Banxia Xiexin Decoction modulates short-chain fatty acid metabolism and mitigates ulcerative colitis by reshaping the intestinal microbiota.

Seizures are common in patients with brain metastases (BMs), causing significant morbidity and reduced quality of life. The relationship between BM location and seizure risk remains unclear. Nononcologic literature suggests that primary motor cortex disruption may predispose to seizures. This study evaluated whether BM in primary motor cortex display increased seizure risk relative to BM in other locations. In this retrospective cohort study, patients with radiographic evidence of BM managed at Brigham and Women's Hospital/Dana-Farber Cancer Institute between 2003 and 2022, and maintained in a database, were included. Abstracted covariables spanned demographic (age, sex, and race), clinical (comorbidities and performance status), oncologic (cancer type, extracranial/intracranial disease extent, and prior systemic therapy), radiotherapeutic/neurosurgical (employment and type of radiation, presence of preceding brain-directed surgery), and outcome/seizure-related (presence, timing, and nature of seizures) domains. The exposure variable was BM in the primary motor cortex, and the outcome measure was seizures on a per-patient level. The effect of primary motor cortex involvement on seizure risk, at diagnosis and thereafter, was evaluated using univariable/multivariable logistic, and Fine and Gray competing risks regression, respectively. To limit confounding by lesion number, analyses were repeated in patients with a single BM at diagnosis (n = 1,174). Among 3,043 patients with (n = 570, 18.7%) vs without (n = 2,473, 81.3%) BM in primary motor cortex, the mean age was 60 vs 61 years, and 61% vs 62% of patients were female, respectively. Primary motor cortex involvement was associated with increased seizure risk at diagnosis (24.4% vs 10.3%, odds ratio 2.87, 95% CI 2.23-3.98, p < 0.001) and after initial diagnosis (hazard ratio [HR] 1.95, 95% CI 1.56-2.43, p < 0.001). Of 1,446 patients who developed additional BM after initial intracranial oncologic involvement, those with disease involving primary motor cortex were more likely to develop seizures thereafter (HR 2.11, 95% CI 1.56-2.86, p < 0.001). Patients with BM in the primary motor cortex may display increased seizure risk. As this study was retrospective, routine use of antiseizure medications in patients with BM in primary motor cortex in the off-trial setting is not recommended. However, dedicated trials evaluating prophylactic antiseizure medications in this population may be warranted.

Zhi-Gan Formula improved insomnia and anxiety comorbidity in a mouse model via PACAP signaling in the medial prefrontal cortex.

Dyslipidemia is a major metabolic disorder and a key risk factor for atherosclerotic cardiovascular disease (ASCVD), particularly in the geriatric population. Elderly patients frequently present with multiple comorbidities, such as hypertension and hyperuricemia, which complicate clinical management and substantially increase cardiovascular risk. Moreover, acute conditions, including trauma-related injuries, may further disrupt metabolic control, functional capacity, and adherence to long-term therapy. This case report describes a 70-year-old male patient (RE) who presented to a primary healthcare center with swelling and intermittent pain in the right lower extremity following a fall. The patient had a known history of dyslipidemia, hypertension, and hyperuricemia. Laboratory investigations revealed elevated total cholesterol (242 mg/dL), borderline fasting plasma glucose (102 mg/dL), and uric acid level of 6.6 mg/dL. Physical examination was unremarkable except for edema and localized tenderness in the affected limb, consistent with a soft tissue injury. A holistic management approach was implemented, integrating pharmacological and non-pharmacological interventions. Statin therapy was initiated to address dyslipidemia, antihypertensive treatment was optimized, and analgesic therapy combined with limb elevation was provided to manage acute pain and edema. Non-pharmacological strategies included comprehensive lifestyle modification, encompassing dietary counseling (low saturated fat, low salt, and low purine diet), gradual resumption of physical activity following injury recovery, and structured patient–family education to improve adherence and prevent recurrent falls. Follow-up evaluation demonstrated clinical improvement, including resolution of edema, improved functional mobility, and better metabolic control. The novelty of this case lies in demonstrating how acute trauma in geriatric patients can act as a critical entry point for integrated chronic disease management within primary care settings. This case emphasizes that holistic, biopsychosocial–spiritual management not only improves lipid and blood pressure control but also enhances functional outcomes and quality of life in elderly patients with complex comorbidities.

The quality of life of competitive and recreational Spanish surfers and para surfers.

