed by violence experience, and finally cognitive-emotion regulation strategies. All assumptions of linearity, normality, and homoscedasticity were satisfied. Results: In Model 3, after controlling for demographic and work-related variables, maladaptive emotion regulation strategies, experiences of violence, and education level emerged as significant predictors of PTS among psychiatric nurses. These variables together explained a substantial proportion of the variance in PTS. Conclusions: To reduce PTS among psychiatric nurses, it is necessary to develop and implement violence prevention and coping programs, stress and mental health management initiatives, and educational programs. Based on the findings, hospitals should strengthen organizational systems by establishing structured mechanisms for reporting and debriefing after violent incidents. In addition, hospitals should provide regular training on cognitive-emotion regulation and enhance institutional support to help nurses manage the psychological impact of workplace violence. Such interventions may not only minimize violent incidents but also reduce reliance on maladaptive cognitive-emotion regulation strategies. While the findings provide important insight, the cross-sectional design limits causal inference. Further longitudinal research is recommended to verify these relationships. Full article

Background/Objectives: To investigate the impact of a routine botulinum toxin type A (BoNT-A) injection in combination with outpatient therapy on the daily activities of stroke survivors with upper extremity spasticity and to facilitate patient-centred assessment focusing on individual needs during daily life. Methods: Design: Observational study across one treatment cycle (3 months). Setting: Spasticity outpatient clinic of a neurorehabilitation hospital in Germany. Participants: Adult stroke survivors (n = 27) with upper extremity spasticity receiving routine BoNT-A treatment. Interventions: Participants received one BoNT-A injection and outpatient therapies as part of their routine management. Augmented assessment was conducted directly before the injection (T0), and at 4 to 6 weeks (Tmax1) and 12 to 14 weeks (T2) following the injection. Main outcome measures: The Canadian Occupational Performance Measure (COPM), Goal Attainment Scaling (GAS), and Arm Activity Measure (ArmA). Secondary outcome measures: The Resistance to Passive Movement Scale (REPAS), Motricity Index (MI), SF-12v2 Health Survey (SF-12v2), Global Clinical Impression (GCI), and importance of and satisfaction with the BoNT-A treatment. Results: Performance of individually selected daily activities and satisfaction with their performance (COPM), passive care tasks (ArmA, part A), and resistance to passive movement (REPAS) significantly improved from T0 to Tmax1. Improvements largely remained at T2. Individual goals were all set at the activities and participation levels of the International Classification of Functioning, Disability and Health. These improved for 75% of participants and were fully attained by 33.3% at Tmax1. Responder analysis indicated that COPM and ArmA improvements were clinically significant for up to 50% of participants. Active upper extremity use (ArmA, part B), health-related quality of life (SF-12v2), and upper extremity strength (MI) remained unchanged. Conclusions: Our results indicate that BoNT-A in combination with routine outpatient therapy positively influenced the individually valued daily activities of stroke survivors. COPM, GAS, and ArmA are suitable for facilitating a patient-centred and daily life-oriented spasticity management post-stroke. Full article

Background: The potential long-term effects of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection on the brain structure have not yet been fully elucidated. Even though existing studies have reported structural changes in the post-COVID-19 period, the results remain highly inconsistent and controversial. As such, identifying an imaging biomarker for post-COVID brains is still under investigation. This review aims to comprehensively summarize the structural MRI (sMRI) studies that focus on volumetric brain changes at least two weeks following COVID-19 infection. Methods: A systematic literature search was conducted on PubMed, SCOPUS, Web of Science, EMBASE, and Google Scholar up to 9 September 2025. Studies that utilized sMRI to assess volumetric brain changes post-COVID at greater than two weeks following infection were included. Exclusion criteria encompassed research involving pediatric or adolescent populations and imaging modalities other than sMRI. Preprints, reviews, case reports, case series and post-mortem studies were also excluded. Results: Forty-one studies satisfied the inclusion criteria and consisted of 2895 patients and 1729 healthy controls. Despite the wide variability in image acquisition protocols, data processing methods, and comorbidities between studies, multiple studies reported statistically significant volumetric reductions in the hippocampus, amygdala, thalamus, basal ganglia, nucleus accumbens and the cerebellum months to years after infection, especially in older hospitalized patients with severe COVID-19. Conclusions: The emerging literature reports long-term volume changes across various brain regions in individuals previously infected with COVID-19; however, the evidence is inconsistent. Specific imaging biomarkers following exposure to SARS-CoV-2 infection and the underlying mechanisms of these changes are yet to be identified. Future studies with harmonized imaging protocols, longitudinal designs, and integrated biomarker and clinical data are needed to define robust biomarkers and elucidate the pathophysiology of these findings. Full article

