A mechanistic framework for oxaliplatin-induced peripheral neuropathy: from neuronal vulnerability to neurotoxic persistence.

Objective: To explore the efficacy of the implementation of quality control (QC) program for children with fulminant myocarditis (FM) on improving the survival rate, reducing mortality and complication rates, and to evaluate the feasibility of the QC protocol. Methods: A retrospective cohort study was conducted. A Clinical Medical Quality Control Scoring Scale for Pediatric Fulminant Myocarditis (the QC Scale) was implemented since January 2021. Clinical data and the QC Scale data of 187 children with FM admitted to 8 tertiary hospitals capable of pediatric extracorporeal membrane oxygenation (ECMO) treatment over 6 years were collected, including the pre-QC group (January 2018 to December 2020) and the post-QC group (January 2021 to December 2023). Independent-samples t-test, Mann-Whitney U test, Chi-square test or Fisher's exact test were used for intergroup comparisons; and multivariate Logistic regression was performed for risk factor analysis. The clinical characteristics of pediatric FM and the feasibility and clinical efficacy of the QC protocol were evaluated. Results: A total of 187 children with FM were enrolled, including 82 cases in the pre-QC period and 105 cases in the post-QC period. The age was (8±4) years, and the weight was (28±14) kg. There were 104 female cases (55.5%) and 83 male cases (44.5%). A total of 156 children survived and 31 died, with an overall in-hospital mortality rate of 16.6% (31/187). The completion rates of electrocardiogram or cardiac monitoring and echocardiography or non-invasive hemodynamic monitoring within 30 min after admission were 98.7% (81/82) and 92.6% (72/82) in the pre-QC group, compared with 96.2% (101/105) and 90.5% (95/105) in the post-QC group. The post-QC group showed significantly higher completion rates of blood lactate measurement and Glasgow Coma Scale assessment within 60 min of admission than the pre-QC group (86.5% (71/82) vs. 98.1% (103/105), 62.2% (51/82) vs. 81.9% (86/105), χ²=9.43, 8.72; P=0.002, 0.003). The pre-QC completion rates of reaching blood lactate ≤5 mmol/L, central venous oxygen saturation ≥65%, and urine output≥1 ml/(kg·h) at 12 h after treatment were 82.1%(46/56), 72.1%(31/43) and 72.7%(48/66), respectively, compared with 81.1%(77/95), 69.1%(47/68) and 80.9%(76/94) in the post-QC group. The time from admission to ECMO initiation was shorter in the post-QC group than in the pre-QC group ((11±17) vs. (7±10) h, t=2.09, P=0.037). The mortality rates were 22.0% (18/82) in the pre-QC group and 12.4% (13/105) in the post-QC group. Compared with the pre-QC group, the post-QC group presented decreased rates of pre-ECMO cardiopulmonary resuscitation, cerebral injury and severe renal injury (51.2% (42/82) vs. 28.6% (30/105), 19.5% (16/82) vs. 8.6% (9/105), 19.5% (16/82) vs. 8.6% (9/105); χ²=9.97, 4.76, 4.76, all P<0.05). Conclusions: The implementation of the QC protocol for pediatric FM improves the ability of organ injury identification and standardized treatment, facilitates timely ECMO initiation, reduces the occurrence of cardiac arrest and major complications, and is of great significance for improving long-term quality of life. The pilot hospitals achieves high completion rates of QC indicators, indicating good feasibility of the protocol.

Premature ventricular contractions (PVCs) are common arrhythmia encountered in patients with and without structural heart disease. Although often benign and asymptomatic, they may also cause palpitations, exercise intolerance, presyncope, and reduced quality of life, and in some patients can contribute to PVC-induced cardiomyopathy or trigger malignant ventricular arrhythmias. Their clinical significance depends on symptom burden, PVC frequency, ventricular function, and the presence of underlying myocardial disease. Diagnostic evaluation includes electrocardiography, ambulatory rhythm monitoring, echocardiography, exercise testing, and cardiac magnetic resonance imaging for tissue characterization and risk stratification. Management ranges from reassurance and lifestyle modification to pharmacologic therapy and catheter ablation. Beta-blockers and nondihydropyridine calcium channel blockers remain common first-line options, whereas antiarrhythmic drugs may be considered in carefully selected patients. Catheter ablation is an effective treatment for symptomatic PVCs, high PVC burden, and PVC-induced cardiomyopathy, with high procedural success rates and favorable effects on arrhythmic burden and ventricular function. Novel approaches, including electrocardiographic imaging-guided planning, pulsed field ablation, stereotactic radioablation, neuromodulation, and renal denervation, may further expand future therapeutic options. This review summarizes the pathophysiology, clinical implications, diagnostic evaluation, and contemporary management of PVCs, with emphasis on medical therapy, catheter ablation, and emerging treatments.

