Search Results (247)

Purpose: Child sexual abuse (CSA) is a major public health and forensic concern, often involving delayed disclosure that limits evidence collection and affects judicial outcomes. This study analyzed disclosure patterns, victim–perpetrator characteristics, and forensic findings in CSA cases evaluated in Greece, contributing to the limited Southern European evidence base. Material and Methods: A retrospective review of 89 CSA cases (2014–2024) examined by a certified forensic physician at the Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, was conducted. Data from official medico-legal reports included demographics, abuse context, forensic findings, and disclosure interval. Statistical analyses explored factors associated with delayed disclosure (>7 days). Results: Victims were predominantly female (69.7%) with a mean age of 9.8 years. Most perpetrators were adult males, and over half of cases (53.9%) involved intrafamilial abuse. The mean delay in disclosure was 79 days; only 29.2% reported within one week. Recurrent abuse correlated with delayed disclosure (p = 0.006), while early disclosure was associated with biological evidence collection (p < 0.001). Physical injuries were observed in 23.6% of victims, genital findings in 17%, and anal findings in 3.4%. Conclusions: Delayed disclosure was common and significantly reduced the likelihood of identifying forensic evidence. The early application of trauma-informed examinations, which adopt a child-centered approach emphasizing safety, emotional regulation, and the prevention of re-traumatization, is essential for the medical and forensic evaluation of abused children. Adopting hospital-based multidisciplinary units could improve forensic documentation, interagency coordination, and psychosocial care in Greece. Full article

Fungal diversity has been well explored worldwide, but such knowledge in special environments remains limited. Here, we focus on the soil from Ngari Prefecture with high altitude in the northwestern part of Xizang, China. Among the 514 fungal strains isolated from the soil samples, two strains are newly described as Cymostachys pangongensis and Emericellopsis rutogensis in the Hypocreales on the basis of both morphological and phylogenetic evidence. Cymostachys pangongensis exhibits typical characteristics of Cymostachys, viz., irregularly cymosely branched conidiophores and olivaceous brown to dark brown, fabiform conidia. It represents the sixth known species of Cymostachys and the first species isolated from soils in this genus. Emericellopsis rutogensis has typical chlamydospores and conidia of Emericellopsis, although its sexual ascomata and ascospores were not observed. Notably, these two new species belong to interesting fungal genera, whose members are well known for rich medicinal natural products. In summary, this study enriches the knowledge of fungal diversity in special environments, and the isolated strains may provide important bioresources for future applications. Full article

Sexual and gender minority (SGM) people report considerable dissatisfaction with health services compared to heterosexual and/or cisgender people, with health professionals highlighting insufficient training. Teaching about the health of SGM people is not mandated in UK health professionals’ educational curricula. A review of published and unpublished surveys and of UK training courses evaluating LGBTQ+ content, in the UK and Ireland, examining the teaching of the health of SGM people to health professionals was conducted. Fifteen surveys from the perspectives of educators and students were compared and contrasted. Surveys were found from educators from undergraduate medicine, nursing and midwifery, and pharmacy schools, from students at dental, medical, and pharmacy schools, and from qualified doctors and paramedics. Students and clinical staff perceived that they have insufficient training in SGM health, although there is a contradiction in the perception of teaching amount between students and educational staff. Two curriculum reviews of Royal College postgraduate medical training showed either no or very few requirements on SGM health. Although some courses make considerable efforts to fully incorporate SGM health into mandatory curricula appropriately, professionals mention insufficient training. Until curriculum setters mandate SGM health, patient complaints will continue. Full article

Internal Boxing (neijiaquan 內家拳) is an advanced form of the Daoist gymnastic exercise of daoyin (導引). However, how it achieves a paradigmatic shift from qi/blood regulation to deep-level transmutation of sexual energy still requires further exploration. Therefore, it is of great significance to look into how Internal Boxing inheres and integrates various techniques of “desire transmutation” (zhuanyu 轉欲) from internal alchemy (neidan 內丹), thereby transcending traditional daoyin, bringing about a significant systematic reconfiguration in the model of body cultivation practices in Daoist medicine. The traditional daoyin (i.e., “guiding and stretching”) practice emphasizes the regulation of qi/blood, but it remains limited in accounting for and producing the self-conscious transmutation of sexual energy. In contrast, Internal alchemy provides a different system of theory and techniques, which is centered on the concept of “transmutation of desires”, converting human desires into high-level life energy through a process of interaction between one’s internal spirit (xinshen 心神) and internal breathing (neixi 內息). This study thus examines the ways in which Internal Boxing integrates and reconfigures these techniques within its bodily training regimen. In the core of all these styles is the goal to refine the primordial essence (yuanjing 元精) by transitioning the method to induce the flow of vital energy from breathing to somatic movements. As a result, this study shows that the innovations of Internal Boxing reconfigure the qi/blood regulation model in the traditional daoyin practice, causing a systematic reconfiguration in the transmutation of sexual energy and, further, bridging the gap between daoyin and internal alchemy in both theory and practice. Furthermore, such innovations also develop a holistic view of the human body as marked by an emphasis on the “unity of pre-heaven (xiantian 先天) and post-heaven (houtian 後天) states”, which expands in both depth and breadth the theories of body cultivation practices in Daoist medicine. Full article

