Some studies report that certain blood groups are associated with vascular disease. However, only a few studies have assessed the association between atherosclerosis and ABO blood groups. We investigated whether ABO blood groups are associated with carotid atherosclerosis.

A retrospective cohort study of 3855 patients from 1985 to 2021 at the Stroke Prevention and Atherosclerosis Research Center (SPARC). The database included patients with a history of vascular disease and those referred to SPARC for primary prevention. Carotid plaque burden was measured as total plaque area; percent stenosis was calculated from peak systolic velocity. Total plaque area and stenosis are compared in blood groups, using unadjusted comparisons. Quantile regression analyses were performed adjusting for risk factors including age, sex, blood pressure and smoking status. The association between carotid stenosis and blood groups was analyzed using logistic regression models. Subgroup analysis was stratified by presence or absence of vascular disease at baseline and the burden of atherosclerosis.

In quantile regression analysis, we found no significant associations between total plaque area and ABO blood groups. Carotid stenosis as a categorical and binary variable (defined as cases with stenosis ≥50% vs. < 50%) and total plaque area as a binary variable (TPA ≥ 1.19 cm2 vs. <1.19 cm2) had no association with ABO blood groups. In patients with cardiovascular disease (CVD), there was no association between blood groups and total plaque area.

Blood groups are not associated with carotid atherosclerosis. Prevention efforts should focus on controlling risk factors and living a healthy lifestyle.

The COVID-19 pandemic raised concerns about the mental health of an already burdened healthcare workforce. This study examined mental health trajectories among healthcare workers (HCWs) across the pandemic and identified personal and employment factors associated with different symptom patterns.

Longitudinal data were drawn from the NHS CHECK cohort, including clinical and non-clinical staff from 18 NHS Trusts in England (April 2020–April 2023). Growth curve and growth mixture models identified latent classes of HCWs characterized by distinct trajectories of probable common mental disorders. Secondary outcomes included anxiety, depression, alcohol misuse, and post-traumatic stress symptoms. Logistic regression examined associations between baseline personal and employment characteristics and class membership.

The analytical sample included 22,764 participants. For each outcome, growth mixture models identified two latent classes. Approximately 31% of HCWs experienced persistently high symptoms of probable common mental disorders, while 69% experienced persistently low symptoms. Similar patterns were observed for secondary outcomes, with small subgroups demonstrating worsening symptoms followed by improvement. Logistic regression analyses showed that being female, younger, single, working as a nurse, or having a pre-existing mental health diagnosis increased the odds of belonging to a high symptom class. Perceived support from colleagues and managers was protective.

While many HCWs reported consistently low mental health symptom levels, almost a third belonged to a latent class characterized by persistently high symptoms across all time points. These findings underscore the need for mental health support for vulnerable HCW groups, embedded within routine NHS practice rather than limited to crisis periods.

Nursing home residents have been disproportionately impacted by respiratory virus-related morbidity and mortality due to inherent vulnerability and communal living environments. This study aims to identify nursing homes with higher infection rates during a period of intense SARS-CoV-2 transmission and explore facility-level characteristics potentially associated with infection surges.

A longitudinal k-means clustering approach followed by exploratory regression analyses.

U.S. Nursing homes reporting to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN).

A longitudinal k-means method (kmlShape) classified the facilities based on their weekly SARS-CoV-2 incidence rate epidemic curve, identifying two categories (low vs high infection peak) based on the magnitude of infection peaks. A logistic regression model with bootstrapping was developed to assess facility characteristics associated with higher SARS-CoV-2 infection surges.

Among 11,990 nursing homes analyzed, 9,058 were classified as having a low infection peak, while 2,932 had a high infection peak. Nursing homes that are for-profit (OR = 1.570, 95% bootstrap confidence interval [BCI] 1.441–1.807), with high staff turnover (OR = 1.292, 95% BCI 1.154–1.451), or located in areas with higher social vulnerability (OR = 1.457, 95% BCI 1.239–1.880) were more likely to experience high infection peaks. Nursing homes with higher residents’ vaccination coverage (OR = .321, 95% BCI .248–.380) and located in urban areas were less likely to experience high infection peaks.

The facility-level characteristics associated with lower SARS-CoV-2 infection peaks may indicate resiliency and help evaluate the capacity of nursing homes to endure stressors such as respiratory viruses and other communicable illnesses.

To identify, describe and analytically interpret relational recurrent patterns shaping interactions in PC settings, and to offer practical guidance to haelth care professionals navicating complex end-of-life-scenarios.