Objective: To analyze the clinical diagnosis and treatment strategies for acquired tracheoesophageal fistula (aTEF) and bronchoesophageal fistula (aBEF) in children, and explore the value of interventional bronchoscopy in their management. Methods: A case series study analyzed the clinical data of 9 pediatric patients with aTEF and aBEF admitted to the Department of Respiratory Intervention and Department of Gastroenterology, Children's Hospital Affiliated to Shandong University, from February 2014 to July 2025. The clinical features, diagnostic and therapeutic processes, and treatment outcomes were summarized. Results: Among the 9 patients, 7 were male and 2 were female, the age of onset was 1.7 (1.0, 4.0) years. Etiologies included esophageal corrosive injury due to button battery ingestion (4 cases), and 1 case each of esophageal corrosive injury from caustic alkali ingestion, esophageal perforation by foreign body, fall from height, neck stab wound, and iatrogenic injury.Clinical manifestations: 6 cases of dyspnea, 5 cases of recurrent cough and choking during feeding. There were 6 cases of aTEF and 3 cases of aBEF. Seven patients underwent interventional therapy via bronchoscopy or gastrointestinal endoscopy: 4 cases received covered metallic stent placement via bronchoscopy for fistula occlusion, 1 case underwent titanium clip closure via gastroscopy, 1 case underwent mucosal deepithelialization combined with titanium clip closure via gastroscopy, and 1 case received combined bronchoscopic stent placement, epidermal growth factor injection, and gastroscopic titanium clip closure. Seven patients underwent surgical treatment, including aTEF or aBEF repair in 6 cases, gastric fundoplication with gastrostomy in 2 cases, and jejunostomy in 1 case. Conclusions: The management of aTEF, aBEF in children is challenging. For patients presenting with respiratory symptoms, palliative interventions such as airway-covered stent placement or gastroscopic fistula clip closure can be considered to occlude the fistula. A multidisciplinary collaborative approach is essential for managing children with aTEF, aBEF, improve nutrition and manage complications to enhance the quality of life of the pediatric patients.

Evaluating quality of life in thoracic malignancy trials: A scoping review on ESMO-MCBS quality of life checklist adherence and concordance with progression-free and overall survival.

Childhood cancer and parental well-being: Exploring the relationship between caregiver burden and quality of life.

Orthognathic surgery effectively corrects dentofacial deformities, but patients often present with considerable preoperative psychological distress which may compromise postoperative satisfaction. The incidence of anxiety and body dysmorphic disorder (BDD) in preoperative dentofacial deformity patients, and their impact on patients' quality of life, remain insufficiently defined. To investigate the prevalence of anxiety level, BDD and quality of life in preoperative patients for orthognathic surgery, and evaluate the associations between psychological factors and quality of life. In a cross-sectional study of 392 patients scheduled for orthognathic surgery, we assessed preoperative state-trait anxiety, BDD severity, and orthognathic quality of life. Sociodemographic and clinical variables were recorded. Spearman correlations and hierarchical regression examined associations and predictors. High anxiety was reported by 25.8%-32.7% of participants, while clinically significant BDD symptoms were present in 22.9%. The median score of orthognathic quality of life was 34.5, with facial aesthetics and oral function most impaired. Anxiety level and BDD severity jointly explained 49.6% of the variance in orthognathic quality of life, exceeding demographic and clinical factors. Class III malocclusion predicted poorer quality of life, whereas being married and higher income were protective. Preoperative patients for orthognathic surgery experience high rates of anxiety levels and BDD, which are the primary determinants of preoperative quality of life. Integrating psychological screening and support into preoperative care may optimize outcomes.

