Caring for patients receiving ECMO in the ICU is a complex process that requires advanced knowledge, technical skills, and confident clinical decision-making from nurses. Despite the increasing use of ECMO in Türkiye, no comprehensive, validated tool exists to measure ICU nurses' self-efficacy in ECMO care. This methodological study aimed to develop the ECMO Nursing Self-Efficacy Perception Scale (ECMO-SEPS) and evaluate its psychometric properties. The scale was developed in two stages. In the first stage, an item pool was generated through an extensive literature review and qualitative interviews with seven ICU nurses experienced in ECMO care. In the second stage, the scale's content and construct validity were assessed using confirmatory factor analysis, including convergent and discriminant validity evaluations. Reliability analyses included internal consistency, evaluated by Cronbach's alpha coefficients, and test-retest reliability, assessed with intraclass correlation coefficients. The final scale consists of 37 items across three subscales: cognitive, affective, and psychomotor, collectively explaining 70.5% of the total variance. Confirmatory factor analysis supported the three-factor structure with acceptable to good model fit indices. The overall Cronbach's alpha was 0.97, with 0.97, 0.81, and 0.96 for the cognitive, affective, and psychomotor subscales, respectively, indicating high internal consistency. Test-retest results demonstrated excellent stability over time. In conclusion, the ECMO-SEPS is a valid and reliable instrument for objectively assessing ICU nurses' self-efficacy in ECMO care. Its use may facilitate standardized evaluations and inform evidence-based education, workforce planning, and clinical practice in ECMO programs.

Wiskott-Aldrich syndrome (WAS) is an X-linked primary immunodeficiency caused by pathogenic variants in the WAS gene, resulting in absent or dysfunctional WAS protein (WASp) and a clinical triad of eczema, recurrent infections, and micro-thrombocytopenia. Allogeneic hematopoietic stem cell transplantation has historically represented the only curative option, but outcomes are constrained by donor availability, graft-versus-host disease, and transplant-related toxicity. Autologous gene therapy emerged as a compelling alternative. Early gammaretroviral vector trials confirmed that ex vivo correction of hematopoietic stem and progenitor cells could restore WASp expression and produce meaningful clinical benefit. However, insertional oncogenesis exposed an unacceptable genotoxic liability and drove the field toward self-inactivating lentiviral vectors. Clinical trials employing lentiviral platforms demonstrated durable, multi-lineage engraftment, sustained WASp expression, and robust immune reconstitution, with no reported cases of vector-related leukemia. These outcomes culminated in the FDA approval of WASKYRA (etuvetidigene autotemcel) in December 2025, establishing autologous gene therapy as a licensed standard of care for WAS patients lacking a suitable HLA-matched related donor. Next-generation precision gene-editing strategies and in vivo delivery platforms offer a path toward safer and more accessible correction. This review traces the full arc of WAS gene therapy, from early preclinical proof of concept through regulatory approval.

Remote-controlled genetic circuits use externally applied physical signals to regulate gene expression and cellular functions with spatial and temporal precision. Light, ultrasound, and magnetic fields provide complementary advantages in controllability, tissue accessibility, and biological compatibility, but their performance depends on both physical-field propagation and efficient conversion of external energy into intracellular signals and predictable gene-regulatory outputs. This review presents a unified framework of physical transduction, biological sensors, signal processors, and genetic effectors for comparing prokaryotic and eukaryotic systems. Core genetic circuits are distinguished from delivery and auxiliary platforms that support cargo release, cellular uptake, or energy conversion without directly regulating genes. Representative systems are compared by circuit architecture, transduction mechanism, stimulus parameters, dynamic range, basal leakage, response kinetics, reversibility, in vivo actuation, delivery requirements, and safety. The evolution from inducible switches toward multi-input logic, tunable regulation, genetic memory, and feedback control is discussed. An end-to-end codesign workflow and modality-specific reporting framework are proposed to integrate physical inputs, transducers, genetic circuits, delivery strategies, and stimulation devices. Quantitative benchmarking and standardized safety evaluation are essential for advancing these systems toward predictable and clinically translatable therapeutic platforms.