Introduction/Goal: Stress and negative emotions have been shown to exert a substantial impact on cancer patients, affecting their ability to adapt to therapy and the overall effectiveness. Elevated cortisol levels, a stress-induced hormone, have been shown to suppress immune system function, potentially reducing the body’s capacity to combat cancer cells. On the contrary, prolactin, a hormone that stimulates the immune system, has shown potential in this context but requires further study. The objective of this study was to investigate the acute physiological changes that occur during a single Conscious Connected Breathing (CCB) session, as part of a larger investigation on Integrative Breathwork Psychotherapy (IBP), a novel integrative psychosomatic intervention designed to improve psychosomatic and immune status in cancer patients. Methods: The project involved 93 breast cancer patients hospitalized for postoperative radiotherapy who participated in a ten-session IBP program. Fifty-six patients agreed to participate (response rate: 60%). During the experiment, 8 patients were excluded from the analysis. IBP consisted of small group sessions (up to six participants) conducted three times weekly. Each session included 45 min of CCB—defined as rhythmic circular nasal breathing at a depth exceeding resting tidal volume, without breath-holding, performed in a state of mindful acceptance—followed by 15 min of free emotional expression (verbal articulation of emerging feelings and sensations). This was a within-subject pre-post design: physiological measurements were obtained immediately before and 30 min into the tenth session (when participants had achieved technical proficiency) in all participants, who served as their own controls. Outcome measures included: arterialized capillary blood gas parameters (pH, pCO₂, pO₂, ctO₂, COHb, HHb, cH⁺), serum cortisol and prolactin concentrations, and immunoglobulin A (IgA). Results: During the CCB session, blood gas analysis revealed significant changes consistent with mild respiratory alkalosis: decreases in pCO₂ (p = 0.003), pO₂ (p < 0.001), cH⁺ (p < 0.001), ctO₂ (p < 0.001), COHb (p = 0.03), and HHb (p = 0.004), alongside an increase in pH (p < 0.001). Concurrently, prolactin levels increased significantly (p < 0.001), while cortisol (p < 0.001) and IgA (p < 0.001) decreased. Conclusions: This study is the first to analyze acute changes in capillary blood gas parameters and neuroendocrine balance during Conscious Connected Breathing sessions in cancer patients, revealing measurable immunostimulatory and stress-modulatory effects. The observed shift toward respiratory alkalosis, combined with increased prolactin and decreased cortisol, suggests that CCB may facilitate favorable neuroendocrine-immune interactions. These findings support the potential of breathwork as a complementary therapy for cancer patients. Further research is needed to explore underlying mechanisms and assess long-term psychological and immunological impacts. Full article