To examine factors, including symptom burden profiles and self-care, associated with quality of life among individuals with heart failure and multimorbidity. A cross-sectional design. 353 adults aged 50 years or older with heart failure and at least one additional chronic condition were recruited from a university-affiliated hospital. Three symptom burden groups were identified (low, moderate, and high) through latent profile analysis of the Edmonton Symptom Assessment Scale scores. The Heart Failure Self-care Index and EuroQoL-5D-5L measured self-care behaviours and quality of life. This study examined group differences and associations overall and stratified by symptom burden groups via multivariable linear regression. A higher disease burden and the high symptom burden group compared to the low symptom burden group were associated with lower quality of life. Self-care maintenance was positively associated with a higher quality of life, but not in the high-burden group. Among individual symptoms, pain and depression were associated with lower quality of life. In the high-burden group, older age was positively associated with quality of life. Higher symptom burden groups included a greater proportion of women and middle-aged adults. Symptom burden and self-care maintenance show significant associations with quality of life in multimorbidity. Symptom burden profiles identified through latent profile analysis may complement conventional approaches by targeting high-risk individuals, such as middle-aged individuals and women with high symptom burden, for follow-up and integrated multimorbidity management. For healthcare providers, including nurses, these findings underscore the importance of holistic, symptom-based care approaches combined with routine support for self-care maintenance. Adopting a life-course approach, through early identification and management of high-risk individuals, may help promote aging in place with a better quality of life for those with heart failure and multimorbidity. STROBE checklist. No patient or public contribution.

Hashimoto's thyroiditis (HT) is the most common autoimmune thyroid disease. Although levothyroxine therapy effectively normalizes thyroid-stimulating hormone (TSH) in most patients, persistent symptoms are frequently reported, suggesting that autoimmunity and inflammation contribute to reduced quality of life (QoL) independently of thyroid hormone levels. According to PRISMA guidelines, we systematically searched for MEDLINE, Scopus, and Web of Science studies that assessed the association of thyroid autoimmunity, inflammatory markers, and QoL in adults with HT. Included designs were observational, interventional, and longitudinal studies that published qualified QoL outcomes and immune/inflammatory markers. Across diverse study designs, HT patients-typically euthyroid or receiving long-term levothyroxine therapy-consistently reported lower QoL compared with controls, particularly in cognitive, affective, and vitality domains. Elevated anti-thyroid antibodies (anti-TPO, anti-Tg) were negatively correlated with QoL, whereas TSH and thyroid hormone levels showed no consistent association. Interventional studies demonstrated that total thyroidectomy or therapies associated with reduced antibody titers were accompanied by improvements in fatigue and QoL. However, an important caveat must be emphasized. Some studies did not confirm a direct association between antibody levels and symptom severity, likely reflecting methodological variability and heterogeneity in QoL assessment tools. There is evidence that HT exerts a multidimensional impact beyond endocrine dysfunction, with chronic autoimmunity and low-grade inflammation contributing to impaired QoL. These findings should be taken into account and perhaps challenge a purely TSH-centric model and call for a broader, patient-centered approach that integrates immunological, psychological, and subjective outcomes. Properly designed longitudinal and interventional trials are required to establish causal pathways and support the personalization of therapy.

This study was conducted to examine the mediating role of eudaimonic well-being in the effect of perceived poverty on quality of life in the elderly. This descriptive cross-sectional study was conducted with 523 elderly individuals aged 65 years and over living in Erzurum province between July and November 2024. R programming language 4.1.3, G*Power 3.1, and SPSS-22 program were used in the analysis of the study. The variable 'Perceived Poverty' has a negative and statistically significant effect on eudaimonic well-being (coefficient = -0.2546, p < 0.001). The variable 'eudaimonic well-being' has a positive and statistically significant direct effect on Quality of Life (coefficient = 0.4366, p < 0.001). The variable 'Perceived Poverty' has a negative and statistically significant direct effect on Quality of Life (coefficient = -0.2580, p < 0.001). The indirect effect measured through the variable 'eudaimonic well-being' was statistically significant (Effect = -0.1111, BootLLCI = -0.1385, BootULCI = -0.0826). According to the Shap graph, Perceived Poverty is identified as the most important variable in predicting the Quality of Life variable. Eudaimonic well-being significantly mediates the negative impact of perceived poverty on elderly quality of life. These findings highlight the need for holistic care programs that combine material support with interventions fostering purpose and personal growth. It is recommended that longitudinal studies be conducted on quality of life among the elderly.

Exercise interventions for physical function, psychological health, and quality of life in patients with myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia: A systematic review and network meta-analysis.

Predictors of Prosthetic Eligibility after Major Lower Limb Amputation: A Retrospective Cohort Study.

Acupuncture-like transcutaneous electrical nerve stimulation for patients with irritable bowel syndrome: Pilot mixed-methods study.

