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A Qualitative Evidence Synthesis to Explore Relationship-Centred Dental Care for Older People Living in Care Homes
Full text link\ua9 2026 The Author(s). Gerodontology published by Gerodontology Association and John Wiley & Sons Ltd.Background: Patient groups and policymakers are calling for the implementation of relationship-centred, co-ordinated care for vulnerable older people. Relationship-centred care highlights the significance of strong, quality relationships among residents, their families and the broader healthcare team. The present work performed a qualitative evidence synthesis to explore issues relating to the provision of relationship-centred dental care for older people living in care homes, as perceived by care home staff, dental professionals, family and residents. This builds on the existing evidence base and outlines areas for improvement of dental care provision within residential care homes. Methods: A ‘best fit’ framework synthesis of primary research was used to understand how and why current dental care might or might not be relationship-centred. A palliative healthcare-focused conceptual framework for relationship-centred care was used as the basis for the synthesis. The review focuses on qualitative primary research studies exploring dental care for care-home residents. Results: Of 235 unique citations, fifteen qualitative primary research papers were included. The synthesis identified supporting evidence for all five of the broad a priori themes from the relationship-centred care coding framework: Relationship-centred care, Integration within the wider health and social care systems, Digital inclusion, Workforce support and Parity of esteem. Relationships between themes were articulated. Conclusions: This ‘best-fit’ framework synthesis found that care home staff identified numerous barriers to providing relationship-centred dental care for older residents. Dentists, families and residents were underrepresented, highlighting the need for further research into their perspectives. By acknowledging the complexity of dental care and addressing issues such as integration, workforce support, digital services and parity of esteem, the synthesis suggests that applying organisational change research may help improve oral health outcomes in care homes
An umbrella review of psychological capacity and mental health trajectories across the life course
Full text link\ua9 The Author(s) 2026.Understanding population trajectories of psychological capacities can guide interventions to protect and enhance them across the life course. We conducted an umbrella review of systematic reviews examining the trajectories of a wide range of psychological capacity measures. Searches were performed in MEDLINE, EMBASE, PsycINFO, the Cochrane Database of Systematic Reviews and Google Scholar (11 December 2023 and 26 June 2025). Thirty-six reviews synthesizing 1,307 primary studies were included. Here we show that most reviews focused on depression, anxiety and trauma-related symptoms, with stable low-symptom trajectories being most common. Being a girl/woman and socioeconomic disadvantage were frequent risk factors, while social support emerged as protective. We found a comparative lack of reviews focused on less common mental-health conditions, positive outcomes and older adults. Future reviews should engage with a robust quality assessment of the analytical approach used and the (lack of) geographical and sociodemographic diversity in the primary studies included. Similarly, more evidence on the Global South and on minoritized and marginalized groups within populations is needed. The protocol is pre-registered in PROSPERO (CRD42023490490)
Molecular Plasticity Results in Oncofetal Reprogramming and Therapeutic Vulnerabilities in Juvenile Myelomonocytic Leukemia
No full text\ua92025 American Association for Cancer Research. Persistent fetal gene expression in childhood neoplasms is usually explained by a maturation block originating in the prenatal phase. In contrast, reactivation of fetal genes in adult malignancies is considered a consequence of oncofetal reprogramming (OFR) and is associated with aggressive disease. By reconstructing epigenetic ontogeny in juvenile myelomonocytic leukemia (JMML), we identified a postnatal maturation state of JMML stem cells with high transcriptional plasticity indicative of OFR in high-risk disease. Similarly, postnatal activation of oncogenic signaling by inducible Ptpn11E76K mutation in mice triggered molecular plasticity and reactivation of fetal gene expression. Integrative multi-omics analysis revealed aberrant CD52 expression as a feature of high-risk JMML stem cells. Anti-CD52 treatment depleted JMML stem cells and blocked disease propagation in xenograft models. Our results challenge the prevailing maturation block model of pediatric leukemogenesis and establish RAS-associated stem cell plasticity as a determinant of OFR and potential therapeutic vulnerabilities in high-risk JMML. SIGNIFICANCE: Persistent fetal gene expression in pediatric malignancies is considered a consequence of prenatal maturation blockade. In this study, we demonstrate that oncogenic PTPN11 mutations enhance cellular plasticity. This leads to partial restoration of fetal molecular programs, creating new therapeutically exploitable vulnerabilities. See related commentary by Miao and Xu, pp. 168
Radiative Forcing of Western Tibetan Vortex on Surface Air Temperature in Spring