This study explores the dynamics influencing relational interactions in palliative care (PC) settings. Building upon 1 author’s extensive clinical experience, reflection, and prior research, we aim to further illuminate the clinical and cultural factors that shape relational interactions and scenarios within PC. By integrating personal observations with scholarly literature and describing specific recurring global patterns of interaction, this article seeks to deepen understanding of PC culture and to provide healthcare professionals with practical strategies to improve engagement with patients and families.

This study aimed to explore and analytically describe recurrent relational patterns shaping interactions in PC settings through an analytic autoethnographic lens. Short evocative phrases were used to define the identified patterns as clinical vignettes. Based on recurrent clinical observations and reflexive positioning, and through an iterative analytic process, patterns were progressively identified, named, and situated within a theoretical framework. Ethical standards were upheld.

Three end-of-life scenarios – “The Palliative Honeymoon,” “The Cousin of France,” and “Do Everything!” – emerged and were analyzed. The findings emphasize the importance of understanding these behavioral patterns in order to educate health professionals and enhance care provision.

This original Portuguese analytic autoethnographic study is grounded in extensive experiential knowledge and addresses a gap in the literature regarding interactional patterns in PC. By integrating long-standing personal clinical experience with scholarly evidence, this autoethnographic study renders explicit what is often tacit in PC practice – the hidden cultural elements that shape clinical interactions. It is part of a continuum of research that willcontinue and be relate to elements of PC identity. By describing clinically relevant phenomena and integrating them with existing literature, this work offers strong practical implications and contributes to better preparing clinicians for the complex realities of PC practice.

Recent research indicates that neuropathological alterations may propagate via brain networks, as illustrated by network diffusion models (NDMs). The application of NDM to internet gaming disorder (IGD) has yet to be evaluated. This study was set to identify possible epicenters of neuroanatomical alterations using NDM in IGD.

Structural magnetic resonance imaging (MRI) data were obtained from 288 IGD participants and 165 matched recreational game users. Gray matter volume (GMV) was computed through CAT12 and segmented according to the Brainnetome Atlas. NMD was utilized to simulate the propagation of pathology. We initiated diffusion from each location to pinpoint probable epicenters of GMV alterations in IGD and correlated eigenmodes of the Laplacian matrix with observed atrophy and expansion patterns.

Abnormal brain regions with altered GMV were observed in IGD. Specifically, IGD demonstrated a great loss in GMV in the caudal cuneus gyrus, precentral and postcentral gyrus, as well as the cingulate cortex while simultaneously exhibiting an increase in the amygdala. The pallidus and putamen showed positive correlations with gaming craving. Both the right cingulate gyrus and the left amygdala were identified by the model as significant epicenters of disease dissemination.

The results suggest that gray matter morphological abnormalities can predict temporal sequencing of pathology progression in IGD. Subcortical gray matter volume increases in reward-processing-related regions were positively correlated with gaming craving severity in IGD, consistent with altered reward processing and motivational drive in addiction models.

Schizophrenia (SCZ) and bipolar disorder (BD) share substantial clinical and neuroanatomical features, yet the neurogenetic basis underlying their shared gray matter volume (GMV) deficits remains poorly understood.

We conducted meta-analyses to identify convergent GMV alterations across the two disorders. Genome-wide association studies (GWAS) were performed to uncover genetic variants associated with the shared GMV deficits region in UK Biobank participants. Polygenic risk score (PRS)-GMV associations were analyzed to examine the cumulative influence of genetic risk on GMV in regions with shared deficits. Furthermore, pleiotropic SNPs jointly associated with SCZ, BD, and shared GMV deficits were identified. Spatiotemporal gene expression profiling was utilized to characterize the developmental trajectories, and molecular docking was performed to explore potential drugs.

Meta-analysis revealed consistent overlapping GMV reductions in frontal, temporal, and insular regions across SCZ and BD, based on 6,620 patients and 7,762 controls. GWAS identified 14 SNPs associated with the shared GMV deficits. PRS analyses showed that modestly higher SCZ polygenic risk correlated with decreased GMV of shared regions. Two pleiotropic SNPs – rs11191368 and rs79668541 – were linked to both disorders and the shared GMV deficits. Spatiotemporal expression analyses demonstrated distinct developmental trajectories, and molecular docking highlighted 168 drugs with binding interactions for shared genes.

This study delineates shared neurogenetic mechanisms linking GMV abnormalities to genetic risk across SCZ and BD. Given the cross-sectional design, future longitudinal studies in independent cohorts are warranted to validate these findings and clarify the temporal relationships.