This study intended to examine the effects of High Tone Power Therapy (HTT) on pain, range of motion, and quality of life (QOL) in patients with lumbosacral radiculopathy. It is a serious condition that can impair a person's function and daily living activities due to irritation of the nerve roots. Evaluations were conducted on 52 patients both before and after treatment. A visual analog scale for pain (VAS-P) and a pain pressure threshold (PPT) algometer were used to measure pain intensity. A back range of motion (BROM) goniometer was used to measure lumbar ROM, and quality of life was assessed using the Short Form Health Survey (SF-36) to measure Physical Component Summary (PCS), Mental Component Summary (MCS), and total SF-36 score. The study group was given the High Tone Power Therapy along with the chosen physical therapy program, while the control group was given the physiotherapy program plus sham High Tone Power Therapy without current flow. For 4weeks, both groups attended three sessions a week. Results revealed a significant improvement in the study group after treatment, with VAS-P considerably decreasing (p<0.05), while PPT, lumbar ROM, PCS, MCS, and SF-36 total score increased more than in the control group. High Tone Power Therapy is an effective physical therapy strategy for improving function, discomfort, and quality of life while lowering Lumbosacral Radiculopathy symptoms.

Are there distinct symptom clusters in women with endometriosis and adenomyosis, and how do these clusters predict quality of life? Latent class analyses of 22438 women with endometriosis identified four symptom phenotypes, including high pain-gastrointestinal and psychological-neurological clusters; adenomyosis cases were concentrated in high‑pain classes without a minimal‑symptom group, and high‑burden phenotypes had poorer quality of life. Endometriosis and adenomyosis are heterogeneous conditions with diagnostic delays of 4-11 years. The classification based on surgical findings and imaging fails to capture the complex, systemic symptom combinations that affect patients' quality of life (QoL). Large-scale cross-sectional cohort study using data from the United States-based All of Us Research Program (Controlled Tier v8; May 2018-October 2023). The dataset included 22438 women with electronic health records (EHR) and/or self-reported endometriosis. Four Latent Class Analyses (LCA) were performed on different patient groups: (i) the full endometriosis cohort (n = 22 438); (ii) an age-corrected subset restricted to premenopausal women (aged 18-45; n = 5542) to minimize menopausal confounding; and two subgroups derived from the age-corrected cohort to test whether concomitant adenomyosis defines distinct symptomatic phenotypes: (iii) clinically confirmed endometriosis without adenomyosis (n = 1797) and (iv) adenomyosis with endometriosis (n = 643). LCA was performed using 19 self-reported and EHR-derived symptoms and comorbidities (e.g. chronic pelvic pain, migraine, depression, gastrointestinal symptoms) to identify patient subgroups. Multinomial logistic regression assessed sociodemographic (age, BMI, deprivation index) and clinical predictors (hormonal contraceptive use, surgical history) of class membership. The association between latent classes and QoL outcomes was evaluated using data from the 'Overall Health' and 'Health Care Access and Utilization' surveys. Data are available via the All of Us Researcher Workbench (https://workbench.allofus.org). Latent class analysis of clinically confirmed endometriosis identified four distinct symptom phenotypes, most notably a severe 'High Pain & Gastrointestinal with Mood Symptoms' (High) cluster and a unique 'Predominantly Psychological/Neurological' cluster that challenges traditional gynecological-focused diagnostic frameworks. Patients with adenomyosis exhibited a distinct profile with two high-pain symptom classes and the absence of a fully asymptomatic group, indicating a higher overall disease burden. Membership in the High class was significantly associated with lower general health scores, reduced social satisfaction, and increased barriers to healthcare access. The All of Us is a United States-based research program, and the findings should be replicated in other independent cohorts to confirm generalizability across other geographical regions. The cross-sectional design limits causal inference regarding QoL outcomes. Also, the analyses rely on a mix of diagnostic approaches, including surgical and non-surgical clinical and self-reported diagnoses, which is both a strength and a limitation. The 'Minimal Symptom Burden' class may reflect under-documentation of symptoms in clinical records rather than a true lack of symptoms, and the High class may reflect to patients who have higher multimorbidity, hence have more hospital visits. These results support a shift toward personalized, interdisciplinary management of endometriosis that addresses mental health and gastrointestinal symptoms alongside pelvic pain. The identification of a 'Predominantly Psychological/Neurological' cluster suggests that young women presenting with non-classical symptoms (anxiety, migraine, depression) could be screened for endometriosis to reduce diagnostic delays and improve life-course potential. D.K. was supported by a 'Ramón y Cajal' fellowship from the Spanish Ministry of Science and Innovation (RYC2024-050099-I). O.G. was supported by a postdoctoral award from the Amy P Goldman Foundation. I.F. is the co-founder and co-owner of Sur180 Therapeutics, which is developing a novel treatment for endometriosis, and the Chief Scientific Officer of Nura Health, which is developing a non-invasive diagnostic solution for the disease. I.F. has received ARPA-H grant no. ARPA-H-ICHUB-24-101-1035 as Principal Investigator, consulting fees from Nura Health and Sur180 Therapeutics, and stock and share options in both companies. I.F. is also the inventor on patents for 'Compositions and methods for treating endometriosis' (US10695341 and US10729693) and serves as an unpaid Board Member of the World Endometriosis Society and the Fundación Puertorriqueña de Pacientes con Endometriosis (ENDOPR). H.S.T. received speaker fees from Gedeon Richter, a grant from AbbVie through Yale University, consulting fees from Regeneron, and is a co-inventor on Yale's endometriosis biomarkers and treatments (including US11993816B2, US10982282B2, and US12286629B2). He also serves on the boards of the Environmental Health Trust and Environment and Human Health. N/A.