Background/Objectives: Sexual health is shaped by lifestyle factors alongside biomedical determinants. This review synthesises evidence on physiotherapy, balneology/peloidotherapy, and diet therapy as preventive and therapeutic adjuncts for female sexual dysfunctions and related gynaecological conditions. Methods: A structured narrative review of PubMed and Google Scholar (June–July 2025) was conducted by three independent reviewers using predefined keywords in English and Polish. Case reports, preprints, and studies before 2015 were excluded. From 7322 records, 47 studies met the inclusion criteria for qualitative synthesis. Results: Physiotherapy—particularly pelvic floor muscle training, multimodal manual therapy, neuromuscular electrical stimulation (including PTNS), magnetostimulation, short-wave diathermy, and capacitive–resistive monopolar radiofrequency—was consistently associated with reductions in dyspareunia, chronic pelvic pain, and urinary symptoms, with parallel improvements in sexual function and quality of life. Balneological procedures (brine baths/irrigations, crenotherapy, selected radon/sulphide/iodine–bromine applications) and peloidotherapy demonstrated analgesic, anti-inflammatory, and perfusion-enhancing effects, with signals of benefit in vulvodynia, endometriosis, and infertility support. Dietary measures—higher fruit intake (notably citrus), adequate vitamin D, targeted omega-3 use in PCOS, a Mediterranean dietary pattern, and prudent red-meat limitation—were associated with favourable endocrine–metabolic profiles and, in selected contexts, reduced disease risk. Conclusions: Integrating lifestyle–medicine modalities with standard care may meaningfully prevent and manage female sexual dysfunctions by addressing pain, perfusion, neuromuscular control, and endocrine–metabolic drivers. Implementation frameworks and high-quality trials are warranted to refine indications, dosing, and long-term effectiveness. Full article

Female cancers, including breast and gynecological malignancies, are among the most prevalent oncological conditions worldwide. Advances in screening, diagnosis, and treatment have markedly improved survival, resulting in a growing population of female cancer survivors. Consequently, long-term health and quality of life have become essential aspects of comprehensive cancer care. Among survivorship issues, sleep disturbances—particularly insomnia—are highly prevalent and associated with adverse outcomes including mood and cognitive impairment, fatigue, immune and cardiometabolic dysregulation, and reduced adherence to therapy. Insomnia, defined as difficulty initiating or maintaining sleep or experiencing poor sleep quality with daytime impairment, affects 6–10% of the general population and is more common in women. In cancer survivors, poor sleep quality appears to be three times more frequent, reaching 62% in breast cancer survivors, although these data may be underestimated, especially for other cancer types, due to the small sample size and heterogeneity of the studies. The pathogenesis of insomnia in female cancer patients is multifactorial, involving cancer-related inflammation, hypothalamic–pituitary–adrenal axis dysregulation, neuroimmune alterations, treatment effects, psychological distress, and behavioral factors. Hormonal disruption plays a central role, as oncological treatments are often the cause of iatrogenic menopause, leading to vasomotor symptoms, mood and cognitive disturbances, sexual dysfunction, and genitourinary complaints, all contributing to sleep disruption. Importantly, estrogens and progesterone independently regulate sleep–wake pathways via central mechanisms, influencing sleep quality even in the absence of vasomotor symptoms. Management requires a multidisciplinary approach integrating oncology, gynecology, and sleep medicine. Cognitive Behavioral Therapy for Insomnia (CBT-I) is first-line, while pharmacologic options include benzodiazepines, Z-drugs, SSRIs/SNRIs, melatonin, or new medication like DORAs. Menopausal hormone therapy (MHT) should be considered for premature menopause management in selected women without contraindications, improving both vasomotor symptoms and sleep quality. Emerging neurokinin receptor (NK-R) antagonists show promise, and ongoing trials suggest significant potential even in breast cancer survivors. Full article