To evaluate the effectiveness of a specialist-led structured preventive educational intervention on diabetic foot outcomes in adults at risk of diabetic foot complications.Study designParallel-group randomized controlled trial with an embedded qualitative component.SettingSpecialised diabetic foot unit within a public healthcare setting.ParticipantsAdults with diabetes classified at any ulceration risk level according to the International Working Group on the Diabetic Foot were randomly assigned to the intervention or control group. Forty-two participants completed the 6-month follow-up.InterventionsThe intervention group received a specialist-led structured preventive educational programme comprising two structured group sessions in addition to standard podiatric care. The control group received standard podiatric care alone.ResultsForty-two participants completed the study. No diabetic foot ulceration occurred during the 6-month follow-up. Participants receiving the educational intervention improved disease-related knowledge, preventive self-care behaviours, and foot skin quality. Qualitative findings indicated greater confidence, emotional support, and engagement in preventive self-care.ConclusionsA specialist-led structured preventive educational intervention improved disease-related knowledge, preventive self-care behaviours, and foot skin quality in adults at risk of diabetic foot complications. These findings support the integration of structured education into routine preventive diabetic foot care.

A column ranking system was developed for the separation of all 20 proteinogenic amino acids using hydrophilic interaction liquid chromatography mode across 18 polar stationary phases with acetonitrile/aqueous mobile phases. Each amino acid was individually evaluated on all columns using gradient elution, and the retention time data were compiled into a statistical ranking algorithm that enables selection of any analyte subset and identifies the column providing the greatest separation between successively eluting analytes. Since most of these analytes lack strong chromophores, evaporative light scattering detection was employed for quantitative detection. Mobile phase pH (3.5 to 6.0) and ammonium formate concentration (10 to 100 mM) were then optimized on the three highest-ranked columns (Accucore-150-Amide HILIC, TSKgel Amide-80, and Poroshell 120 HILIC-OH5). Retention of most amino acids was insensitive to pH, whereas arginine and lysine showed inverse dependence on buffer concentration compared with all other analytes, and 50 mM ammonium formate without pH adjustment gave the best compromise for the complete analyte set. Re-querying the ranking algorithm for smaller analyte subsets returned a different optimal column in each case, confirming that no single stationary phase is universally preferable. Knowledge gained from evaluating the design space facilitated the rapid development of a quantitative method for the determination of the amino acid composition of a capsule formulation. The isocratic assay was linear for leucine, isoleucine, and valine over approximately 0.1 to 1.0 mg/mL (R2 ≥ 0.997), recovered 102%-104% of label claim across six independent preparations, and gave injection precision of ≤ 0.45% relative standard deviation with quantitation limits of ≤ 114 µg/mL.

Perceived organizational support is an important organizational resource that may shape nurses' psychological well-being, workplace engagement, and performance-related outcomes. This study examined the relationship between perceived organizational support and nurses' job performance and explored whether burnout and quiet quitting showed indirect associations consistent with mediation. A cross-sectional correlational study was conducted in a tertiary university hospital in the Black Sea Region of Türkiye. Of 980 eligible nurses, 439 responded (response rate: 44.8%); after excluding 14 questionnaires, 425 nurses were included in the final analysis, representing 43.4% of the eligible population. Data were collected using standardized instruments measuring perceived organizational support, burnout, quiet quitting, and individual work performance. Descriptive statistics, Pearson correlation analysis, and multiple mediation analysis using Hayes' PROCESS macro were performed. Perceived organizational support was positively correlated with job performance (r = 0.27, p < 0.001) and negatively correlated with burnout (r = -0.47, p < 0.001) and quiet quitting (r = -0.37, p < 0.001). Burnout (r = -0.31, p < 0.001) and quiet quitting (r = -0.31, p < 0.001) were negatively correlated with job performance. The total effect of perceived organizational support on job performance was significant (b = 0.23, β = 0.27, p < 0.001). The direct association between perceived organizational support and job performance remained significant even after accounting for burnout and quiet quitting (b = 0.10, β = 0.12, p = 0.025). Significant indirect associations were observed through burnout (b = 0.07, β = 0.08, 95% CI = 0.03-0.12) and quiet quitting (b = 0.06, β = 0.07, 95% CI = 0.03-0.09). These findings suggest that supportive organizational environments may be associated with higher job performance among nurses by reducing burnout and quiet quitting. Given the cross-sectional design, these findings should be interpreted as associations consistent with mediation rather than causal evidence. The study was conducted in a single tertiary university hospital in the Black Sea Region of Türkiye, which may limit generalizability to other settings.

