Search Results (1,439)

Spirituality and religion are underrecognized components of mental health and substance use (MHSU) care for youth of African descent. This study explores the dual role of spirituality and religion in influencing the help-seeking behaviors, recovery journeys, and care outcomes of youth of African descent aged 18 to 25 residing in Nova Scotia, Canada. Drawing on findings from a Canadian Institutes of Health Research (CIHR) funded community-based study using mixed methods, including interviews, focus groups, and arts-based approaches, the research highlights both the supportive and ambivalent roles spirituality plays in MHSU care. Participants shared themes such as spiritual reflection as a turning point, the assurance of a higher power, the culturally responsive support of faith-informed providers, and the significance of meditation and unseen connection as healing tools. While the narratives of research participants attested to the role of spiritual and religious practices in offering a sense of belonging, hope, and culturally aligned care, they may also reinforce stigma or act as a barrier to accessing formal MHSU services. These themes were derived from qualitative analysis of in-depth interviews with 60 youth participants. Through the lens of Ubuntu and Afrocentric paradigms, this paper calls for a more holistic and culturally inclusive approach to care, one that respects or honors the spiritual and communal lives of youth of African descent. It also reinforces the importance of training MHSU care providers to recognize, respect, and integrate spirituality as a legitimate component of wellness and recovery for help-seeking youth of African descent. Full article

Cardiovascular disease (CVD) is increasingly recognized as a significant comorbidity in people living with HIV (PWH), contributing to increased morbidity and mortality. Epidemiological studies indicate that PWH have a 1.2–2-fold higher risk of myocardial infarction (MI) and other CVD events compared to HIV-negative individuals. While the mechanisms underlying HIV-associated CVD are not fully understood, they are likely to include a combination of cardiovascular-related adverse effects of HIV medications, vascular dysfunction caused by HIV-induced monocyte activation, and cytokine secretion, in addition to existing comorbidities and lifestyle choices. This comprehensive review examines the complex relationship between HIV infection and CVD, highlighting key pathophysiological mechanisms such as chronic immune activation, inflammation, endothelial dysfunction, and the role of antiretroviral therapy (ART) in promoting cardiovascular risk. Alongside conventional risk factors such as smoking, hypertension, and dyslipidemia, HIV-specific elements, especially metabolic abnormalities associated with ART, significantly contribute to the development of CVD. Prevention strategies are crucial, focusing on the early identification and management of cardiovascular risk factors as well as optimizing ART regimens to minimize adverse metabolic effects. Clinical guidelines now recommend routine cardiovascular risk assessment in PWH, emphasizing aggressive management tailored to their unique health profiles. However, challenges exist in fully understanding the cardiovascular outcomes in this population. Future research directions include exploring the role of inflammation-modulating therapies and refining sustainable prevention strategies to mitigate the growing burden of CVD in PWH. Full article

People living with HIV-1 (PLWH) are part of the so-called “fragile” populations to which COVID-19 vaccines were/are strongly recommended. The fact that most widely used COVID-19 vaccines rely on the production of a biologically active SARS-CoV-2 Spike protein expressed by synthetic mRNA poses the relevant question of whether and how this vaccination influences the fate of the HIV-1 reservoir. This report presents a detailed analysis of the literature data on the effects of SARS-CoV-2 Spike and COVID-19 vaccines on HIV-1 latently infected cells. Despite being limited in number, the experimental evidences consistently indicate that vaccine mRNA and/or SARS-CoV-2 Spike can effectively reactivate latent HIV-1. This conclusion has been drawn after “in vitro”, “ex vivo”, and “in vivo” assays, and with virus-associated Spike, soluble Spike, or its intracellular expression, as well as with COVID-19 mRNA vaccines. On the other hand, real-world observations on vaccinated PLWH under antiretroviral therapy (ART) provided evidence of HIV-1 reactivation almost exclusively in PLWH with unsuppressed viremia, as measured in terms of size of the HIV-1 reservoir. Although several issues still need to be clarified through urgent additional investigations, these data suggest the possibility that the Spike protein and/or the vaccine mRNA molecules affect the HIV-1 latency in PLWH. Full article

