Substance use disorders are highly prevalent among offenders and are closely associated with increased rates of recidivism. This service evaluation assessed the effectiveness of compulsory forensic treatment for offenders with substance abuse in reducing recidivism. The study compared recidivism rates of 279 offenders who received mandated treatment under Section 64 of the German Criminal Code with those of a matched control group of 274 incarcerated individuals. An additional propensity score analysis confirmed the adequacy of the case-to-case matching. Over a mean follow-up of 6.5 years, the absolute risk reduction remained stable at around 16.5%, with recidivism rates at 7 years of 63.4% in the treatment group and 80.3% in the prisoner group. These findings attest to the effectiveness of compulsory addiction treatment in reducing recidivism compared to subjects who only serve a prison sentence, even though a substantial number (48%) of patients had been returned to prison but were still included in the treatment group at follow-up (intention-to-treat-analysis). The practical implications of these findings are discussed in light of recent legislative changes affecting the application of Section 64.

Introduction: Schizophrenia is a complex mental health disorder characterised by variable treatment responses. Previous research has explored factors influencing patient experiences; however, the understanding of how modifiable and non-modifiable factors relate to treatment effectiveness remains limited and, at times, inconsistent. Aim: To explore how the sociodemographic and clinical factors influence illness severity, treatment outcomes, and functional adjustment in work and social domains in patients with Schizophrenia. Materials and Methods: The present cross-sectional observational study was conducted at Sree Balaji Medical College and Hospital, Chennai, India, from July 2022 to July 2023, on 74 schizophrenia patients with at least six months of follow-up. The study assessed sociodemographic factors, treatment adherence, and illness severity in relation to therapeutic outcomes and social adaptation. Data were analysed using Epi Info software version 7, applying Mann-Whitney, Chi-square, and Wilcoxon signed-rank tests, with a significance level set at p <0.05. Results: The current study included individuals diagnosed with schizophrenia spectrum disorders (mean age: 36.1 years), with balanced gender distribution. Most participants were unemployed (71.6%) and married (59.5%). A significant reduction in illness severity was observed post-intervention (p <0.001). Demographic variables such as age, sex, and marital status showed no significant differences; however, marked and severe illness was associated with lower treatment efficacy (p<0.001) and poor resilience (p=0.001). Treatment response assessed via effectiveness index and global improvement categories. Treatment effectiveness was significantly associated with factors such as employment status (p=0.028), illness severity (p<0.001), age of illness onset (p=0.021), Higher Mental Function (HMF) (p=0.002), insight (p=0.007), resilience (p=0.019), and antipsychotic dose (p=0.041). Global improvement was significantly associated with factors such as employment status (p=0.012), illness severity (p<0.001), age of illness onset (p=0.035), HMF (p=0.003), insight (p=0.037), resilience (p<0.001), and treatment adherence (p=0.023). Individuals with milder illness, better insight, preserved HMF, higher resilience scores, and active treatment adherence showed more favourable outcomes. Functional impairment was significantly greater among those with inadequate treatment response and higher illness severity, particularly affecting work, home management, leisure, and interpersonal relationships (p<0.001). Despite overall improvement, a subset of patients continued to experience residual functional limitations, highlighting the link between treatment effectiveness and real-world functioning. Conclusion: According to the present study results, higher resilience, good insight, employment and strong family support are the key factors associated with better outcomes. The study also supports the role of early intervention, sustained treatment engagement and a recovery oriented approach for better clinical and psychosocial care.

Effectiveness of exercise therapy versus passive conservative treatments for rotator cuff-related shoulder pain: a systematic review and meta-analysis of randomized controlled trials.

Disease models of anti-N-methyl-d-aspartate receptor encephalitis: Investigating pathogenesis and targeted therapy.

Brain aging in bipolar disorder using a neuroimaging and machine learning-derived metric: Findings from the ENIGMA BD Working Group.

pH-driven progression: Dental caries to pulpal and periapical disorders.

Genome-wide CRISPR/Cas9 screen identified MCL1 as a senolytic target for clearing palbociclib-induced senescent and PD-L1-positive cells in colorectal cancer.

Alglucosidase alfa demonstrates effectiveness and safety in Chinese patients with late-onset Pompe disease: A multi-center prospective study.

The cholinergic system is involved in cervical dystonia - An [18F]FEOBV PET study.

