The natural history of the most common ATP1A3-related disease, alternating hemiplegia of childhood (AHC), has not been determined. We investigated three hypotheses: (1) AHC worsens over time; (2) several novel factors correlate with long-term outcomes; and (3) AHC manifests high mortality.

Within an early intervention child protection service (ages 0-3), interactive guidance is a key tool in efforts to improve the quality of parenting resources and sensitivity to support the optimal development of the children receiving care. The framework and video support provide access to modifying dysfunctional interactive patterns linked to the child's symptoms, particularly in the case of a parent suffering from complex trauma. This therapy is fully aligned with the parenting support missions entrusted to the early educational intervention service in the community.

Agapé is a light-touch relationship enhancement smartphone app. This study used data from a longitudinal study of couples using the Agapé app to explore change within an array of behavioral processes to uncover patterns of interconnected change, thereby providing some of the first quantitative insights into how various relationship processes might be linked as relationships change over time. A sample of 405 couples in long-term relationships (810 partners, 50% women, 75% white, together M = 4.5 yrs, 50% living together, 33% currently dissatisfied) completed assessments across their first month of using Agapé. Men and women significantly improved on 15 of the 16 relationship processes assessed. As the study lacked a randomized control condition, it remains unclear if those improvements were due to using the Agapé app or to factors like expectancy effects, regression to the mean, self-selection, demand characteristics, or general participation effects. Network analyses explored correlational linkages among the self-reported pre-post changes observed. Results highlighted increases in three processes (quality time spent together, perceived partner responsiveness, and gratitude toward partner) as the processes most proximally linked to increases in relationship quality. The network findings also uncovered a number of patterns of interconnected change to be explored in future studies (e.g., increases in couples talking about their relationships to increases in mindful awareness within those relationships to increases in gratitude and quality time to increases in relationship quality). Thus, the results offer some of the first comprehensive multivariate (albeit correlational) insights toward understanding how relationship processes might work in concert with one another within a broader multivariate pattern of self-reported relationship change.

Nursing values include commitment to care for all and facilitation of healthy environments. The actualisation of these values, however, is often constrained by healthcare systems when overly influenced by neoliberal priorities for revenue generation. Assuming this context, the dynamics of two ontological nursing motives, loving service (agape) and creative agency (eros), are considered as they relate to nursing axiology, lived experience, and practice. Transversal analysis is engaged to further explore the implications that posthumanist philosophy may have for the relationship of eros-agape dynamics. Consequences for nursing practice and qualitative experience are considered. The analysis concludes in three propositions. The first, that in realigning loving service (agape) aspects of nursing with the nurse person's development of creativity and agency (eros), the nurse-person may be more satisfied in ego reward, and the actualisation of nursing values that hold commitment to all persons, facilitation of healthy environments, and actions of human caring, could be better supported. The second, that posthumanism, particularly the aspects of intersubjectivity and co-being, may transform the possibilities of eros and agape ontological motives in nursing to support greater emergence of connected multidirectional caring; so that the nurse-person is less alienated in providing care and, instead, is an active member of caring ecologies. The third, that in realigning loving service (agape) aspects of nursing with the nurse person's development of creativity and agency (eros), the nurse-person may be more satisfied in ego reward, and the actualisation of nursing values that hold commitment to all persons, facilitation of healthy environments, and actions of human caring, could be better supported.

AGAPE (computational G-quadruplex stabilization prediction) is a novel machine learning (ML)-based tool designed to predict the stabilizing potential of small molecules targeting G-quadruplexes (G4s). G4s, prevalent in telomeres and oncogene promoters, are promising therapeutic targets, but designing selective binders remains challenging. Building upon a curated data set of 1217 compounds labeled through Förster Resonance Energy Transfer (FRET) melting assay data, AGAPE integrates 5666 molecular descriptors, both classical and quantum chemical. It captures features relevant to G4 recognition, driving researchers to predict the potential G4 stabilization of small molecules, including both organic ligands and metal complexes. Among the trained ML models, XGBoost achieved the best performance with an accuracy of nearly 91%, using 489 selected features. SHAP analysis highlighted descriptors related to molecular topology, polarizability, and electrostatic potential as key contributors to the classification. AGAPE is deployed through a user-friendly web interface, http://agape.fondazionerimed.com/, supporting batch prediction and secure data handling, and provides a robust and interpretable tool to accelerate the discovery of G4-stabilizing compounds, integrating quantum chemical information within an ML-driven cheminformatics framework.

The beauty of the romantic relationship between men and women is not a matter of comparison. The aftermath is a natural and compassionate expression of agape. Friendship may be the gateway to romance. Theories of liking and courtship address the psychological paradigm of commitment to living together. Above all, the romance flourishes through culture, lifestyles, and the philosophy of life.

Incredible breakthroughs in scientific discoveries for the treatment of breast cancer have led to rapid improvements in health outcomes and quality of life for patients seeking healthcare solutions. However, the lack of inclusion of patients in clinical research who are disproportionately impacted by this devastating condition remains a significant challenge to researchers, healthcare institutions and communities alike. This report presents a framework for the inclusion of under-represented women, namely Black women, with breast cancer in clinical research. It also examines key factors influencing recruitment and retention, including patient perspectives. These insights can be applied across therapeutic areas to inform study design, enhance patient engagement, and improve population-based representation in clinical research.