Public health restrictions during COVID-19 disproportionately affected older adults, especially those in long-term care (LTC) and their families. Family caregivers (FCs) are essential care partners in LTC settings, yet pandemic policies largely excluded them, creating emotional and systemic consequences. This study explored FCs’ experiences of visitation restrictions in British Columbia, Canada, using an arts-based qualitative approach within a larger mixed-methods project. Eight FCs participated in completing a total of twelve artworks, including photographs, collages, and creative writing that reflected their experiences. Virtual talking circles were used to facilitate the sharing and description of their experiences. Findings revealed three interconnected theme categories with eleven sub-themes. These themes suggest a plausible pathway: infection-control rules may lead to caregiver exclusion, disrupting relational continuity and oversight and contributing to distress and task-centered care. While context-specific and exploratory, results underscore the need for trauma-informed, family-inclusive policies and cultural safety in LTC. Arts-based research methods provided a powerful lens for capturing emotional realities often missed by conventional research. Full article

Background: Vitamin D deficiency (VDD) is highly prevalent among people living with human immunodeficiency virus (HIV), with reported rates of insufficiency and deficiency substantially higher than in many general-population cohorts. This study aims to assess the prevalence of vitamin D deficiency and to investigate the risk factors contributing to its occurrence among people living with HIV who are receiving antiretroviral therapy (ART) and are registered at the Craiova Regional Center (CRC). Methods: A retrospective study was conducted from May 2024 to August 2024, including individuals with HIV aged 18 years and older who were registered at the CRC. Results: A total of 138 patients were included in the study. The prevalence of vitamin D deficiency (<20 ng/mL) and vitamin D insufficiency (20–29.9 ng/mL) was 36.2% and 33.3%, respectively, with an average vitamin D level of 26.4 ± 9.9 ng/mL. Vitamin D deficiency was associated with obesity (p = 0.0013), high HIV viral load (p = 0.043), low CD4 nadir (<200 cells/mm³, p = 0.006), prolonged ART exposure (p = 0.002), and the use of tenofovir disoproxil fumarate or protease inhibitor-containing regimens (p = 0.034 and p = 0.016, respectively). Conclusions: These findings indicate that monitoring vitamin D levels could be particularly relevant for patients with HIV with higher-risk profiles. However, our study included a relatively small number of participants, so further research in larger cohorts is needed to better understand these patterns. Full article

In Tinseltown and Full Rehearsal are examples of digital found-footage practice that explore the creative potential of the glitch. Featuring Monroe and Mickey, the two films conjure up what Walter Benjamin called figures of a “collective dream”. In his recent work, the artist blasts these two figures open and subjects them to a drastic process of digital decomposition, revealing the inner workings of the imaging system that determines their appearance on screen. In doing so, the glitches and malfunctions of the software reveal the presence of a machinic substratum—the convulsing expression of encoded dreams that carry the repressed traces of the mechanical, the graphic, and the organic. However, in their reliance on live-action footage on the one hand and animation film on the other, the two works arguably stand as examples of two separate forms of unconscious, as introduced by Benjamin in “The Work of Art”. In our analysis of In Tinseltown and Full Rehearsal we suggest that Arnold’s work allows for a radical reconsideration of the visual unconscious as previously defined in 20th century thought, exposing the ways in which not only the frontiers between the functioning of the psyche and the machinic have become progressively more porous, but how the very notion of the unconscious is in question. Full article

This article will bring together and explore the relations between four aspects of Wittgenstein’s remarks on, and his relation to, religious language. The first is his sense of the special role that religious language can play in the lives of people. The focus is not on traditional issues in the philosophy of religion—not the Ontological Proof of the existence of God; not any of Aquinas’ Five Ways; not the argument from Design or the Cosmological Argument; and not any other philosophico-religious matter concerning arguments for the existence or non-existence of any deity. His interests lie elsewhere. Second, we see that what Wittgenstein is centrally concerned with is the life-structuring power that religious language can possess and exert; it concerns both the sense-making power of pattern-lives in religious narratives and the metaphorical content of religious ways of thinking and perceiving. The third aspect is the distinctive, and in its way transcendental, way of seeing the world and existence sub specie aeternitatis, that is, under the aspect of eternity. Or, I will suggest, under the aspect of timelessness, or of having the sense of being above and outside of time. Wittgenstein said that he was not a religious person, but that he could not help but to see every problem from a religious point of view. In this third theme of the article, I will attempt to explicate what that remark can mean—how it reveals what Wittgenstein elsewhere in his work calls “a way of seeing.” And then fourth, this article will connect these three aspects to the special, non-pragmatic (and often in the above sense, transcendental) way that we view works of art. In his Notebooks of 1914-16, Wittgenstein wrote, “The work of art is the object seen sub specie aeternitatis; and the good life is the world seen sub specie aeternitatis. This is the connection between art and ethics.” At the close, I suggest that the way we learn to see the world through and within religious language (again, apart from any theological claim concerning divine existence or not) is parallel to one important way of seeing art—where the parallel is one that casts light from each side to the other. Along with some other works, my most central example in art will be the paintings of Morandi: in conveying an unmistakable sense of timelessness, they both convey, and in viewing them invite us to enact, the special way of seeing objects sub specie aeternitatis. Full article

