The graduation rate of Black undergraduate students in nursing programs remains lower than that of their peers despite a notable increase in enrollment. Without disaggregated data, anecdotal and emerging evidence suggests student attrition rates are associated with unreasonable demands and unmet learning needs. Black nursing students experience systemic anti-Black racism from instructors, nurses, peers, and patients, which also contributes to their slow progress. These experiences impact equity, diversity, and inclusion in higher education and nursing. We explored the experiences of Black students in the two undergraduate nursing programs in Saskatchewan, Canada, to deepen our understanding of their needs and inform strategies for addressing anti-Black racism in nursing education. Using focused ethnography grounded in critical race theory and intersectionality, N = 26 individual interviews with current and former Black students from Saskatchewan nursing programs were analyzed using thematic analysis. Racist experiences reported by study participants were more prominent in clinical than classroom settings. Five main themes were identified. This paper focuses on Theme 1, "Racism is part of the culture in nursing," and its subthemes, namely racial microaggressions, racial stereotyping and accent bias, isolation and exclusion, unfavorable environment, and impact on mental health and well-being. Support and accountability measures in nursing education are needed to facilitate social justice.

Alzheimer's disease (AD) is one of the most prevalent neurodegenerative disorders worldwide, requiring early identification for timely intervention and to slow disease progression. However, existing diagnostic approaches, while effective at later stages, remain limited in detecting early-stage AD. Handwriting analysis has recently emerged as a non-invasive, cost-effective, and ecologically valid digital behavioral biomarker that reflects neurocognitive impairment. This review examines the role of handwriting as a neurocognitive marker for AD, focusing on integrating deep learning methodologies to enhance early diagnostic accuracy. It also elucidates the neurocognitive mechanisms linking handwriting behavior and AD, addressing current methodological and translational challenges. We performed a PRISMA-informed structured literature search and narrative synthesis of handwriting- and drawing-based studies for detecting AD/mild cognitive impairment (MCI), including offline handwriting images and online pen-stroke kinematics captured by digital devices. Task paradigms, data dimensions, preprocessing pipelines, modeling strategies (traditional machine learning and deep learning), evaluation practices, and translational considerations were summarized, and studies were organized by detection purpose and analytic approach. Our findings show that handwriting-based models generally discriminate AD/MCI from healthy controls with accuracy exceeding 80%, while deep learning models (e.g., convolutional neural network and multimodal Transformer fusion) approach 90% in structured tasks like clock drawing and figure copying. Online kinematic markers (e.g., reduced velocity, prolonged in-air time, increased pausing, and pressure instability) recur across studies, and multimodal integration with speech, gait, or facial signals can further improve sensitivity and ecological validity, although most studies are small and single-center.

In patients with Duchenne muscular dystrophy (DMD), the gene transfer therapy delandistrogene moxeparvovec delivers a functional form of dystrophin, which has been shown to stabilize or slow disease progression. We assessed cardiac safety of delandistrogene moxeparvovec in clinical trials with ≤ 5years of follow-up. Data were collected from clinical trials 101 (NCT03375164, n = 4), 102 (NCT03769116, n = 41), ENDEAVOR (NCT04626674, n = 48), and EMBARK (NCT05096221, n = 125), which excluded patients with left ventricular ejection fraction (LVEF) < 40%. Adverse events and cardiac echocardiography were assessed regularly in all trials. TroponinI was assessed regularly in ENDEAVOR and EMBARK. Cardiac magnetic resonance imaging (MRI; without gadolinium enhancement) was assessed within an EMBARK substudy. Of 218 patients (baseline mean age [range], 6.4 [3.2-20.2] years; mean LVEF [range], 63.8% [48.9-78.0%]), 210 (96%) were ambulatory; 216 received delandistrogene moxeparvovec treatment. Two myocarditis cases were reported within 4days after delandistrogene moxeparvovec infusion; both resolved within 3weeks. Except in the two myocarditis cases, troponinI fluctuations were asymptomatic. Thirteen patients with baseline and postbaseline echocardiography data had elevated troponinI at baseline; 1year post infusion, only one of these patients had LVEF < 50%. LVEF in all four patients with 5-year follow-up remained > 50%. Although cardiac MRI without gadolinium revealed no relevant differences in heart function between patients 1 or 2years after delandistrogene moxeparvovec versus patients 1year after placebo infusion, subclinical fibrosis cannot be ruled out. Results from delandistrogene moxeparvovec trials with 1 to 5years of follow-up suggest a manageable cardiac safety profile in this study population of predominantly younger, ambulatory patients with DMD who had no signs of persistent treatment-related cardiac injury.