Population ageing is accompanied by increasing exposure to psychosocial challenges, including age-related stereotypes and stigma. Internalized age-related stigma has emerged as an important psychosocial factor associated with mental health and well-being among older adults. However, empirical evidence examining its associations with well-being, quality of life, depressive symptoms and perceived social support remains limited, particularly in non-Western cultural contexts. This cross-sectional quantitative study included 139 adults aged 65 years and older attending an internal medicine outpatient clinic. Cognitive eligibility was assessed using the revised Turkish version of the Mini-Mental State Examination. Data were collected through face-to-face interviews. Measures included the Internalized Stigma of Ageing Scale (ISAS), WHO-5 Well-Being Index, Geriatric Depression Scale (GDS-15), WHO Quality of Life-AGE (WHOQOL-AGE), Multidimensional Scale of Perceived Social Support (MSPSS), and the Attitudes Towards Ageing Questionnaire. Statistical analyses comprised t-tests, one-way analysis of variance, Pearson correlation and hierarchical multiple linear regression. Participants demonstrated moderate levels of internalized age-related stigma. Internalized stigma was significantly higher among participants who were unemployed and those living alone or with adult children. Internalized stigma was negatively associated with well-being, quality of life and perceived social support, and positively associated with depressive symptoms. Regression analyses indicated that lower well-being, poorer quality of life, higher depressive symptoms and lower perceived social support were significantly associated with higher internalized stigma. Internalized age-related stigma is a significant psychosocial correlate of mental well-being and quality of life in later life. Interventions targeting psychological well-being and social support may play a role in mitigating stigma-related vulnerability in later life.

Preferences for palliative care services for patients with advanced cancer from the demand-supply perspective: A multicenter discrete choice experiment.

Understanding factors impacting quality of life in patients with keratinocyte carcinoma: A cross-sectional analysis of Mohs surgery patients.

To analyse the impact of a comprehensive range of menstrual symptoms-including various physical and psychological symptoms associated with menstruation-on work productivity and quality of life (QoL). A cross-sectional study. A menstrual cycle tracking application in Japan; current app users were recruited via in-app notification provided electronic informed consent from June to August 2022. Japanese women who have experienced menarche. Menstrual Distress Questionnaire (mMDQ) was used to determine severity of menstrual symptoms, and participants with mMDQ score ≥ 103 were grouped as severe. Work productivity was assessed using the Work Productivity and Activity Impairment Questionnaire: General Health (WPAI-GH), and QoL was measured using the 36-Item Short Form Survey version 2 (SF-36v2). Differences in absenteeism, presenteeism, overall work impairment and activity impairment on the WPAI-GH between the severe and normal groups; differences in the summary scores of the SF-36v2; correlation coefficients between scores of symptom groups of the mMDQ, WPAI-GH and the summary scores of the SF-36v2. Overall, 456/1988 (23.0%) women had severe mMDQ scores (≥ 103). The median overall work impairment was 30% higher in the severe group than in the normal group. In multiple regression analysis, mMDQ severity was significantly associated with increased absenteeism, presenteeism and activity impairment, as well as reduced mental and social QoL. Negative affect, impaired concentration and behaviour change were associated with greater presenteeism, while pain showed weaker correlations. Negative affect was strongly associated with reduced mental QoL. Our findings demonstrate that, in addition to pain, mental and psychosocial symptoms are significantly associated with both work productivity and QoL.

Quality-of-life outcomes after varicose vein surgery: A 12-month prospective study of 605 patients identifying key prognostic factors.