Background/Objectives: Endoscopic submucosal dissection (ESD) is a state-of-the-art en bloc resection for early gastro-intestinal cancers and precursors developed and validated in Japan. Western expertise with this complex technique remains limited. Tutored training might be optimal for patients and ESD learning. We established ESD tutoring courses led by experienced Japanese experts to provide (i) optimal long-term curative outcomes and low complication rates for patients and (ii) hands-on training on difficult lesions for European endoscopists under direct expert supervision. Methods: Prospective data from 2011 to 2015 (follow-up to 12/2024) were analyzed. A total of 118 neoplasms (50% HGIEN and cancer) in 101 patients (median age 68 [37–91] years; 38% with significant comorbidities) were treated with expert or tutored ESD. Japanese experts performed 28 ESDs, while 22 trained beginners conducted 90 supervised procedures on difficult lesions during 5 live and 20 tutoring events (1–4 days each). Results: Analysis of the complete data showed curative and en bloc resection rates of 88% and 95%, respectively, with no recurrence after R0 resections during a median follow-up of 9.8 [1.5–14.9] years. Long-term survival remained recurrence-free after endoscopic resection of 3 recurrent adenomas (at R1/Rx) and curative surgery/2nd ESD for 5 non-curative ESDs. Adverse events occurred in 9.3% without emergency surgery or 30-day mortality. Comparing expert-only vs. tutored ESD procedures, beginners correctly applied curative ESD indications in 94% of 118 neoplasms. Experts resected larger lesions (22 cm²) at a rate of 9.3 cm²/h in 121 min. Tutored beginners achieved a 75% [25–100] self-completion rate on 33% smaller lesions in 112 min. Conclusions: ESD tutoring courses led by Japanese experts ensure excellent patient outcomes and standardized procedural training. This model may foster professional ESD performance across European referral centers. Full article

Human immunodeficiency virus type 1 (HIV-1) continues to be a major global health burden. Combination antiretroviral therapy (cART) effectively abrogates HIV-1 replication and has transformed HIV-1 infection from a fatal to chronic disease. While ART can suppress viremia to undetectable levels in people living with HIV-1 (PWH), a small reservoir of cells infected with replication-competent HIV-1 persists and can lead to viral rebound upon ART interruption. This persistent HIV-1 reservoir can be quantified and characterized by measuring replication of infectious HIV-1 using a quantitative viral outgrowth assay (qVOA), or by measuring HIV-1 DNA, RNA, or protein levels as a proxy for the reservoir. Tools to quantify the reservoir in these distinct molecular compartments have been developed for HIV-1 subtype B, which is predominant in the Global North. However, non-B subtypes constitute the majority of HIV-1 infections worldwide. Here, we discuss the wide range of reservoir quantitation and characterization tools, explore their limitations, and, where applicable, their adaptations to non-B subtypes. We conclude that standardized tools should be used to characterize reservoir dynamics of HIV-1 B and non-B subtypes. These tests should be well-validated and accessible to all laboratories world-wide to be able to draw conclusions about subtype-specific reservoir dynamics. Full article

Multimodal methods provide valuable opportunities within Participatory Action Research (PAR), to foster meaningful participation, and amplify marginalized voices. However, conventional research approaches have not always adequately captured the complex realities of the lived experiences of families, and multimodal techniques have remained underutilized for the exploration of such experiences. This study aimed to explore the use of creative multimodal methods, within a PAR framework, grounded in care among vulnerable South African families. A qualitative design was adopted, incorporating Human-centered Design principles, within a PAR approach. The participants were recruited from the Saldanha Bay Municipality area (n = 70), as well as Mitchells Plain (n = 59). The multimodal methodology included Draw-and-Tell, painting, object and photo elicitation, I-Poems, and LEGO^®-based activities. Data were annotated and transcribed verbatim, followed by thematic analysis. A total of 42 participants contributed towards the validation of the methods. The participants described experiences of deep emotional insight, self-reflection, and self-recognition, through engagement with the multimodal activities. The findings revealed that these approaches were: (1) credible, producing internally valid and contextually rich data; (2) contributory, generating original and applicable insights into family life; (3) communicable, offering accessible and structured ways for diverse participants to express their experiences; and (4) conforming, ensuring ethical engagement through inclusive participation. These findings demonstrate the potential of creative, arts-based, and participatory approaches, to advance methodological innovation in qualitative family research. Full article