mRNA vaccines and therapeutics are produced with an in vitro transcription reaction (IVT), a condensation of nucleoside triphosphates (NTPs) into a nascent mRNA chain templated by DNA and catalyzed by RNA polymerase. While tools exist to monitor NTP consumption, the role of the essential cofactor Mg2+ in IVT has not been extensively studied due to the lack of suitable analytical methods. In this study, we report the development of a high-throughput analytical method for monitoring free Mg2+ using selective fluorescent indicators. We combine this free Mg2+ monitoring method with previously reported rapid at-line monitoring of NTP and mRNA concentrations and apply it in batch and fed-batch IVT systems, varying Mg:NTP ratios and NTP concentrations to assess their effects on mRNA yield via free Mg2+. We experimentally demonstrate that free Mg2+ is critical for efficient mRNA production, with low free Mg2+ correlating with slow reaction progression or reaction stalling. For the first time, we experimentally show that under certain IVT conditions, the released free Mg2+ can be effectively utilized to continue the IVT reaction by feeding NTPs only. We also show that pyrophosphatase concentration significantly affects free Mg2+ levels and relate this to IVT kinetics and dsRNA content. Additionally, we demonstrate for the first time that free Mg2+ affects downstream DNase digestion of the pDNA template, resulting in residual pDNA when free Mg2+ levels are insufficient for DNase activity. Our findings provide an accessible methodological platform to improve the efficiency of mRNA production by optimizing IVT conditions and ensuring DNase activity.

UM-6 remodels the tumor immune microenvironment by blocking PD-L1N-glycosylation and promoting ERAD-mediated degradation in cervical cancer.

β-Arrestin-biased activation of type I angiotensin II receptors improves prognosis of murine pediatric heart failure.

Dihydropyridine Calcium Channel Blocker Therapy and Risk of CKD Progression in Type 2 Diabetes Treated With Renin Angiotensin System Inhibitors and SGLT2 Inhibitors: A Real-World Retrospective Cohort Study.

Hippocampal astrocyte St6galnac5 silencing improves spatial memory and preserves synaptic integrity in an AD mouse model.

Extracorporeal shockwave therapy (ESWT) acts as an acoustic wave via momentum transfer and mechanotransduction in aplethora of regenerative ways. Scaphoid non-unions benefit from high-energetic focused ESWT. In lunate necrosis aka Morbus Kienböck focused high-energetic ESWT can reduce pain and improve MRI. In CMC1 osteoarthritis focused ESWT appears to be clinically equal to intraarticular ultrasound-guided hyaluronic acid injection with more pronounced effects 6 months after therapy in the ESWT group. Tendinopathies of the hand can be treated with both, radial and focused ESWT, especially in symptomatic trigger finger and de Quervain tendinopathy. In symptomatic painful Dupuytren disease, focused high-energetic ESWT can reduce pain and slow down progression of the disease.

Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by airflow limitation. Despite the availability of comprehensive, evidence-based guidelines from the Global Initiative for Chronic Obstructive Lung Disease (GOLD), utilization of these recommendations remains limited in clinical practice. COPD contributes substantially to global morbidity, mortality, and economic burden and is projected by the World Health Organization to become the third leading cause of death worldwide by 2030. Early recognition and diagnosis, adherence to guideline-based pharmacologic management, smoking cessation, vaccination, and pulmonary rehabilitation are mainstay strategies to slow disease progression and prevent exacerbations. Understanding the pathophysiology and systemic complications is essential for improving outcomes and enhancing quality of life in patients with COPD.

A synergistic strategy involving reverse-adaptation and engineered MSC exosomes against ferroptosis in osteoarthritis.