Background: Antimicrobial resistance (AMR) is now a critical issue in South Africa, enhanced by considerable inappropriate prescribing of antibiotics. There is currently variable dispensing of antibiotics without a prescription. Where this occurs, it is principally for urinary tract infections (UTIs) and sexually transmitted infections (STIs). Consequently, there is a need to comprehensively evaluate antibiotic dispensing patterns and factors influencing this to reduce AMR. Methods: A previously piloted questionnaire was administered to patients exiting three different categories of community pharmacies in a rural province. The questionnaire included data on the prevalence of antibiotics dispensed, whether without a prescription, and the rationale for this. Results: A total of 465 patients leaving community pharmacies with a medicine were interviewed. 54.4% of interviewed patients were dispensed at least one antibiotic, with 78.7% dispensed these without a prescription from either independent or franchise pharmacies. Metronidazole (36.1%) and azithromycin (32.7%) were the most dispensed antibiotics. STIs were the most common infectious disease for which an antibiotic was dispensed (60.1%), with 99.6% dispensed without a prescription. Upper respiratory tract infections (URTIs) were the most common infection where antibiotics were dispensed with a prescription (60.0%), with little dispensing without a prescription (7.1%). The most frequently cited reasons for obtaining antibiotics without a prescription were prior use (56.8%), long waiting times at PHC clinics (15.6%), and financial constraints (6.0%). Conclusions: There is an urgent need to review community pharmacists’ scope of practice, including allowing them to prescribe antibiotics for infectious diseases such as UTIs, similar to other countries. Concomitantly, utilise trained community pharmacists to engage with prescribers to improve future antibiotic use, especially for URTIs. Full article

Artemisia ludoviciana Nutt. is an important aromatic plant widely used in traditional Mexican medicine for its therapeutic potential. Its medicinal activity is attributed to a wide range of bioactive compounds, including flavonoids. However, overexploitation, habitat loss, climate change and plant diseases threaten its natural populations and diversity. Although the species reproduces both sexually and asexually, conventional propagation methods are often slow, limited by environmental factors, and susceptible to pests and pathogens. Therefore, this research aimed to establish a micropropagation protocol for A. ludoviciana and to evaluate the changes in its phenolic composition and antioxidant activity while adapting to ex vitro conditions. Full-strength Murashige and Skoog (MS) media supplemented with 0.1 mg L⁻¹ 6-benzylaminopurine resulted in the highest number of shoots (3.30 ± 0.34) and shoot length (3.00 ± 0.12 cm). Moreover, 1/2 MS media supplemented with 0.5 mg L⁻¹ indole-3-acetic acid improved the number (14.45 ± 0.56) and quality of roots. Hardening and acclimatization of plantlets showed 100% survival after 10 weeks. Also, the phenolic composition and antioxidant activity of A. ludoviciana changed in response to stress derived from growth conditions. The results support the sustainable use and rapid propagation of the species, as well as provide the basis for the study of secondary metabolism in the plant. Full article

Traumatic brain injury (TBI) is a leading cause of death and disability, with broad heterogeneity in recovery outcomes particularly noted in pediatric patients. Children post-TBI are vulnerable to aberrant neurodevelopment, specifically in structural and functional neural networks as they correlate with cognitive, behavioral, and motor function outcomes. Consideration for sex as a biological variable which innately influences neuroanatomy, neurodevelopment, and functional organization may elucidate risk factors for negative outcomes in pediatric TBI. For example, TBI damage in sexually dimorphic neural structures and networks may explain deficits in social cognition, working memory, as well as internalizing and externalizing behaviors, which differentially impact the quality of life in male versus female TBI patients. However, characterization of sex in conjunction with developmental patterns in normal and injured pediatric populations is limited due to small sample sizes, the low representation of females, a lack of longitudinal data, and the utilization of analyses that are not sensitive enough to detect subtle differences in TBI pathologies and recovery between the sexes. This review aims to analyze and synthesize the existing evidence regarding the influence of sex on the developmental trajectories of neuroanatomical structures, white and gray matter compartments, and the network disruptions that align with sex-specific functional recovery outcomes following pediatric TBI. The delineation of these sex influences will facilitate better precision-based medicine approaches to improve patient outcomes. Full article