Full text link\ua9 2026 The Author(s).As the dominant atmospheric circulation pattern over the western Tibetan Plateau (TP), the Western Tibetan Vortex (WTV) exerts substantial control on springtime 2 m surface air temperature (T2m). However, its underlying radiative processes remain unclear. This study integrates GEWEX satellite observations with ERA5 and MERRA-2 reanalysis, applying surface energy balance diagnostics to quantify the WTV\u27s radiative forcing on T2m variability. We find the WTV explains ∼66% of T2m variance (R = 0.81) across the western TP and the adjacent Southwest Asia. Downward shortwave radiation (DSW) emerges as the primarily radiative factor modulated by the WTV via cloud radiative forcing (CRF) processes. Specifically, anticyclonic WTV events reduce cloudiness, generating positive CRF anomalies that enhancing surface DSW and cause warming. Conversely, cyclonic events increase cloudiness, producing negative CRF anomalies that diminish DSW and induce cooling. These findings advance understanding of the radiative processes by which the upper circulations modulate the surface climate over the TP
Quantifying Eligibility Pattern Shifts: a Data-Driven Paradigm for Early Risk Detection in Clinical Trials
Full text link\ua9 The Author(s) 2026.Traditional Risk-Based Monitoring (RBM) strategies emphasise key risk indicators and site-level performance metrics but seldom address the heterogeneity of patient eligibility profiles. We present a data-driven framework that captures temporal and inter-site shifts in baseline inclusion characteristics. Central to this framework are two new metrics-Borderline Inclusion Index and Eligibility Distribution Divergence-that quantify departures from expected enrolment patterns. A Bayesian composite score synthesises these indicators to prioritise oversight actions. Through simulation experiments and a worked case study, we show that monitoring eligibility pattern shifts offers an early warning signal of operational or scientific risk and strengthens overall trial integrity. We operationalize the framework through an interactive Shiny web application that computes indicator-specific posteriors, generates composite site risk scores, and provides visual decision-support for centralized RBM implementation
GAIN group art psychotherapy for children: a service evaluation and acceptability study
Full text link\ua9 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: Children and young people with long-term physical health conditions (LTPHCs), such as Juvenile Idiopathic Arthritis (JIA), are at increased risk of mental health difficulties, including anxiety and depression. Despite this, access to psychological support in paediatric healthcare settings remains limited. Group Art Psychotherapy Intervention for communicating the Needs of children with long-term health conditions (GAIN) was developed as an online, manualised group intervention to support the psychological well-being of children with LTPHCs and their families. Aims: This service evaluation aimed to assess the acceptability of the GAIN intervention as an online, home-based treatment, explore the suitability of standardised outcome measures, and develop a logic model to inform future implementation. Methods: Twelve young people with JIA participated in two age-stratified, six-session online art psychotherapy groups, facilitated by an HCPC-registered art psychotherapist. Data were collected via focus groups with therapists, patient and parent questionnaires (PedsQL, RCADS, SDQ), therapist session notes, and supervision reflections. Results: The intervention was well-received, with participants reporting increased social connectedness, emotional expression, and empowerment. Four themes were identified from the thematic analysis: Peer support and discussion, Youth centred empowerment, Barriers and revisions, Age group differences. A logic model for the GAIN intervention is presented, and the acceptability of the questionnaires is reported. Conclusions: The GAIN intervention demonstrated strong acceptability and potential benefits for children with LTPHCs, particularly in promoting peer support and emotional expression. Implications for practice/policy/future research: The evaluation informs future adaptations and the development of the evidence base for art psychotherapy in paediatric healthcare settings. Plain-language summary: Children and young people with long-term physical health conditions, like Juvenile Idiopathic Arthritis (JIA), can sometimes feel worried, sad, or lonely. Getting mental health support is not always easy. The GAIN programme (Group Art Psychotherapy Intervention for communicating the Needs of children with long-term health conditions) is an online group art therapy designed to help children and their families. In this study, twelve young people with JIA joined online art therapy sessions led by a trained art therapist. They made art, talked, and shared their experiences. Feedback came from children, parents, therapists, and group discussions. The results showed that most children enjoyed the sessions and found them helpful. They felt less alone, more confident, and better able to express their feelings. The sessions also helped them connect with others going through similar challenges. Overall, GAIN seems to be a helpful and supportive programme for children with long-term conditions. The feedback will be used to make the programme even better and to guide future research on art therapy in children’s healthcare
Characterizing TDP-43 involvement in vascular dementia
Full text link\ua9 2026 The Author(s). Alzheimer\u27s & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer\u27s Association.INTRODUCTION: Vascular dementia (VaD) is a major therapeutic challenge. Tar DNA-binding protein 43 (TDP-43), known for its role in neurodegeneration, may contribute to VaD pathogenesis under chronic cerebral hypoperfusion (CCH). This study investigates TDP-43 dysregulation in VaD. METHODS: TDP-43 and phosphorylated TDP-43 (pTDP-43) expression and localization were assessed in a VaD animal model, neuronal cells exposed to oxygen–glucose deprivation (OGD), and post mortem human brain tissues. RESULTS: Bilateral Common Carotid Artery Stenosis (BCAS)-induced CCH led to increased pTDP-43 and aberrant redistribution of both TDP-43 and pTDP-43. In vitro OGD triggered similar mislocalization. Post mortem VaD brains showed no TDP-43 abnormalities, while Alzheimer\u27s and mixed dementia cases exhibited marked pathology. DISCUSSION: TDP-43 dysregulation appears early in VaD under hypoperfusive stress, distinguishing it from other dementia subtypes. These findings indicate that TDP‑43 may warrant further investigation as a potential early molecular feature of VaD. Highlights: Tar DNA-binding protein 43 (TDP-43) is dysregulated early in vascular dementia models. Hypoperfusion triggers TDP-43 mislocalization and phosphorylation. TDP-43 pathology is absent in late-stage human vascular dementia. TDP-43 is a transient, novel target for vascular cognitive impairment