The evolution of criteria for assessing disease activity and progression in multiple sclerosis (or the "saga of acronyms").

Cognitive impairment begins early in Parkinson disease (PD) and progresses to dementia in most people with PD, reducing quality of life and contributing to growing health-related costs. Physical exercise has potent antiaging effects and improves many outcomes in PD, including cognition. Identifying biomarkers that respond to exercise and determining how they associate with cognition and underlying disease pathology may elucidate key mechanisms for countering cognitive decline. This clinical trial will test the feasibility, adherence, and safety of a 26-week home-based, combined endurance and resistance exercise intervention in people with PD. Secondary objectives are to test the effects of the exercise intervention on (1) global cognition, (2) motor symptom progression, and (3) circulating fluid-based biomarker levels. The Exercise for Cognitive Excellence in Parkinson's Disease study primarily evaluates the feasibility, adherence, and safety of a home-based exercise intervention in people with PD. It is secondarily a pilot randomized controlled trial that measures the effect of this intervention on cognition, motor progression, and circulating biomarkers. Thirty-one participants with PD will be randomized to either a home-based, trainer-supervised endurance and resistance training program (exercise group) or a waitlist control group for 26 weeks. Feasibility will be assessed using the average percentage of maximum heart rate (HR) for aerobic exercise and repetition maximums for resistance exercise. Adherence will be assessed using average days of exercise per week, average duration of exercise at target HR intensity for aerobic exercise, and average duration of exercise for resistance exercise. Safety will be assessed by measuring the number of adverse events and serious adverse events. The efficacy of the combined endurance and resistance exercise intervention will be measured using cognitive assessments, the Movement Disorders Society Unified Parkinson's Disease Rating Scale, and participant-reported outcomes, all obtained at baseline and 26 weeks. Biomarkers in the periphery (blood and saliva) and brain (cerebrospinal fluid) will also be measured before and after the 26-week exercise intervention. Recruitment commenced in July 2023 and concluded in November 2025. The last participant will complete data collection in May 2026. Data will be analyzed starting in June 2026, and results are expected to be published in late 2026 and early 2027. Previous studies have shown that high-intensity endurance exercise effectively slows the progression of motor symptoms in PD and that resistance exercise effectively improves cognition in PD. Establishing whether a clinically relevant, combined endurance and resistance exercise intervention is safe and feasible in PD and can improve cognition and slow motor disease progression would have a significant impact on quality of life for those with PD and their caregivers. Understanding how biomarkers respond to exercise will shed important mechanistic insight.

Latent autoimmune diabetes in youth (LADY) is a poorly characterized form of autoimmune diabetes with onset between 8 and 29 years of age and with slow progression toward insulin dependence, similarly to latent autoimmune diabetes of the adult (LADA), which leads to diagnostic difficulties and possibly to therapeutic implications. In this case series, we discuss two cases of juvenile- and young adult-onset autoimmune diabetes with very low insulin need at least after diagnosis and the efficacy of treatment with semaglutide. In case 1, a 20-year-old woman with obesity (31.8 kg/m 2 ) with a non-ketoacidotic onset of diabetes was initially put on metformin and basal insulin. Previous ultrasound of the abdomen showed a hyperechogenic liver pattern. Tests showed high-titer multiple diabetes-related autoantibodies positivity, but still detectable C-peptide levels; thus, metformin was stopped and semaglutide was started. After 12 months, the patient still continues oral semaglutide and basal insulin, with detectable C-peptide, and has experienced significant weight loss (−20 kg) and resolution of liver steatosis. In case 2, a 13-year-old girl was diagnosed with autoimmune diabetes, with tests showing high-titer multiple diabetes-related autoantibodies positivity. She was initially put on multiple daily insulin injections (MDI). After almost 2 years, presenting to our care with still detectable C-peptide, we decided to stop meal-time insulin and to start oral semaglutide. After 15 months of follow-up on the latter treatment, the patient presents optimal glycemic control and increased C-peptide levels. This is the first case series that shows the possibility of treating LADY with oral semaglutide and basal insulin with optimal glycometabolic outcomes. Moreover, semaglutide treatment also had beneficial effects on weight control and non-confirmed effects on metabolic dysfunction-associated steatotic liver disease (MASLD).