Cardiac reactivity reflects autonomic nervous system regulation, yet its determinants and modulators remain incompletely understood. Although glucose influences cardiac activity at rest, its effects on task-dependent reactivity -particularly during relaxation interventions- are unclear. We examined whether glucose modulates cardiac reactivity during massage and rest, two treatments known to increase parasympathetic activity, and whether such effects relate to sustained attention. Ninety-four adults (age mean=22.84, SD=2.53; 71.28% female) were randomly assigned to consume glucose, or water before receiving a standardized massage or rest treatment, followed by a sustained attention task. Blood glucose, blood pressure, subjective arousal and pleasure, and electro- and impedance cardiography were assessed. Parasympathetic activity was indexed using the root mean square of successive differences (RMSSD) and high-frequency heart rate variability (HF-HRV), and sympathetic activity using pre-ejection period (PEP). Both massage and rest increased parasympathetic activity and reduced arousal. Glucose increased sympathetic activity and prevented sympathetic withdrawal during the massage, but we found no evidence for a modulation of parasympathetic reactivity. Sympathetic activity increased during sustained attention, and higher blood glucose was associated with better performance. Overall, glucose modulated sympathetic but not parasympathetic reactivity, potentially impairing the effectiveness of relaxation treatments.

In vitro efficacy of antibiotics and bacteriophages against Pseudomonas aeruginosa isolates from clinically affected captive falcons in Dubai, United Arab Emirates.

Men with presentations consistent with borderline personality disorder (BPD) and antisocial personality disorder (ASPD) are highly visible in community and forensic services. However, mis/underdiagnosis may be a consequence of their lower than expected engagement with mental health services, and when they do engage, systematised diagnostic biases may inaccurately differentiate these two subtypes. Given the substantial harms experienced by men who have personality disorder (PD), it is important to understand how personality disorder can be better identified and supported in clinical and forensic settings. Ten nationally and internationally recognised clinician participants who have expertise in the diagnosis and treatment of men with PD (80% male; 60% psychologists, 40% psychiatrists) participated in individual, semi-structured qualitative interviews. Participants shared their observations regarding PD presentations in men and recommendations for maximising treatment engagement in community and forensic settings. Transcripts from the 60-90-min interviews were analysed using inductive and deductive thematic analysis. The analysis identified four themes: Getting men through the door, Unmasking Complexity, Holding Steady in the Face of Risk, and Addressing Shame through Connection. Men with BPD tend to under-report their symptoms and distrust mental health services. Clinicians may struggle to differentiate BPD from ASPD, as men's emotional dysregulation often manifests as anger. Participants emphasised appealing to the person's self-interest, building a trusting therapeutic alliance, and carefully addressing shame to facilitate treatment engagement. Half of the expert clinicians were employed in forensic settings where men with BPD are disproportionately prevalent, rendering their perspectives especially valuable. Assessment of empathetic functioning can help counterbalance clinicians' overemphasis on aggressive behaviours when differentiating BPD from ASPD in men. Incorporation of gendered attributes and targeting associated defensive barriers may improve treatment engagement and effectiveness for men with personality disorder.

Growing evidence highlights maternal risk factors that can increase the likelihood of traumatic childbirth experience. Yet little is known about the availability of primary antenatal intervention for childbirth trauma to facilitate optimal maternal and infant outcomes. The aim of this study was to conduct a systematic review of the literature and empirical evidence to identify antenatal interventions and their effectiveness for treatment of childbirth trauma, post-traumatic stress disorder (PTSD), subthreshold PTSD, or post-traumatic stress (PTS) from childbirth. Four databases were accessed: PUBMED, CINAHL, ProQuest, and EBSCOHOST. PRISMA guidelines were followed for screening and reporting. Inclusion criteria were as follows: (1) peer reviewed articles; (2) samples of pregnant women; (3) published in English; (4) measure of PTSD, PTSD symptoms, PTS or fear of childbirth; (5) variable of childbirth trauma or childbirth experience; (6) antenatal intervention; and (7) human studies. We identified 2034 articles, with 12 articles in the final sample. The most common antenatal intervention in four studies was childbirth plans, which were associated with an increase in positive childbirth experience, childbirth control, mastery, and participation, as well as increased self-efficacy and reduced PTSD symptoms (p < 0.01). Other interventions included antenatal counseling and psychoeducation; eye movement desensitization and reprocessing; counseling; haptotherapy; trauma-informed care; cognitive behavioral therapy; and hypnosis for childbirth trauma. Methodological limitations as well as a lack of inclusion of women with perinatal mental health difficulties represent gaps in knowledge. Findings suggest promising evidence for the implementation of antenatal interventions in clinical and hospital contexts to treat childbirth trauma.

Effects of nonpharmacological manipulations and repeated xanomeline treatment on methamphetamine-vs-food choice in Sprague Dawley and Long Evans rats.