Background: Rhodiola quadrifida (Pall.) Fisch. & C.A. Mey. (Crassulaceae) is a rare medicinal species in the Kazakh Altai, yet information on its population structure and genetic diversity remains limited. This study presents findings from an investigation of natural R. quadrifida populations. Methods: The morphometric characteristics, population age structure, and genetic diversity of the plants were analysed using PCR-based genome profiling. Genetic diversity within R. quadrifida populations was assessed using PCR primers for binding sites complementary to a specific region at the 3′ terminus of a particular tRNA. Results: The populations exhibited variations in morphological traits, age structures, and reproductive strategies. The IVA-1, IVA-2 and KOK populations represent the most mature stages, characterized by a dominance of vegetative reproduction and a disturbed age structure, with a predominance of senile and virgin individuals. In contrast, the LIN-1 and LIN-2 population is characterized by a balanced age structure, encompassing all ontogenetic groups, and a mixed reproductive system that includes both sexual and vegetative propagation. Genetic diversity, as measured by Shannon’s information index, ranged from 0.194 to 0.247, indicating low genetic diversity in R. quadrifida. Analysis of molecular variance (AMOVA) revealed significantly greater variation within populations (62%) than among populations (38%). Genetic diversity was higher in the LIN-1 and LIN-2 populations, which employs a mixed reproductive system (clonal and seeds), than in populations dominated by vegetative reproduction. Both LIN populations, characterized by a mixed reproductive system, exhibited higher genetic diversity than the KOK, IVA-1 and IVA-2 populations, where vegetative reproduction predominated. Conclusions: These results underscore the necessity for priority conservation measures, including monitoring population size and age structure in populations with low levels of seed reproduction and disturbed age structure. Additional measures include supporting in situ and ex situ conservation, such as clonal collection, seed banks, and tissue cultures, as well as restricting the harvesting of medicinal raw materials. Full article

Background: Human papillomavirus (HPV) vaccination remains a critical preventive strategy against HPV-related cancers, yet uptake among young adults in Poland remains suboptimal. Objectives: This study aimed to assess HPV vaccination status, determinants, and perceived barriers to vaccination among healthcare students. Methods: This retrospective survey was conducted among 1062 students of the Medical University of Lodz, including those studying Medicine, Nursing, Midwifery, and Public Health. Results: Overall, 20% of respondents reported HPV vaccination, with the highest coverage among midwifery students (26.8%) and the lowest among medical students (16.8%). The major barriers to vaccination were found to be cost and misconceptions regarding vaccination age limits. As most respondents were above 14 years old when receiving the first dose, they were not eligible for the national free vaccination program. The significant motivators were parental influence and guidance from the medical university; however, recommendations for vaccination were infrequent. Multivariable logistic regression analysis found marital status (p = 0.029), paternal medical education (p = 0.003), and prior sexual experience (p = 0.037) to be significantly associated with vaccination status. Adverse events were reported by 45% of vaccinated respondents, most commonly reactions at the injection site. Nursing and midwifery students more often perceived adverse events as moderate or severe, but none discontinued vaccination. Conclusions: These findings underscore the need for financial support mechanisms and targeted educational interventions to enhance HPV vaccine uptake among future healthcare professionals in Poland. Full article

Clematis L., a significant genus of climbing plants within the Ranunculaceae family, boasts widespread germplasm resources distributed across temperate to tropical regions globally, with Asia preserving particularly abundant native populations. This review systematically summarizes recent advances in Clematis research: in terms of physiological characteristics, the research focuses on the evolution of plant classification, chromosomal evolutionary features revealed by karyotype analysis, and studies on genetic diversity and phylogenetic relationships based on molecular markers; in breeding methods, it summarizes the two major technical systems of sexual and asexual reproduction; regarding ornamental traits, it emphasizes the molecular mechanisms of flower color and form development, and synthesizes breakthroughs in techniques for flowering period regulation and research on the biosynthesis pathways of floral scent metabolites; in the field of stress resistance mechanisms, it thoroughly examines physiological responses and molecular adaptation mechanisms under abiotic stresses such as UV radiation, drought, high temperature, and intense light, and outlines research progress on pathogen types of major diseases; in studies of medicinal value, it highlights the material basis and mechanisms of pharmacological activities including anti-inflammatory, analgesic, and antitumor effects. Through multidimensional comprehensive analysis, this review aims to elucidate the comprehensive development potential of Clematis, providing theoretical foundations and practical guidance for germplasm resource innovation, breeding of high-ornamental-value cultivars, and stress resistance applications. Full article