Bacteriophages (phages) are viruses that target bacteria and hold great promise as therapeutics against multidrug-resistant bacteria, pathogen infections, and for microbiota engineering. Despite their potential, the effect of phage therapy on gut microbiota remains insufficiently explored. This study investigated the impacts of recurrent phage administration on the gut microbiota of chickens challenged with Salmonella Enteritidis. Eighty chicks were infected at 7 days of age and either treated with a cocktail of six lytic phages of Salmonella via drinking water for 21 days before and after infection, or left untreated. Surprisingly, continuous high-dose phage treatment led to higher Salmonella colonization levels than short-term pre-infection exposure. Through fecal and cecal microbiota analysis, we found that phage treatment significantly influenced alpha and beta diversities as well as microbiota development, with the most significant changes occurring prior to Salmonella infection, and gradually diminishing over time. Furthermore, phage treatment transiently altered predicted microbiota functions, promoting an oxygen-utilizing microbial community that may have counteracted the protective effects of phages. These findings demonstrate that phages can induce time-dependent modifications in both the composition and functional profile of the gut microbiota, emphasizing the importance of considering these dynamic interactions when developing phage-based strategies against enteric pathogens.

BackgroundHistorically love in nursing has been expressed as tender loving care but a move to technological thinking in nursing and the integration of healthcare systems may have changed this to one where love may be distant or avoided from the arena of care. It may now uncertain if love in nursing is an essential part of care, or supererogatory and additional to a paid duty of care.Research aimA study was conducted to investigate hospital nurses' experiences of providing end-of-life care. A core theme from the study was the nurse's expression of love. This article reports on this outcome and aims to provide clarity regarding the current nature of love in nurses' care.Research designInterpretative phenomenology was used to explore hospital nurses' experiences of providing end-of-life care.Participants and research context6 UK registered nurses with experience of hospital end-of-life care took part.Ethical considerationsEthical approval was gained before commencing the study. All participants consented to take part.FindingsThe nurses' end-of-life care actions were done willingly with goodness, selflessness, sometime courage, placing others before themselves and going beyond their duty of care. As a consequence, their love is universal and not bound by a professional care ethic but given freely of themselves as a gift.DiscussionThe nurses' action described love as both agape and eros suggesting a universal love. This was suggested a love not bound by a professional care ethic but one given freely of themselves as a gift.ConclusionsA contemporary view of love in nursing care is presented; when caring for dying vulnerable people in hospital, the value of love for another person is prevalent in the nursing care provided. It is not bound by a duty to care but is an addition to the process of care and is given freely of self.

BACKGROUND: Neuropsychiatric regression in individuals with Down syndrome (DS), termed Down Syndrome Regression Disorder (DSRD), has been reported to occur in the 2nd and 3rd decade of life. Symptoms of DSRD include acute onset of encephalopathy, catatonia, hallucinations, obsessive compulsive tendencies and “new autistic” features. To determine whether abnormalities in folate transport and/or metabolism may play a role in the pathogenesis of this disorder, studies explored whether abnormalities in serum, red blood cell (RBC), or cerebrospinal fluid (CSF) 5-methyltetrahydrofolate (5-MTHF) are associated with DSRD. METHODS: Prospective observational cohort study of individuals with possible or probable DSRD diagnosed between July 1, 2019, and June 30, 2025, were evaluated. Inclusion required standardized neurodiagnostic testing, including lumbar puncture. Serum folate and RBC folate and CSF 5-MTHF samples were analyzed using high-performance liquid chromatography. Associations between folate levels and clinical variables were assessed. RESULTS: Sixty-seven individuals were enrolled. Median serum folate was 14 ng/mL (IQR 10–19) and RBC folate 729 ng/mL (IQR 604–1113); all but one recording (1%) was within the reference range. Median CSF 5-MTHF was 72 mmol/L (IQR 57–84), with all values within the normal range. In univariate, unadjusted, analyses, CSF 5-MTHF was associated with developmental regression (p = 0.04) and CSF abnormalities including elevated IgG index and oligoclonal bands (each p < 0.001), elevated total protein (p = 0.01), and pleocytosis (p = 0.03); all CSF 5-MTHF values remained within the reference range. After Benjamini–Hochberg FDR correction, associations with elevated IgG index, oligoclonal bands, and any abnormal LP finding remained significant (each q = 0.01). LIMITATIONS: This study is limited by its single center design and homogenous cohort of individuals with DSRD. In addition, this study did not have a control group of individuals with autism spectrum disorder or DS alone. CONCLUSIONS: Serum, RBC, and CSF folate concentrations are normal in individuals with DSRD, suggesting that systemic folate deficiency, and cerebral folate deficiency in particular, are not contributors to its pathogenesis. The authors advise that expanded testing for disorders of cerebral folate metabolism should not be performed in possible cases of DSRD in the absence of clinical symptoms consistent with these conditions.

Omalizumab has been used during venom immunotherapy primarily for high-risk adult patients. We report a similar approach in a child with anaphylaxis in response to Hymenoptera skin testing who successfully tolerated modified rush venom immunotherapy with concurrent use of omalizumab.

The conventional approach to caring for patients pursuing voluntarily stopping of eating and drinking (VSED) allows physicians to disagree with the patient's decisions to pursue VSED, but it assumes clinicians should accept the patient's choice and provide all aspects of supportive care after the patient has autonomously elected to pursue VSED. We argue this conventional approach problematically ignores the problem of complicity with what some physicians take to be an unethical action. We propose an alternative approach that makes space for clinicians opposed to VSED to advise against this course of action, and to provide palliative medicine while resisting interventions that facilitate VSED.