Recent regulatory and guideline changes have established pretreatment DPYD genotyping as a critical strategy to prevent severe fluoropyrimidine toxicity. Following earlier European leadership by the European Medicines Agency, the US Food and Drug Administration added boxed warnings to capecitabine and 5-fluorouracil labels recommending genetic testing before therapy. Concurrent updates from the National Comprehensive Cancer Network and ASCO align US with European practice supporting universal testing. Fluoropyrimidines remain foundational treatments across multiple cancers but can cause life-threatening toxicity in patients with dihydropyrimidine dehydrogenase (DPD) deficiency, most commonly because of inherited DPYD variants. DPYD variant carriers receiving standard doses experience markedly increased risk of severe toxicity and treatment-related mortality, emphasizing the clinical importance of DPYD testing and genotype-guided dosing. Evidence demonstrates that dose individualization based on guidance from the Clinical Pharmacogenetics Implementation Consortium reduces toxicity risk while maintaining treatment effectiveness and potentially reducing overall costs. Patient advocacy, particularly efforts led by Advocates for Universal DPD/DPYD Testing, has accelerated policy change, increased clinician awareness, and highlighted ethical implications of preventable harm. Despite growing adoption, implementation challenges persist, including workflow integration, clinician education, and equitable access. Integrated health systems such as the Veterans Health Administration demonstrate how centralized infrastructure and clinical decision support can facilitate uptake. Barriers are more pronounced in resource-constrained settings, where limited infrastructure, reimbursement uncertainty, and insufficient pharmacogenomic education hinder implementation. Regional initiatives illustrate education-focused, context-adapted strategies to expand testing and address population-specific variant knowledge gaps. Collectively, emerging evidence, regulatory alignment, and advocacy efforts position DPYD genotyping as a patient-safety imperative necessary to achieve safer, more equitable fluoropyrimidine therapy worldwide.

Effects of thermal treatments on instant characteristics, flavor profile, and in vitro digestion-fermentation of germinated brown rice powder.

Improving the validity of treatment effectiveness studies using real-world data in geriatric oncology: Common biases and practical solutions to avoid them.

mNGS-guided precision management of M. pneumoniae pneumonia: Pathogen load assessment and fungal co-detection patterns directing antibiotic optimization.

Multiple mitochondrial stress dysregulation represents an emergent mechanism for inducing tumor cell death. While photodynamic (PDT) and cuproptosis therapies can generate oxidative and proteotoxic stress respectively, their cooperativity and effects are hampered by the uncontrolled spatiotemporal interaction with glutathione (GSH) overexpressed in the tumor microenvironment. Here, we developed a GSH-depleting nanodrug for synergistic mitochondria-targeting PDT and cuproptosis, by co-loading mitochondria-targeting photosensitizer PpIX-TPP with copper ionophore elesclomol (ES) into GSH-responsive dextran-based nanoassemblies. The interaction between GSH in tumor cells and disulfide bonds in nanodrugs led to GSH depletion, thereby triggering the responsive release of the loaded drugs and reducing the limitation of GSH on therapeutic effectiveness. The released PpIX-TPP effectively targeted mitochondria, inducing PDT effects under laser irradiation, causing oxidative stress and further reducing GSH levels. ES carried copper ions into tumor cells and selectively released them in mitochondria, inducing proteotoxic stress through cuproptosis and generating hydroxyl radicals via a Fenton-like reaction to cause extra oxidative stress. The orchestration of multiple mitochondrial stress pathways led to mitochondrial dysfunction, immunogenic cell death, and subsequent immune activation both in vitro and in vivo. This study provides a strategy for enhanced antitumor efficacy through mitochondrial stress amplification and immune activation. STATEMENT OF SIGNIFICANCE: Combining light-activated photodynamic therapy (PDT) with copper-dependent cell death (cuproptosis) is promising for treating melanoma. However, tumors often overexpress glutathione (GSH), which neutralizes reactive oxygen species generated by PDT and blocks the cancer-killing effects of copper, thus compromising both therapeutic modalities. Poor targeting further impairs the treatment effectiveness. Herein, we developed a smart drug delivery system that combines mitochondria-targeting PDT with elesclomol-induced cuproptosis to improve the precision of treatment while depleting GSH to eliminate its negative impact on the therapeutic effect. Our nanodrugs induce abnormal amplification of mitochondrial stress in cancer cells, triggering their self-destruction and activating the immune system to attack tumors. This work provides a new strategy to enhance melanoma treatment through mitochondrial stress amplification and immune activation.

Tuberculosis (TB) remains a major public health challenge in Indonesia and generates significant mortality-related risk for the life insurance sector. This study develops an integrated Susceptible–Infected–Recovered–Deceased (SIRD) model to analyze TB transmission dynamics in Southeast Sulawesi and to estimate related life insurance claims. The model is calibrated using regional TB data from 2021–2023 and validated against 2024 observations. Analytical results include equilibrium analysis and the basic reproduction number, while long-term dynamics are examined through scenario-based simulations. Epidemiological outcomes are translated into actuarial projections by converting cumulative TB-related deaths into annual incremental deaths and expected insurance claims under optimistic, baseline, and pessimistic scenarios. Parameter sensitivity is assessed using Latin Hypercube Sampling and Partial Rank Correlation Coefficients. The results show that the transmission rate is the most influential determinant of the present value of TB-related insurance claims, followed by the recovery rate, whereas TB-induced mortality has a smaller but significant effect. These findings highlight that reducing transmission and improving treatment effectiveness can simultaneously mitigate public health impacts and lower long-term insurance liabilities, demonstrating the relevance of integrating epidemiological modeling with actuarial risk assessment.