Cerebral palsy (CP) is the most prevalent cause of childhood physical disability worldwide, affecting approximately 1.6 per 1,000 live births and imposing permanent deficits across motor, cognitive, and psychosocial domains. Conventional rehabilitation is frequently constrained by poor engagement and inadequate practice intensity in pediatric populations. Game-based interventions - encompassing virtual reality (VR), exergaming platforms, serious games, augmented reality, and telerehabilitation systems - address this challenge by embedding intensive therapeutic motor practice within intrinsically motivating play environments. This narrative review synthesizes evidence on the efficacy, engagement profiles, neuroplasticity mechanisms, and functional outcomes of game-oriented interventions for children with CP.

Cholesterol and oxysterols are key molecules that regulate physiological processes and participate in the occurrence and progression of various major diseases. Accurate and efficient analytical detection of these substances in complex biological matrices is critical for disease mechanism research and biomarker discovery. However, challenges including complex biological matrices, large differences in analyte abundance, susceptibility to auto‑oxidation, low ionization efficiency, and difficulty in isomer separation pose severe obstacles to reliable analysis, making sample preparation the core step for accurate quantification and valid identification. Continuous innovations have been achieved in sample preparation techniques, such as liquid-liquid extraction, solid‑phase extraction, deep eutectic solvent extraction, molecularly imprinted extraction, derivatization, as well as integrated and automated workflows. These advances improve extraction efficiency, selectivity, antioxidant protection, and throughput, while effectively reducing matrix interference and artificial oxidation. This paper systematically reviews the research progress in sample preparation for cholesterol and oxysterol analysis in complex biological matrices from 2015 to 2026, highlights the technical advantages, application scenarios, and current limitations of various pretreatment strategies, and prospects the development trends toward greening, intelligence, and high throughput.

α-Glucosidase is a key therapeutic target in the management of type 2 diabetes, as its inhibition delays glucose absorption into the bloodstream and thus attenuates postprandial hyperglycemia. Although several clinically approved antidiabetic agents function as α-glucosidase inhibitors, their clinical use is often constrained by gastrointestinal adverse effects. These side effects have driven efforts to identify novel α-glucosidase inhibitors with improved therapeutic index. Nonetheless, this increasing interest in the search for new compounds has been hampered by methodological difficulties associated with α-glucosidase inhibitor screening assays. Despite the considerable attention given to natural sources, especially polyphenolic compounds, the substantial differences in experimental setups across studies can compromise the reproducibility and comparability of results reported for the same molecules. This review aims to identify and summarize the methodologies and experimental conditions used to evaluate the inhibitory activity of polyphenols against α-glucosidase. A comprehensive analysis of 102 studies was conducted, focusing on key experimental parameters, including enzyme source and substrate type with their respective concentrations, temperature, pH, buffer, and incubation time employed in the assays. By pinpointing methodological inconsistencies and drawing attention to recurring best practices, this work underscores the importance of increased standardization to ensure reliable cross-study comparisons and to advance the rational development of polyphenol-based α-glucosidase inhibitors.

Monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway have been tested in cluster headache with mixed results, and four systematic reviews and meta-analyses reached different conclusions, leaving clinicians without a clear answer on whether, and in whom, to use these drugs.

Suffering the stress of others (termed empathic stress or stress contagion) may affect an individual's health and well-being. To understand the underlying hormonal processes of empathic stress, N = 108 opposite-sex dyads were tested, with one dyad partner passively observing the other undergoing a standardized psychosocial laboratory stressor. A positive link between oxytocin release and empathic stress response was hypothesized, while a negative relationship was expected for testosterone release. Associations of observer oxytocin and testosterone levels with two components of empathic stress were examined: stress resonance (i.e. synchronized observer-target responses) and vicarious stress (observer responses independent of target stress). During the passive observation of a stressed target, salivary oxytocin and testosterone levels increased by 16.64% and 23.00%, respectively, followed by a drop back to baseline levels. Supporting our hypotheses, increased observer oxytocin reactivity was linked to greater stress resonance in HF-HRV reactivity. This association was reversed in low oxytocin responders. Further, testosterone reactivity was negatively associated with stress resonance in heart rate activity. However, testosterone also showed a positive association with vicarious cortisol activity, which resembles the response pattern seen in first-hand stress exposure. We conclude that stress resonance may be the more empathy-dependent component of the empathic stress construct, aligning with previous work on the involvement of oxytocin and testosterone in empathy. To draw further conclusions about the role of oxytocin and testosterone in empathic stress response, future studies including a control group and hormone stimulation are needed.