Health-related quality of life is central to healthy ageing, yet gender differences among older adults and their underlying determinants are not well understood. We examined gender differences in quality of life in a large cohort of older Australians and the extent to which biopsychosocial factors mediate these differences. We analysed baseline cross-sectional data from the Statins in Reducing Events in the Elderly trial, a randomised controlled trial of community-dwelling Australians aged ≥70years without cardiovascular disease, major physical disability, or dementia. Quality of life was measured across eight domains of the 36-Item Short Form and summarised using the SF-6D index. Gender differences were examined using age-adjusted linear regression, with mediation assessed by the percentage reduction in the association between gender and quality of life after adjusting for individual biopsychosocial factors. Among 9971 participants (52% women; mean age 74.7±4.5years), women scored lower than men in Physical Functioning, Vitality, Mental Health, and Bodily Pain (all p<0.001), but higher in General Health (p<0.001). The SF-6D index was lower in women (mean difference-0.03, p<0.001). Pain severity, depressive symptoms, and histories of osteoarthritis and depression mediated the greatest amount of the gender difference in scores (between 42% and 92%). Older women reported better general health but poorer quality of life than men in most domains. These gender differences were largely attributable to pain and depressive symptoms, both of which are common and modifiable. Targeted management of these symptoms may improve quality of life and reduce gender disparities in later life.

Investigation of the relationships between polypharmacy, medication adherence, and quality of life in elderly individuals.

Impact of Mediterranean diet adherence on quality of life in patients with multiple sclerosis: A prospective study.

The effects of a nurse-led smartphone-based intervention after coronary artery bypass grafting: A randomised controlled trial.

Quality of life, grip strength, health indicators, and clinical risk in older adults: A cross-sectional study.

The high prevalence of mental disorders among college students underscores the importance of examining sub-threshold symptoms and their association with quality of life. To investigate the association between sub-threshold symptoms and quality of life and to explore whether abnormal illness behavior mediates this relationship. A cross-sectional study involving 7529 college students was conducted. Generalized linear models with linear regression analysis were used to examine the physical (PCS) and mental (MCS) component summaries of the 12-item Short-Form Health Survey (SF-12) in relation to anxiety, depression, somatization and insomnia symptoms. The prevalence of sub-threshold symptoms was 27.8% for anxiety, 30.5% for depression, 10.7% for somatization, 10.8% for insomnia, and 29.5% for any comorbid pattern. Multivariate analysis revealed significant negative associations between sub-threshold mental symptoms and both PCS and MCS (P<0.05). Median scores across all SF-12 dimensions were consistently lower in the sub-threshold group. Notably, abnormal illness behavior exhibited a negative mediating effect only in the above-threshold symptom group. Sub-threshold mental symptoms are highly prevalent among college students and are cross-sectionally associated with significant quality of life reduction. Specifically, our findings support a transdiagnostic intervention approach targeting stress load regulation-rather than symptom-specific interventions-as more clinically relevant for this population. Thus, colleges should prioritize stress-focused preventive strategies to mitigate symptom progression and functional impairment in sub-threshold students. Notably, abnormal illness behavior mediates the association between symptoms and quality of life only in the above-threshold group, indicating that colleges should tailor interventions differently for sub- versus above-threshold students.

Autistic individuals experience a heightened risk of depression and lower quality of life; however, the biological underpinnings for this increased risk remain to be fully established. We assessed whether disruption of self-reported sleep and circadian factors mediates the associations of autistic traits with depression symptom severity and quality of life in a community-based survey study. A total of 838 participants (mean: 52.8 [SD=1.3] years, 70% females) from a large-scale observational survey completed the Autism Quotient Scale, Hospital Anxiety and Depression Scale, Cantril Ladder quality of life, Insomnia Severity Index, Pittsburgh Sleep Quality Index, and the Munich Chronotype Questionnaire. Higher autistic traits were significantly associated with higher depression symptom severity (p=0.04) and significantly lower quality of life (p<0.001). Insomnia severity and later chronotype partly mediated the association of autistic traits and depression symptom severity (respectively, β = -0.02, 95% CI -0.03, -0.01; β=-0.02, 95% CI=[-0.04, -0.01). Likewise, insomnia severity and later chronotype partly mediated theassociation of autistic traits with lower quality of life (respectively, β = - 0.09, 95% CI -0.14, -0.02; β=-0.05, 95% CI=-0.09,-0.01). Our findings indicate that autistic traits are associated with higher depression severity and lower quality of life, mediated by insomnia and chronotype. Future studies targeting insomnia complaints and later chronotype in autistic people may help alleviate their mental health complaints and increase quality of life.

Effect of therapeutic play intervention on early-phase nausea, vomiting, and quality of life in children receiving chemotherapy: A randomized controlled study.