International Reference Values for Surgical Outcomes of Total Pancreatectomy
No full text\ua9 2026 American Medical Association.Importance: Total pancreatectomy (TP) is indicated for advanced pancreatic cancer or multifocal tumors. Furthermore, TP may be performed to avoid the risk of pancreatic fistula in selected patients to improve the perioperative risk profile. Objective: To define reference values for TP based on a low-risk cohort treated at expert centers. Design, Setting, and Participants: This multicenter study analyzed outcomes from patients undergoing primary TP for malignant or benign lesions from 25 international expert centers from January 2017 to November 2023. Low-risk patients undergoing TP (LR-TP) were without vascular resections or significant comorbidities. Exposures: TP. Main Outcomes and Measures: Twenty reference values were derived from the 75th or the 25th percentile of the median values of all centers. Outcomes of LR-TP were compared with a cohort of TP with vascular resection, TP due to high-risk pancreatic anastomosis, and the benchmark values for low-risk pancreatoduodenectomy. Results: Of 994 patients, 333 (33.5%; median [IQR] age, 66 [58-72] years; 171 male [51.4%]) qualified as the LR-TP cohort. Reference values included blood loss (≤1000 mL), major complications (≤37%), 3-month postoperative mortality (<6%), and retrieved lymph nodes (≥29). Compared with TP with vascular resections, reference cutoffs were not met for major complications (51% vs LR-TP ≤37%) and 90-day mortality (11% vs LR-TP ≤6%). For TP due to high-risk anastomosis, failure to rescue rate (38% vs ≤6%) and 90-day mortality (11% vs LR-TP ≤6%) were not met. Compared with pancreatoduodenectomy, reference values for postoperative mortality were 3 times higher for LR-TP (≤2% vs ≤6%) and less for resected lymph nodes (≥16 vs ≥29). Conclusions and Relevance: This case-control study provided global reference values for TP, indicating significantly higher postoperative morbidity and mortality compared with pancreatoduodenectomy. Perioperative morbidity of TP was especially increased in patients with vascular resections. These reference values can serve for quality control of pancreatic surgery
Surrogate-Based Multiphysics Design Optimization of a Wound Rotor Synchronous Generator with Enhanced Damping
Full text link\ua9 2026, Iran University of Science and Technology. All rights reserved.In recent years, due to the increase in electricity generation, the need for optimized Wound Rotor Synchronous Generators (WRSGs) has been felt more than ever. One of the important characteristics of a generator in a power system is its voltage harmonics. In addition to this, the amount of generated power and efficiency are also important. The goal of this research is multi-objective design using dampers, with improved number and shape. WRSGs have been selected as a case study. With the help of surrogate modeling and the PSO algorithm, which are more efficient and accurate than classical methods, the final design has been presented. In the end, the comparison of the initial and final designs shows the realization of all goals. Also, economic issues in terms of the selection of damper material have been investigated
Food insecurity and self-reported markers of health across multiple body systems: associations with diet quality, mental well-being, gut symptoms, and immunity
Full text link\ua9 The Author(s) 2026. Aim: To explore the associations between food insecurity (FI) with dietary quality and markers of mental well-being, gastrointestinal symptoms, and immune status among United Kingdom (UK)-based adults. Subject and methods: An online questionnaire was administered to 953 UK-based adults, including 210 individuals living with FI, to evaluate FI status, diet quality, and a series of health outcomes. FI was measured using the six-item US Department of Agriculture (USDA) Household Food Security Survey. Diet quality was assessed using the Easy Diet Screener. Health outcomes included markers of mental well-being (Perceived Stress Scale and GAD-7 [generalised anxiety disorder seven-item scale]), gastrointestinal symptoms (Short Health Scale for gastrointestinal symptoms), and self-reported immune status (Immune Status Questionnaire, cumulative incidence of self-reported infections [CISRI] score, and antibiotic use). Cross-sectional associations were explored using logistic regression, with data presented as odds ratios (OR) with 95% confidence intervals (CIs). Results: Participants living with FI had almost threefold greater odds of following a Western dietary pattern (OR = 2.67, 95% CI [1.85, 3.91], p < 0.001). FI was associated with multiple negative health outcomes including greater odds of high perceived stress (OR = 3.12, 95% CI [2.10, 4.63], p < 0.001), reduced self-reported immune status (OR = 1.91, 95% CI [1.31, 2.77], p < 0.001), and gastrointestinal symptoms (OR = 2.30, 95% CI [1.39, 3.75], p < 0.001). Conclusion: These findings support the accumulating body of evidence that FI is linked with multiple adverse health outcomes and highlight it as a multi-system health risk factor. Tackling FI should be a major public health and policy priority