Adverse childhood experiences (ACEs) can have an impact on emotional development, affecting the ability to regulate emotions effectively. Positive childhood experiences (PCEs) can also occur, enhancing the ability to cope with stressful situations and improving emotional regulation skills.

Analyze the relationship between the ACEs, PCEs, and emotional regulation difficulties (ERD); compare a sample of the community with a sample of perpetrators of sex crimes in terms of these variables, and analyze the predictors of ERD.

The sample comprised 764 males (537 from the community sample and 209 serving time for sex crimes).

A sociodemographic questionnaire, the Adverse Childhood Experiences Questionnaire, the Benevolent Childhood Experiences Scale, and the Difficulties in Emotion Regulation Scale.

Positive correlations were verified between ACEs and ERD, and negative ones between PCEs and ACEs, and between PCEs and ERD. Perpetrators of sex crimes have more ACEs and fewer PCEs and ERD compared to the community sample. Age, education level, sexual abuse, emotional neglect, parental divorce, family mental illness or suicide, and PCEs are predictors of ERD.

This study increases the understanding of the relationship between ACEs, PCEs, and their impact on ERD in adulthood, as well as the differences between the community sample and perpetrators of sex crimes in some of the variables studied. Furthermore, it also highlights the importance of intervening with families to increase PCEs, mitigate the effects of ACEs on ERD, and prevent crime.

Robotic transanal minimally invasive surgery (R-TAMIS) is increasingly used for local excision of rectal lesions, offering improved precision, ergonomics and access compared with conventional TAMIS. Although early reviews demonstrated feasibility, pooled data on operative and oncological outcomes remain limited. This systematic review synthesizes contemporary evidence to provide descriptive weighted estimates of procedural efficiency, safety and short-term clinical outcomes. A systematic search of PubMed, Scopus and Web of Science through June 2025 identified studies reporting R-TAMIS outcomes in ≥ 5 patients. Extracted variables included demographics, operative metrics and oncological results. Continuous data were descriptively pooled when possible, and risk of bias was assessed using Joanna Briggs Institute and Newcastle-Ottawa tools. Owing to heterogeneity, findings were summarized qualitatively. Twenty-two studies (n = 437), predominantly case series, met inclusion criteria. The mean patient age was 63 years, BMI 27.5 kg/m² and ASA score 2.2. Robotic systems used included da Vinci S/Si/Xi/SP and Medrobotics Flex platforms. Mean docking time was 20 min, operative duration 103 min, blood loss 18 mL and hospital stay 1.7 days. Postoperative morbidity remained low (Clavien-Dindo I–II 8%, III 1%) with reoperation and readmission rates of 2%. R0 resection was achieved in 96% of tumors, most of which are early stage (77%). R-TAMIS appears safe and feasible for local excision of early rectal tumors, with descriptive estimates suggesting low perioperative morbidity and short hospital stay. While currently more costly than laparoscopic TAMIS, efficiency gains in high-volume centers may mitigate costs. Further prospective studies are needed to better define outcomes and refine procedural indications.

Peptide nucleic acid (PNA) is a synthetic mimic of DNA where the deoxyribose-phosphodiester backbone is replaced with N-(2-aminoethyl) glycine units. The lack of deoxyribose-phosphodiester bonds enhances enzymatic stability and improves binding affinity of PNA with complementary DNA and RNA strands. To enhance target binding, conformational stability, and pharmacological activity, several chemical modifications have been introduced into PNA. Modified PNAs have demonstrated promising preclinical potential as antisense and anti-gene agents, supporting their use in diverse biomedical applications. The limited in vivo biodistribution and cellular uptake of PNA have significantly hindered its clinical development. Enhancing PNA biodistribution using nanoformulations and bioconjugate-based delivery strategies has resulted in substantial in vivo pharmacological effects. Further, with advancements in chemistry and delivery techniques, PNA holds promise in treating genetic diseases, metabolic disorders, cancers, and infectious diseases. This review summarizes PNA's pharmacological mechanisms, chemical modifications, delivery strategies, and therapeutic applications while addressing limitations for clinical translation.

We tested GamerFit, a theory-based health coaching and exergaming intervention delivered via mHealth app for feasibility and preliminary efficacy to improve physical activity (PA), sleep, perceptions of barriers and support, and mental health outcomes in youth with heterogeneous/comorbid mental health disorders (HCMHD).

A convenience sample of youth ages 13-17 with HCMHD were recruited via clinical referral, listservs, and media platforms. The primary outcome of feasibility was assessed relative to the original intervention, which was not delivered via mHealth app. Groupings were randomized 1:1 to the 12-wk GamerFit intervention arm (GamerFit) or active comparator arm (AC) using single-blind design to assess preliminary efficacy. GamerFit participants used the mHealth app and a Fitbit^™ to follow a progressive exergaming and gamified step program. AC participants were given PA/sleep tips and Fitbit^™ to track PA/sleep. Intervention feasibility was assessed for the GamerFit group using process data and parental/participant report; PA duration/intensity (actigraphy, self-report), sleep duration/quality (actigraphy, self-report), sleep hygiene, perceptions of social support, self-regulation, positive/negative affect, and global quality of life were measured at wks 0, 12 and 16. Mixed effects linear models were used to account for the repeated measures correlation over time with an unstructured covariance matrix. The covariates in the model included the main effect for time and treatment as well as the interaction of these effects.