Background/Objectives: This study presents a comprehensive and updated epidemiological and public health assessment of human immunodeficiency virus (HIV) in Romania during 2022–2024, situated within the wider European context. Methods: For this retrospective descriptive study, we analyzed national surveillance data from the National Institute of Infectious Diseases “Prof. Dr. Matei Balș” and European Centre for Disease Prevention and Control (ECDC) reports, between 1985–2024, focusing especially on 2022–2024 period. Key indicators included incidence, mortality, transmission routes, age and gender distribution, and treatment coverage. Comparative analyses were performed between Romania and European Union (EU)/Eastern Europe data. Results: Between 1985 and 2024, Romania registered a cumulative total of 28,793 HIV cases, with 18,768 individuals living with HIV (PLHIV) as of 2024. In that year, 810 new HIV cases were diagnoses, indicating a modest uptick compared with 2022–2023. Heterosexual transmission continued to predominate (59.4%), followed by cases among men who have sex with men (MSM) (30.5%) and intravenous drug users (IDUs) (5.2%). Men represented more than three-quarters of all new infections. Mortality displayed considerable year-to-year variability, increasing from 125 HIV-related deaths in 2023 to 193 in 2024. Despite this, treatment coverage improved steadily, with 16,464 individuals receiving antiretroviral therapy (ART) by the end of 2024. At 2.51 cases per 100,000 population, Romania’s incidence remained below the European average of 3.5 per 100,000. Nonetheless, the proportion of infections attributable to MSM transmission rose sharply—from 3.91% in 2007 to 32% in 2024—bringing Romania’s epidemiological profile increasingly in line with broader trends observed in Eastern Europe. Conclusions: These findings suggest that although Romania maintains a comparatively lower HIV incidence than the European average, the evolving transmission dynamics—most notably the substantial increase in MSM-related cases—signal a shifting epidemiological landscape that warrants strengthened, population-specific prevention measures and continued investment in comprehensive treatment and monitoring frameworks. Full article

The accurate measurement of audience engagement in real-world live events remains a significant challenge, with the majority of existing research confined to controlled environments like classrooms. This paper presents a comprehensive survey of Computer Vision AI-driven methods for real-time audience engagement monitoring and proposes a novel, holistic architecture to address this gap, with this architecture being the main contribution of the paper. The paper identifies and defines five core constructs essential for a robust analysis: Attention, Emotion and Sentiment, Body Language, Scene Dynamics, and Behaviours. Through a selective review of state-of-the-art techniques for each construct, the necessity of a multimodal approach that surpasses the limitations of isolated indicators is highlighted. The work synthesises a fragmented field into a unified taxonomy and introduces a modular architecture that integrates these constructs with practical, business-oriented metrics such as Commitment, Conversion, and Retention. Finally, by integrating cognitive, affective, and behavioural signals, this work provides a roadmap for developing operational systems that can transform live event experience and management through data-driven, real-time analytics. Full article

Contemporary neural and generative architectures are deficient in self-preservation mechanisms and sustainable stability. In uncertain or noisy situations, they frequently demonstrate oscillatory learning, overconfidence, and structural deterioration, indicating a lack of biological regulatory principles in artificial systems. We present Bio-RegNet, a meta-homeostatic Bayesian neural network architecture that integrates T-regulatory-cell-inspired immunoregulation with autophagic structural optimization. The model integrates three synergistic subsystems: the Bayesian Effector Network (BEN) for uncertainty-aware inference, the Regulatory Immune Network (RIN) for Lyapunov-based inhibitory control, and the Autophagic Optimization Engine (AOE) for energy-efficient regeneration, thereby establishing a closed energy–entropy loop that attains adaptive equilibrium among cognition, regulation, and metabolism. This triadic feedback achieves meta-homeostasis, transforming learning into a process of ongoing self-stabilization instead of static optimization. Bio-RegNet routinely outperforms state-of-the-art dynamic GNNs across twelve neuronal, molecular, and macro-scale benchmarks, enhancing calibration and energy efficiency by over 20% and expediting recovery from perturbations by 14%. Its domain-invariant equilibrium facilitates seamless transfer between biological and manufactured systems, exemplifying a fundamental notion of bio-inspired, self-sustaining intelligence—connecting generative AI and biomimetic design for sustainable, living computation. Bio-RegNet consistently outperforms the strongest baseline HGNN-ODE, improving ARI from 0.77 to 0.81 and NMI from 0.84 to 0.87, while increasing equilibrium coherence $\kappa$ from 0.86 to 0.93. Full article