Pulmonary fibrosis is a progressive and debilitating lung disease characterized by chronic inflammation, extracellular matrix deposition, and irreversible scarring that ultimately impairs respiratory function. Current pharmacological options, including pirfenidone and nintedanib, slow disease progression but are limited by systemic side effects and poor patient compliance. Phytoceuticals bioactive compounds derived from medicinal plants offer promising antifibrotic, antioxidant, and immunomodulatory properties that can be harnessed for pulmonary therapy. Recent advances in drug delivery have enabled inhalation-based strategies to achieve targeted deposition in the lungs, enhancing local drug concentration while minimizing systemic toxicity. This review provides translational insights into phytoceutical-based pulmonary drug delivery for fibrosis therapy, with emphasis on inhalable nanocarriers such as liposomes, polymeric nanoparticles, micelles, and PEGylated systems. Mechanistic pathways underlying the antifibrotic potential of phytoceuticals, along with opportunities and challenges in clinical translation, are discussed. Collectively, inhaled phytoceutical formulations represent a novel and patient-centric approach to improve therapeutic outcomes in pulmonary fibrosis.

Multiple system atrophy (MSA) is a rare and devastating neurodegenerative disorder. Accumulating clinical and preclinical evidence suggests that diabetes and insulin resistance may adversely influence MSA pathophysiology. We investigated the potential association between diabetes, impaired glucose homeostasis, and MSA neuropathology in rodents. We subjected the PLP-SYN (proteolipid promoter) transgenic mouse model of MSA to either a standard chow diet or a high-fat diet (HFD) for 4 months to induce diet-associated metabolic alterations. Metabolic, neuropathological, and behavioral parameters were subsequently evaluated at multiple time points. PLP-SYN mice fed a HFD exhibited a more pronounced diabetic phenotype, characterized by aggravated peripheral glucose dysregulation and insulin resistance, compared with wild-type mice on the same diet. Moreover, 4 months of HFD feeding aggravated MSA-related neuropathology, as evidenced by increased α-synuclein accumulation and enhanced dopaminergic neurodegeneration, accompanied by accelerated impairment of fine motor function. Collectively, these findings indicate an association between dysregulated glucose metabolism and MSA neuropathology. Our results further support the potential of modulating glucose metabolism to slow disease progression in MSA and provide additional rationale for exploring whether antidiabetic agents could provide therapeutic benefits. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

To investigate the effect of switching to a different type of myopia control spectacles on myopia progression. This retrospective matched-cohort study involved 1012 children or adolescents who were prescribed myopia control spectacles. Participants were divided into two groups: the change-of-type group (n=253), who switched to a different spectacle type, and the type-maintenance group (n=759), who retained the same type, using 1:3 propensity score matching. The primary outcome was the annual rate of spherical equivalent refraction progression (D/year) compared between and within groups before and after the switch. The initial prescription of myopia control spectacles occurred at a mean age of 9.46±2.11 years. Subsequent prescription (renewing the same type or switching to a new type) was provided at a mean age of 10.63±2.16 years. Before switching spectacles, the change-of-type group exhibited a significantly faster myopia progression rate than the type-maintenance group (-0.66±0.40 D/year vs -0.37±0.49 D/year; p<0.001). After switching, the progression rate slowed in the change-of-type group (mean reduction 0.18 D/year, p<0.001), narrowing the intergroup difference from 0.30 D/year to 0.08 D/year (-0.48±0.61 vs -0.40±0.50 D/year; p<0.001). However, the improved effect in the change-of-type group was not sustained, with myopia progression accelerating again with prolonged use (early vs late phase, -0.33 vs -0.53 D/year, p=0.024). Switching to a different type of myopia control spectacle may help slow myopia progression for children exhibiting suboptimal response to their initial spectacles. However, this beneficial effect tends to wane over time with prolonged wear.

SLCs in diabetic kidney disease: From pathogenic roles to therapeutic promises.

Multi-strategy investigation identifies amentoflavone as a novel D3R antagonist for Parkinson's disease treatment.

Axial changes and long-term myopia progression with orthokeratology: A risk-stratification study.