This study investigates differing aspects of wishes to hasten death (WTHD) distinguished by the extent to which WTHD were linked to patients’ agency: desire for hastened death (DHD), defined as general wishes for death to come sooner, and hastening death intentions (HDI), defined as thoughts about ending one’s life. In particular, this study aims to examine the differences between DHD and HDI in patients with amyotrophic lateral sclerosis (pALS) and identify predictive factors for both.

A cross-sectional nested study was conducted within a multi-center longitudinal study involving pALS from 5 European countries. Data collected included DHD (Schedule of Attitudes toward Hastened Death), HDI (“could you currently imagine ending your life?”), sociodemographic and clinical characteristics, psychological distress, quality of life, and social and spiritual-existential aspects.

In our sample of 121 pALS, 12.4% (15/121) expressed DHD, and 28.1% (34/121) expressed HDI. Of the 38 patients reporting any WTHD, only 11 experienced both DHD and HDI simultaneously. 23 patients reported HDI without DHD, while 4 patients expressed DHD without HDI. Multivariable logistic regression identified loneliness (OR = 1.33, 95% CI 1.03–1.71, p = 0.028) and reduced meaning in life (OR = 0.89, 95% CI 0.84–0.95, p < 0.001) as independent predictors of DHD. For HDI, independent predictors were female gender (OR = 3.31, 95% CI 1.37–7.98, p = 0.008) and lower spirituality (OR = 0.92, 95% CI 0.88–0.95, p < 0.001).

One in 3 pALS expressed WTHD. Our separate analysis of DHD and HDI supports the existence of distinct manifestations of WTHD and varying underlying factors. While DHD and HDI were associated with different predictors, our results point to the crucial role of spiritual-existential factors in the experience of WTHD, identifying these aspects as target points for intervention. This study highlights the importance of a nuanced understanding and communication regarding WTHD.

Recent proposals for revising the Diagnostic and Statistical Manual of Mental Disorders (DSM) aim to improve psychiatric diagnosis. While these efforts reflect substantial ambition, they continue to operate within assumptions embedded in the DSM’s underlying classificatory logic. This editorial examines whether such incremental revision is sufficient.

We provide a critical analysis of the recently published DSM roadmap and accompanying subcommittee commentaries. Drawing on contemporary literature, we identify five structural blind spots in the current reform agenda: public mental health, scientific inference, lived experience, epistemic governance, and the function of diagnosis. Based on this analysis, we propose an alternative dialogical redesign for the DSM.

We argue that current revision considerations risk increasing complexity without resolving fundamental limitations in psychiatric classification. Specifically, our analysis highlights several areas that warrant further consideration, including the relationship between diagnostic expansion and societal conditions, the applicability of group-level scientific findings to individual care, the incorporation of experiential knowledge, participatory governance in revision processes, and the identity-related implications of diagnosis. In response, we propose redesigning the DSM as a hybrid dialogical system that retains coarse-grained classificatory categories for pragmatic purposes while shifting diagnostic practice toward contextual interpretation, collaborative meaning-making, relational understanding, and individualized care formulation.

The challenges facing psychiatric diagnosis require more than incremental refinement. We therefore argue for a dialogical redesign of the DSM that better reflects the context-dependent, experiential, and relational nature of mental health conditions, positioning diagnosis as a starting point for collaborative inquiry.

Patients with recurrent breast cancer and liver metastases complicated by hepatic failure have limited treatment options and poor prognoses. Narrative-based medicine (NBM) and shared decision-making (SDM) may support patient-centered decisions even in critical clinical situations

To describe the role of NBM and SDM in guiding treatment decisions for a patient with recurrent breast cancer and diffuse hepatic metastases associated with severe liver dysfunction.

We present the case of a woman with recurrent breast cancer who developed hepatic failure caused by diffuse liver metastases. Repeated SDM discussions were conducted among the patient, her family, and a board-certified breast oncologist with certification in palliative care. Chemotherapy with eribulin was initiated together with intensive supportive care despite life-threatening organ failure.

Following the initial onset of adverse effects, the patient’s liver function improved, allowing continuation of outpatient chemotherapy and fulfillment of her goal of spending meaningful time with family. The patient survived for approximately 5 months after treatment initiation.

This case suggests that individualized care guided by NBM and SDM may support safe and goal-concordant treatment decisions, even near the end of life. Integration of oncologic and palliative expertise may help align medical interventions with patient values and preferences in complex clinical situations.