62 participants were randomized (15.0 ± 1.5 avg age, 24 % female-identifying, 21 % non-white, 74 % on medication). GamerFit averaged 88 % coaching attendance, 34.8 min/wk exergaming, and 8033 steps/day, exceeding the original intervention's feasibility benchmarks for coaching attendance and steps per day, but not exergaming minutes per week. Parental/participant acceptability/accessibility was high. Days/wk of PA increased significantly in GamerFit vs. AC (diff 2.0 ± 0.9, 95 % CI, p = 0.04). GamerFit significantly improved sleep hygiene, sleep quality, barriers to exercise, emotional and informational support, affect, and reduced unhealthy days; AC did not. GamerFit showed clinically meaningful improvements on all self-regulation sub-scales; AC did not.

GamerFit shows promise to improve health behaviors and outcomes among youth with HCMHD. An effectiveness RCT should take place in a more racially/ethnically diverse population.

Immunisation reduces morbidity and mortality from vaccine-preventable diseases (VPDs). While childhood vaccination in India has improved, adult immunisation remains insufficient, especially among individuals with non-communicable diseases (NCDs). We aimed to evaluate vaccination coverage, awareness, and influencing factors among adults in a tertiary Armed Forces hospital.

A cross-sectional observational study was conducted from April 2024 to April 2025 at an adult immunisation clinic in a tertiary Armed Forces hospital. Data from 2,645 adults were analysed using descriptive and inferential statistics to assess vaccine uptake and its association with demographic and clinical variables.

Among 2645 participants, 57.3% were male. Influenza (45%) and pneumococcal (47%) vaccines were most administered. Herpes zoster and Tdap vaccines had lower uptake (5.7% and 1.5%, respectively). Uptake was highest in those aged 60-70 years. Awareness of adult vaccination was noted in 24.56% and was significantly associated with higher uptake (P < 0.001). Prior hospitalisation also positively influenced vaccine acceptance (P = 0.02). Adverse events were predominantly mild (pain, swelling, fever) and showed no significant variation between vaccines.

Adult respiratory vaccination coverage remains suboptimal despite moderate influenza and pneumococcal uptake. Awareness and prior healthcare interactions significantly influence uptake. National adult immunisation strategies are urgently needed.

Adolescents with type 1 diabetes are at increased risk of impaired cognitive function, particularly in tasks requiring memory, attention, and executive functioning. Given the emerging evidence that excess adiposity may impair cognition through metabolic and inflammatory pathways, we investigated the association between body composition components and spatial navigation in adolescents with type 1 diabetes.

In this observational study, 64 adolescents (39 boys, mean age 15.9 ± 2.2 years) with type 1 diabetes completed spatial navigation assessment by the Virtual Morris Water Maze Task (vMWMT) and underwent body composition assessment via bioelectrical impedance analysis. Glycaemic control was evaluated through HbA1c measurement and continuous glucose monitoring metrics. Associations between vMWMT outcomes (time-to-first move, time-to-platform, and path length) and body composition components [body mass index (BMI) and muscle-to-fat ratio (MFR) z-scores] were analysed by sex-stratified correlation and multivariable linear regression models.

Mean BMI z-scores did not differ between sexes, whereas girls had lower muscle-to-fat ratio (MFR) z-scores than boys (-0.60 ± 0.84 vs. 0.25 ± 1.00, p < 0.001). The boys' longer time-to-first move and time-to-platform were positively correlated with lower MFR z-scores and higher HbA1c levels, greater time in marked hypoglycemia and in severe hyperglycemia and longer diabetes duration. Boys' diabetes duration predicted a longer time-to-first move (B = 0.064, p = 0.009), while both diabetes duration and a lower MFR z-score predicted a longer time-to-platform (R² = 0.457, p < 0.001). The girls' longer time-to-platform was positively correlated with higher BMI z-scores. Their HbA1c levels at diabetes onset predicted longer time-to-first move (B = -3.46, p = 0.018), and their relatively higher BMI z-scores predicted longer time-to-platform (B = 9.33, p = 0.022).

Spatial navigation performance in adolescents with type 1 diabetes is influenced by body composition in boys and weight status in girls. Identifying and managing sex-specific risk factors may help optimise cognitive function in adolescents with type 1 diabetes.

The prevalence of type 2 diabetes is increasing alarmingly worldwide. Evidence consistently shows that nurse-led care by diabetes specialist nurses is crucial for delivering efficient front-line primary diabetes management. This study aimed to explore diabetes specialist nurses' experiences of the prerequisites for person-centred care and for their professional practice in primary diabetes healthcare.

A total of 16 diabetes specialist nurses from western Sweden participated in four focus-group discussions during May 2025. The data were analysed to identify common themes among the participants' experiences according to Krueger and Casey's descriptions.