Purpose: Peripapillary choroidal melanoma provides a unique challenge; proximity to visually important structures, such as the optic disc and fovea, confers a high risk for the development of maculopathy and optic neuropathy, leading to poorer visual outcomes with most forms of radiotherapy. Ocular proton therapy (OPT) requires an aperture to shape the beam to the tumour. An aperture ‘notch’ may minimise damage to the optic disc and/or the fovea. This study aims to explore if there are any additional advantages to incorporating a notch over the optic nerve beam area. Design: Retrospective audit (cohort study). Participants: Participants included eighty-three patients treated at Liverpool with proton beam therapy from January 2012 to March 2020 for their peripapillary choroidal melanoma. All had a minimum of two and a half years of follow-up vision data; this was to ensure there was enough visual acuity assessment data to perform sufficient analysis. Patients excluded had choroidal melanoma situated over 3 mm from the optic disc, as these were unlikely to have an aperture notch. Methods: A retrospective audit was undertaken in accordance with the Declaration of Helsinki, and registered with the Royal Liverpool Hospitals audit department (audit reference number: Ophth/SE/2024-25/25). Data was collated from the Liverpool Ocular Oncology database, clinic letters and the individual proton beam 3D plans. Robust statistical analysis using a mixed effects model was used to explore associations between notched beams and vision loss and complications. Main Outcome Measures: The primary outcome measure is visual acuity loss post-proton beam therapy. Secondary outcome measures were enucleation and other complication rates. Results: Analysis shows that at 10 years post-OPT, there would be an expected 0.058 (p = 0.077) logMAR of vision saved using a notch for the optic disc compared to no notch (normal apertures); this is considered clinically significant. This cohort also loses vision at a slower rate than other cases. No other predictors were found to be statistically significant for loss of vision, and notched beams showed no advantage in reducing rates of complications. Conclusions: There is some evidence of a trend that utilising a notch for optic disc does show long-term vision benefit; it demonstrates a clinically significant benefit in patients with peripapillary choroidal melanoma. Full article

Background: The intersection between oncology and intensive care has shifted from predominantly end-of-life care to a therapeutic bridge that can preserve anticancer trajectories in carefully selected patients. Yet, criteria separating benefit from futility remain fragmented. Objective: This paper seeks to map contemporary evidence (2015–2025) on outcomes after Intensive Care Unit (ICU) admission in adults with cancer and to identify clinical constellations in which ICU-level care still changes prognosis. Methods: PRISMA-ScR scoping review (PCC framework). PubMed search (2015–2025), dual screening, standardized extraction; narrative/thematic synthesis across six clusters (hematologic, solid tumors, sepsis/non-COVID-19 infection, COVID-19/viral pneumonia, novel/targeted-therapy toxicities, end-of-life/aggressive ICU) were used. No meta-analysis given heterogeneity. Results: Seventy-three studies (>170,000 ICU admissions) were included, mostly cohort designs across 27 countries. ICU mortality ranged 8–72% (weighted mean ≈ 41%); hospital ≈ 38%; 90-day ≈ 46%; 1-year ≈ 62%. About one third of ICU survivors resumed systemic therapy. Benefit concentrated in early admissions, single-organ failure, controlled/remission disease, postoperative/elective monitoring, and reversible treatment-related toxicities (e.g., ICI pneumonitis, CAR-T CRS/ICANS). Futility clustered around ≥3 organ supports, RRT > 7 days, refractory/progressive disease, and ECOG ≥ 3. Sepsis outcomes averaged 45–55% ICU mortality but improved with rapid recognition and source control; COVID-19 mortality was particularly high in hematologic malignancies early in the pandemic, with subsequent declines post-vaccination. Conclusions: In modern oncologic practice, ICU care changes prognosis when the acute physiological insult is reversible and cancer control remains plausible; conversely, high organ-support burden and refractory disease define practical futility thresholds. These signals support time-limited ICU trials, earlier ICU involvement for sepsis/irAEs, and embedded palliative care to align intensity with goals. Full article

Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are characterized by high morbidity and mortality. We retrospectively analyzed 468 hospital admissions from 80 patients to evaluate the prognostic value of inflammation-based hematologic indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil-percentage-to-albumin ratio (NPAR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII). All biomarker–outcome associations were specified a priori as exploratory in this hypothesis-generating design. In PAH, both NPAR and SII were associated with in-hospital mortality (odds ratio [OR] 1.129, 95% confidence interval [CI] 1.011–1.261, p = 0.031; OR 1.001, 95% CI 1.000–1.002, p = 0.002), post-discharge mortality (NPAR OR 1.181, 95% CI 1.062–1.313, p = 0.002), and poorer overall survival (log-rank p = 0.002 and p = 0.012, respectively). Higher LMR was associated with reduced in-hospital mortality (OR 0.291, 95% CI 0.108–0.790, p = 0.015), while NLR predicted increased in-hospital mortality. In CTEPH, NLR and LMR were the strongest predictors, correlating with worse survival (log-rank p = 0.007 and p = 0.044) and higher post-discharge mortality (NLR OR 1.289, 95% CI 1.029–1.615, p = 0.027). Receiver operating characteristic (ROC) analysis suggests the potential value of SII in PAH and the promising performance of NPAR in CTEPH. Inflammation-based hematologic indices, particularly NPAR, SII, and NLR, may provide valuable prognostic information and may serve as practical, non-invasive tools for predicting hospitalization duration and mortality in PAH and CTEPH. Full article