Loeselia mexicana (Polemoniaceae) is a Mexican shrub with significant medicinal value since pre-Hispanic times. Despite its ethnobotanical importance and apparent role in supporting pollinator communities, detailed information about its reproductive biology remains limited, hindering conservation efforts for this increasingly harvested species. We investigated the reproductive ecology of L. mexicana across two flowering seasons (2023–2024 and 2024–2025) in central Mexico through an integrated approach examining flowering phenology, floral morphology, sexual maturation sequence, nectar characteristics, floral visitors, and breeding system experiments. Flowering occurs from September to March, peaking in October. Flowers exhibit protandry, with anther dehiscence on days 1–2 and stigma receptivity from day 2 onward (flower lifespan: 2.85 ± 0.11 days). Maximum nectar production (1.46 ± 0.05 µL per flower; 193.13 ± 8.8 mg/mL) coincided with peak visitor activity. Despite possessing classic ornithophilous traits, we recorded 21 floral visitor species (5 hummingbirds, 3 hymenopterans, 13 butterflies) with similar visitation patterns, challenging previous assumptions about pollination specialization. Controlled pollination experiments confirmed self-incompatibility, with cross-pollination producing significantly more seeds than autonomous selfing. Our findings reveal that L. mexicana maintains a generalized pollination system, while protandry and self-incompatibility enforce outcrossing, providing critical baseline information for conservation strategies. Full article

Laboratory tests play a crucial role in the diagnostic process for both adults and children. Indeed, they are essential for evaluating health status and formulating effective treatment strategies in the presence of disease. However, in the case of pediatrics, distinct physiological and developmental features of children should be taken into account when compared to adults. Consequently, it is necessary to consider some factors, such as reference intervals that vary significantly at different stages of development due to sexual development, cerebral maturation, and biological and environmental influences; furthermore, it must be considered that extremely small volumes of biological samples are often necessary to obtain accurate laboratory results. Finally, timely test results are critical, especially for pediatric conditions that are treatable when diagnosed early. This review article provides a comprehensive overview of advanced diagnostic technologies, including rapid next-generation sequencing and complex point-of-care testing, within the context of pediatric laboratory medicine. Special attention is given to diagnostic tools that support neonatal and pediatric intensive care units, with a focus on how innovative technologies, particularly those utilizing artificial intelligence algorithms, can accelerate diagnostic workflows. Full article

Background: Sexual dysfunction (SD) is a common yet under-recognized consequence of traumatic brain injury (TBI), with significant implications for physical health, psychological well-being, interpersonal relationships and social reintegration. Although TBI research has largely focused on cognitive, motor and behavioral outcomes, the impact of SD remains insufficiently addressed in both clinical practice and rehabilitation programs. Objectives: This review aims to synthesize current evidence on the prevalence, mechanisms and management of SD following TBI, while emphasizing the importance of gender-sensitive and multidisciplinary approaches to care. Methods: A narrative review was conducted by searching PubMed, Scopus and Web of Science for English-language articles published between 2000 and 2025 using combinations of the following keywords: traumatic brain injury, sexual dysfunction, neuroendocrine dysfunction, psychological sequelae and rehabilitation. Priority was given to peer-reviewed clinical studies, systematic reviews and expert consensus guidelines that addressed neurological, endocrine, cognitive, psychological and social aspects of SD in TBI survivors. Exclusion criteria included case reports with insufficient clinical detail and non-peer-reviewed sources. Articles were screened for relevance to both pathophysiological mechanisms and therapeutic strategies. Results: The etiology of post-TBI SD is multifactorial, involving direct neurological injury, hypothalamic–pituitary dysfunction, emotional and cognitive impairments, as well as psychological challenges such as stigma and relationship strain. Men and women may present distinct symptom profiles; for instance, men more frequently report erectile dysfunction and hypogonadism, whereas women more commonly experience challenges with arousal, lubrication and psychological stress. Effective interventions include pharmacotherapy, hormone replacement therapy, psychotherapy and rehabilitative approaches designed to restore intimacy and quality of life. Optimal outcomes are achieved through multidisciplinary collaboration among neurology, endocrinology, psychiatry, psychology and rehabilitation medicine. Conclusions: Sexual dysfunction should be recognized as a critical component of TBI sequelae rather than a secondary concern. Routine screening, gender-sensitive assessment and the integration of individualized, multidisciplinary care pathways are essential to improving patient outcomes. Advancing clinical awareness and standardization in this area holds the potential to significantly enhance the holistic recovery and reintegration of TBI survivors. Full article