In vitro manipulation of human spermatozoa during Assisted Reproductive Technology (ART) can induce several damages to sperm structure and functions. This study investigated the protective effects of Raphanus sativus seed extract and its active compounds on several sperm parameters during in vitro incubation and cryopreservation. Extracts from five seed-batches were characterized by HPLC-DAD-MS and ¹H-NMR, identifying sinapine and sinipic glycosides as the main characteristic compounds. Sperm DNA fragmentation (sDF) was detected by the Sperm Chromatin Dispersion test and LiveTUNEL. Excessive reactive oxygen species (ROS) production was detected by MitoSOX Red in viable spermatozoa. Caspase activity was detected by FLICA. Cryopreservation was conducted with two alternative freezing media. In vitro incubation with the extract protected against the loss of motility and reduced the induction of sDF, sperm ROS production, and caspase activity. Similarly, during cryopreservation, it allowed much better recoveries of sperm viability, motility, and DNA integrity by decreasing sperm ROS production with both freezing media. Sinapine and sinapic acid completely mimicked the protective effects of the whole extract during both in vitro incubation and cryopreservation, suggesting that they are included among the active principles. These findings support Raphanus sativus seed extract and its active compounds as candidates for inclusion in handling and freezing media for human spermatozoa in ART. Full article

Background/Objectives: Uterine fibroids are the most common benign neoplasms of the female genital tract, with a prevalence of 20% to 40% among women of reproductive age. Their management in the context of Assisted Reproductive Technologies (ART) represents a major clinical challenge, characterized by controversies, contrasting approaches, and a lack of shared guidelines. Indeed, the detrimental effects of fibroid treatments are not well known and may be influenced by the size, location, and number of fibroids. The impact of hysteroscopic myomectomy in women affected by submucosal myomas (FIGO classification type: G0–G2) is well documented in the current literature; however, the impact of intramural and subserosal myoma removal (FIGO types 3–8), in particular those <4/5 cm in diameter, remains controversial. The aim of the present study is to introduce and share a pragmatic surgical approach to uterine fibroid management prior to In Vitro Fertilization (IVF), to reduce the knowledge gap regarding uterine fibroid treatment. Methods: We conducted a retrospective observationally study that included 94 cases of infertile women, who underwent myomectomy at our IVF centre at Sandro Pertini Hospital, Rome, Italy, between 2020 and 2025. These patients met the inclusion criterion of having an idiopathic/tubal factor of infertility and were aged < 40. We evaluated a group of 17 women (group A) who underwent hysteroscopic myomectomy for submucosal fibroids (FIGO types 0–2) and a group of 39 women (group B) who underwent open (laparotomic) myomectomy for intramural/subserosal fibroids (FIGO types 3–8). Group B was compared with a control group of 38 women who were similar in terms of all demographic and clinical parameters and myoma features (group C) and did not want to undergo a myomectomy procedure. All surgical procedures were executed by the same expert surgeon following our proposed model: submucosal fibroids were always removed by operative hysteroscopy, while intramural/subserosal fibroids were removed if there were three or more and if they were at least 1 ≥ 3 cm in size. All enrolled patients subsequently underwent IVF treatment at our centre, which consisted of an antagonist protocol for ovarian stimulation, and all transferred embryos were of good quality according to the recent European Society of Human Reproduction and Embryology (ESHRE) classification. Results: In group A, we observed an implantation rate of 41% and a clinical pregnancy rate of 35.2%, and these results are consistent with the current literature. In group B, we obtained statistically significant differences in the implantation (31% vs. 12.9%) and pregnancy rates (28.1% vs. 7.8%) compared to group C (p = 0.02 and p = 0.03, respectively). In addition, the live birth rate was statistically higher compared to that in group C (p < 0.01). Miscarriage and preterm delivery rates were lower in group B, although the differences were not statistically significant. No severe post-surgical complications, such as uterine rupture, were observed during subsequent pregnancies. Conclusions: Despite the limited patient sample size, the monocentric experience, and the retrospective design, we emphasize the effectiveness of our proposed surgical model in women affected by myomas. Indeed, the surgical treatment of submucosal, intramural, and subserosal lesions may improve ART and pregnancy outcomes (through a higher implantation rate, pregnancy rate, and live birth rate, as well as a lower miscarriage/preterm rate). Full article