Objective: This study is designed to systematically assess the safety and efficacy profiles associated with varying procedural sequences of endovascular aortic repair (EVAR) and percutaneous coronary intervention (PCI) in clinical practice. Methods: We conducted a retrospective cohort analysis encompassing patients diagnosed with aortic aneurysm and concomitant coronary artery disease (CAD) who underwent EVAR at Beijing Anzhen Hospital, Capital Medical University, between January 2010 and December 2022, with planned staged (preoperative or postoperative) or simultaneous PCI. The cohort was stratified into three groups: PCI followed by EVAR, EVAR followed by PCI, and simultaneous EVAR and PCI. The primary endpoint was a composite of all-cause mortality, non-fatal myocardial infarction, cerebrovascular events, and aortic-related complications within 12 months post-intervention. Secondary endpoints included duration of hospital stay, total hospitalization costs, and incidence of in-hospital adverse events. Multivariate logistic regression analysis was employed to identify independent predictors of the primary endpoint. Results: The study cohort comprised 374 patients, with 209 (55.9%) undergoing PCI followed by EVAR, 133 (35.6%) receiving EVAR followed by PCI, and 32 (8.5%) undergoing simultaneous EVAR and PCI. Comparative analysis revealed no statistically significant differences in the incidence of in-hospital adverse events (p = 0.867) or the risk of primary endpoint events (p = 0.645) across the three treatment groups. Notably, the simultaneous treatment group demonstrated a significantly reduced total hospital stay (10.6 days) compared to the PCI followed by EVAR group (16.0 days) and the EVAR followed by PCI group (17.2 days) (p < 0.001), accompanied by lower hospitalization costs (p = 0.002). Conclusions: For patients with aortic aneurysm complicated by CAD requiring both EVAR and PCI, simultaneous intervention appears to be a safe and feasible therapeutic option. This approach significantly reduces hospital stay duration and associated costs without increasing the risk of in-hospital adverse events or compromising 12-month postoperative outcomes. However, this exploratory finding requires validation in large-scale randomized controlled trials. Full article

Background: Schizophrenia is a complex psychiatric disorder that requires both pharmacological and behavioral treatment and is often accompanied by multimorbidity. Physical activity supports overall health and plays an important role in preventing and managing both somatic and mental disorders. This study aimed to evaluate the impact of an Adapted Physical Activity program using Nordic Walking (AAF-NW) on the quality of life of patients with schizophrenia, depending on the number of steps taken during an eight-week intervention, and to assess its influence on body composition and posture. Methods: A prospective, single-center pilot study was conducted using a pre–post experimental design and direct participatory observation. Eighteen patients from a psychiatric hospital (16 men, 2 women; mean age 43.9 years) completed the intervention. Quality of life (WHOQOL-BREF), musculoskeletal pain (Nordic Musculoskeletal Questionnaire), and subjective exercise intensity (Borg scale, 6–20) were assessed. Measurements were taken before and after the program. All continuous variables (step counts, anthropometric measures, and WHOQOL scores) were tested for normality using the Shapiro–Wilk test and visual inspection of histograms and Q–Q plots. Depending on distribution, parametric or non-parametric tests were applied, with results quantified using appropriate test statistics, effect sizes, and p-values to ensure methodological rigor and transparency. Results: No systematic increase in the number of steps was observed during the training period. A non-significant improvement in quality of life was noted, along with significant reductions in body weight and waist circumference. Conclusions: Regular, structured AAF-NW group activities may potentially support the rehabilitation and treatment process in psychiatric hospitals when implemented on a continuous basis. Although improvements were observed, the findings are exploratory and should be interpreted with caution. Further studies on larger, more homogeneous samples are needed to confirm these preliminary results. Full article