The analysis resulted in one main theme: "maintaining professionalism in a changing and strained primary diabetes care". This theme included five subthemes that described diabetes specialist nurses' experiences regarding the prerequisites for person-centred care and professional practice. The diabetes specialist nurses reported daily challenges in delivering person-centred care in contemporary primary diabetes healthcare. Their professional commitment was evident in their clinical practice and in their efforts to maintain professional competence. Despite emphasising the importance of long-term, person-centred patient engagement in diabetes care, they face limited time to interact with patients and insufficient managerial support for their professional learning.

The findings underscore diabetes specialist nurses' need for organisational support, particularly from managers who value and actively promote person-centred care, as well as opportunities for continuous professional development. Taken together, such supportive measures could lay the groundwork for a sustainable primary healthcare system for diabetes in the future.

Diabetes-associated cognitive impairment (DACI) represents a debilitating complication lacking effective therapeutics. Extracellular vesicles (EVs) demonstrate a paradoxical dual role in DACI pathophysiology. Under diabetic conditions, EVs secreted by metabolically dysregulated adipose tissue and activated circulating inflammatory cells deliver neurotoxic cargo (miR-9-3p, miR-125a-5p) inducing neuronal ferroptosis, synaptic loss, and blood-brain barrier disruption via MEK/ROCK signaling. Brain-derived EVs enriched in complement proteins and mitochondrial markers serve as minimally invasive diagnostic biomarkers validated in multicenter cohorts. Conversely, mesenchymal stem cell-derived and brain endothelial cell-derived EVs exhibit substantial therapeutic potential, attenuating neuroinflammation, promoting neurogenesis, and restoring cognitive function across preclinical models. Clinical translation confronts challenges in GMP-compliant manufacturing, regulatory harmonization, and standardized potency assays. Engineering strategies encompassing cargo optimization and surface modification for brain targeting offer transformative solutions. This review establishes an integrated framework for developing EV-based diagnostics and therapeutics to address this prevalent complication.

Escherichia coli (E. coli) is a leading cause of urinary tract infections (UTIs) and diabetic foot ulcers, especially in individuals with weakened immune systems. Pathogenic strains (PEC) employ virulence genes including fimH, hlyA, usp, traT, and papC to establish infection, evade immune responses, and cause tissue damage. However, despite its clinical significance, there is a lack of integrative studies profiling virulence genes and identifying mutations in PEC, which may contribute to pathogenicity, antimicrobial resistance, and limitations in targeted therapy. In this study, 210 E. coli isolates were collected from diabetic patients with UTIs or foot ulcers at Hayatabad Medical Complex (HMC), Peshawar. Identification was performed through biochemical profiling and confirmed via PCR targeting 16S rRNA. Antibiotic resistance was assessed using the Kirby-Bauer disk diffusion method. The presence of virulence genes was detected by PCR, and sequencing data were analyzed using bioinformatics tools such as Multiple Sequence Alignment, PROVEAN, InterProScan, and SWISS-MODEL. A significantly higher prevalence of all five virulence genes was observed in diabetic isolates (fimH OR = 2.63; hlyA OR = 3.17; usp OR = 3.57; traT OR = 3.31; papC OR = 3.45; p < 0.001). Several mutations were identified, with PROVEAN predicting deleterious mutations including V20G (FimH), S130L (HlyA), G3R (USP), G1V and Q104L (PapC), and E27K (TraT). Structural modeling revealed localized conformational shifts, while InterProScan indicated conserved functional domains. Phylogenetic analysis showed that mutated genes formed distinct clusters, pointing to evolutionary divergence. This study emphasizes the value of molecular monitoring and the development of targeted therapies to control antibiotic-resistant E. coli infections in diabetic patients.

In recent years, various diabetic socks have been developed and introduced to help prevent diabetes related foot ulcers (DFUs). However, the question of which type of sock is most suitable for individuals with diabetes has not been adequately addressed. This review systematically explores the current evidence regarding the performance and structural properties of diabetic socks, along with a narrative analysis of commercial socks.

Four databases, including Web of Science, PubMed/Medline, CINAHL (EBSCO), and Google Scholar, were examined, resulting in the selection of nine articles. Methodological quality of the clinical trials was assessed using the Downs and Black tool. Additionally, 17 commercially available socks were selected for analysis.

Among the selected articles, four were clinical trials, two mixed-design studies, and three laboratory-based investigations. The clinical studies exhibited poor quality and were unable to demonstrate significant outcomes. Laboratory-based studies indicated that functional finishes on yarns could prevent microbial growth and that the blend of fibres and the structure of the socks significantly affect the overall performance. Commercially available socks reporting new types of fibres lack clinical evidence to support their claims, complicating the understanding of their performance in people with diabetes.

Current evidence regarding the structure and function of diabetic socks is limited, with clinical trials characterised by poor methodological quality. Technical suggestions for diabetic sock design are based on limited evidence from laboratory-based studies, highlighting gaps in the literature. This review highlights the need for further investigation to establish the evidence base for diabetic socks in supporting diabetic foot care.