Owing to the global aging of people with multiple sclerosis (pwMS), there is an emerging need to distinguish neurological disability from age-related conditions in this population. To examine the overlap between frailty, disability, and comorbidity in pwMS, and their associations with quality of life (QoL) and falls. Two hundred and three pwMS (mean age=51.8 ± 12.6 years; median Patient Determined Disease Steps (PDDS) score=1.0 [IQR=2.0]; 73.9% women) underwent established assessments of frailty (FRAIL scale, Tilburg frailty indicator, and frailty index), disability (PDDS), comorbidity (Charlson comorbidity index), QoL (MSQoL-54), and falls (12-month fall-history survey). Frailty, disability, and comorbidity were distinct but overlapping: 1.5-10.3% of participants had frailty alone, 4.4-14.3% had disability alone, and 11.8-14.3% had comorbidity alone; between 9.4% and 19.7% had all three. Multivariable quantile and logistic regression analyses revealed that all frailty measures were more strongly associated with lower QoL (median regression coefficients ≤-4.76, p-values˂0.001) and greater odds of falling (ORs ≥1.47, p-values≤0.001) than disability or comorbidity. Participants with all three conditions had significantly worse physical QoL and a higher median number of falls than those with any one condition alone. Frailty, disability, and comorbidity represent separate conditions in pwMS, as they can present in isolation, and each has distinct associations with QoL and falls. Comprehensive assessment of all three conditions may enhance risk stratification and inform individualized rehabilitation and aging support strategies.

Fibre manipulation to manage symptom severity and quality of life in patients with functional bowel disorders: A systematic review.

Introduction: Ischaemic Heart Disease (IHD) and other cardiovascular conditions remain the foremost contributors to global illness and death, with India bearing a considerable share of this burden. Although progress has been made in treatment through medical and surgical approaches, inadequate patient awareness, limited self-care practices, and poor adherence to lifestyle changes continue to affect outcomes and Quality of Life (QoL). Nurse-led interventions, focusing on patient education, counselling, and ongoing support, have emerged as a potential strategy to address these challenges. Aim: To assess the impact of a nurse-led transitional care model on health outcomes (selected bio-physiological parameters) and QoL among individuals with IHD. Materials and Methods: A two-phase design was adopted. Phase I employed a mixed-methods exploratory approach at Dhiraj Hospital, Vadodara, Gujarat, India and Railway Hospital, Lucknow, India. The study period for Phase I was 7 weeks, including (quantitative data collection for 4 weeks and qualitative data collection for consecutive 3 weeks). Based on these findings, a structured video-assisted nurse-led intervention was developed. In Phase II, an experimental study was carried out involving 90 post-operative IHD patients, who were randomly allocated to intervention and control groups. The intervention group received structured counselling, video-assisted education, and weekly telephone follow-ups for 12 weeks, while the control group continued with routine care. Outcomes were assessed using the McNew Heart Disease Health-Related Quality of Life Questionnaire and clinical parameters such as Blood Pressure (BP), Body Mass Index (BMI), and lipid profile, as shown by the results of the mean, standard deviation, and Unpaired t-test results. Results: In Phase I, a total of 46 patients were included, and the mean age of participants was 55.36±7.00 and 56.2±6.34 among the control and intervention groups. The majority of the population (n=17) highlighted major gaps in patients’ understanding of lifestyle adjustments, medication adherence, recognition of danger signs, and follow-up practices. In Phase II, after 12 weeks of intervention, patients in the experimental group showed significant improvements in clinical variables life including systolic BP (p-value=0.001), diastolic BP (p-value=0.016), and BMI (p-value=0.004). Lipid profile changes were not statistically significant, as evident from the mean, standard deviation, and the Unpaired t-test results. Quality of life showed marked improvement in physical, social, and global domains (p-value &lt;0.001), though the emotional domain did not show significant change. Overall, 64.4% of participants in the intervention group reported good QoL compared to only 13.3% in the control group. Conclusion: The nurse-led intervention effectively improved QoL and clinical outcomes in IHD patients, highlighting the value of structured education, video learning, and follow-up, with larger multicentric studies needed to validate these findings.

The long-term influence of early rehabilitation nursing on neurological improvement and life quality in patients with severe traumatic brain injury: A prospective cohort study.

Does physical activity provide additional benefit in individuals with rotator cuff related shoulder pain?

Introduction. Specialized units for children with medical complexity (CMC) aim to improve the quality of life of these patients. The objective of this study is to analyze the characteristics of patients and families evaluated in a recently created CMC specialized unit, as well as factors related to their quality of life. Population and methods. Analytical cross-sectional study that included CMCs seen in a monographic consultation between 2020 and 2024. Clinical data were collected, and parents completed a questionnaire with questions taken from quality-of-life scales. Results. We included 60 of the 217 children who were seen. The mean age was 7.18 years. 68.3% were male. 41.7% had cerebral palsy; 38.3% were dependent on technical support. About the questions, 11/19 related to parents and 1/12 related to patients showed negative answers. Risk factors were non-Spanish origin, behavioral disorders, and sleep disturbances. Conclusions. Our results showed different perspectives on quality of life between CMCs and their families, identifying origin, behavior, and sleep as risk factors.

Longitudinal effects of dimethyl fumarate on patient-reported outcome measures in multiple sclerosis: treatment satisfaction, quality of life, depressive symptoms, sleep, and work productivity.