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464 papers

"I'm Not Here to Teach You How to Be Gay:" LGBTQ+ Client Experiences of Othering in Emotionally Focused Couple Therapy.

Edwards C et al. · Jul 1, 2026

Despite the increasing emphasis on addressing the intersections of client and therapist identity to improve therapeutic outcomes, therapy clients holding marginalized identities continue to experience othering. Othering is a process that engenders marginalization and inequality based on preconceived group identity, involves the hegemonic construction of belonging and not belonging, and often entails both stereotyping and racialization. This paper reports on the experience of lesbian, gay, bisexual, transgender, queer/questioning plus (LGBTQ+) emotionally focused couple therapy (EFCT) clients' experience of othering both in their own therapy and as part of participating in a research study on tailoring EFCT to account for the unique lived experience of members of the LGBTQ+ communities. This study relied on negative case analysis in the context of thematic analysis (TA) to develop three themes: (1) understanding versus inflating identity, (2) educating the therapist, and (3) deepening discussions around identity.

Psychology

Sedative Effects of Dexmedetomidine and Ketamine or Dexmedetomidine and Midazolam on Tear Production, Ocular Perfusion Pressure and Pupil Diameter in Rabbits.

Mohammadzadeh M et al. · Jul 1, 2026

Background Administration of sedatives may be necessary for anxious and uncooperative animals. However, different sedative combinations may have confounding effects on ocular parameters. These effects can be crucial in ophthalmology. Objectives This study aims to investigate the effects of sedation with dexmedetomidine and ketamine, or dexmedetomidine and midazolam, on tear production (TP), ocular perfusion pressure (OPP) and pupil diameter (PD) in fourteen male New Zealand rabbits. Methods The animals were randomly divided into two equal groups. In the DK group, a combination of dexmedetomidine (0.025 mg/kg) and ketamine (30 mg/kg), and in the DM group, a combination of dexmedetomidine (0.1 mg/kg) and midazolam (2 mg/kg) was administered. TP, OPP and PD were measured 15 min before administration of the sedatives, as well as 5, 15 and 20 min after. Results Both sedative protocols induced a significant decrease in TP and OPP (p 0.05). While the mean TP did not significantly differ between the two groups, the DK group showed considerably lower mean OPP and higher mean PD compared to the DM group. Conclusions According to our results, using artificial tears following both prescribed sedative protocols seems necessary. However, we recommend that dexmedetomidine-ketamine not be administered in rabbits at risk for glaucoma, as this protocol can significantly reduce OPP. Otherwise, the mentioned protocol can be a good choice in situations where fundoscopy is required, as it does not lead to miosis in healthy rabbits.

Veterinary

Trajectories Associated With the Use and Deprescription of Benzodiazepines and Z-Drugs in a Network of Geriatric Outpatient Clinics.

do Carmo Júnior NM et al. · Jul 1, 2026

Purpose To determine the trajectories of benzodiazepine (BZD) and Z-drug use among older adults (n = 3590) followed in a network of geriatric outpatient clinics in Brazil. Methods This longitudinal study evaluated BZD and Z-drug use over a 24-month follow-up period. The proportion of use at baseline and at the end of the study period was compared using the McNemar test. Two trajectories were considered: started using and stopped using. Comparisons between trajectories and independent variables were performed using Pearson's chi-square test. Variables with p Results A small but significant reduction in overall BZD or Z-drug use was observed (17.4% to 16.0%; p = 0.007), with a marked decrease in isolated Z-drug use (6.1% to 4.0%; p Conclusions Clinical vulnerability and psychiatric conditions were associated with BZD or Z-drug use and initiation, while pharmacist consultations were associated with both initiation and discontinuation trajectories.

Psychology

Age- and Sex-Dependent Dynamics in Pituitary Thyrotroph and Thyroid Hormones in Dromedary Camels (Camelus dromedarius): A Histochemical Approach.

Jaspal SAS et al. · Jul 1, 2026

Background The hypothalamic-pituitary-thyroid axis plays a crucial role in regulating metabolism and reproduction, yet its age- and sex-related dynamics in dromedary camels remain poorly understood. Objective This study aimed to investigate age- and sex-dependent variations in pituitary thyrotroph morphometry and thyroid hormone profiles in dromedary camels. Methods A total of 90 clinically healthy Brela breed camels of both sexes (aged 2 to ≥11 years) were grouped based on age and physiological status (lactating and non-lactating). Pituitary tissues (n = 60) were subjected to immunohistochemical analysis for thyroid stimulating hormone (TSH)-producing thyrotrophs. Morphometric parameters, including cell count, size, and nuclear dimensions, were measured. Plasma concentrations of TSH, triiodothyronine (T 3 ), and thyroxine (T 4 ) were determined using ELISA. Results Thyrotroph cell counts did not differ significantly among groups. However, older camels (≥11 years) showed significantly increased cell and nuclear dimensions (p 3 concentrations varied significantly with age and sex, with higher levels in younger males. T 4 levels declined with age but were not significantly influenced by sex (p > 0.05). Conclusion Thyrotroph morphology and thyroid hormone dynamics in dromedary camels are significantly influenced by age and sex, indicating adaptive modulation of the hypothalamic-pituitary-thyroid axis in response to metabolic and reproductive demands.

Agricultural and Biological Sciences

Diets, Fruit and Vegetable Intake, and Nutritional Status in Benin, Fiji, the Philippines, Sri Lanka, and Tanzania: Foreword.

Olney DK et al. · Jul 1, 2026

Improving diets can improve nutrition and health outcomes. In this supplement, evidence from five low-and-middle-income countries on the country specific dietary (including F&V) intake patterns, nutrition issues and evaluated solutions to improve diets across population groups is presented. Based on this evidence, the final paper offers perspectives and future priorities.

Nursing

Comparative Effectiveness of CagriSegma, Semaglutide, Cagrilintide and Tirzepatide in the Management of Overweight and Obesity: A Network Meta-Analysis of Randomized Clinical Trials.

Hamarsheh S et al. · Jul 1, 2026

Background Obesity is a chronic, progressive disease affecting over 1 billion adults worldwide, linked to serious comorbidities, including diabetes, hypertension, and cardiovascular disease and associated with increased mortality. Achieving clinically meaningful weight loss is critical to reducing cardiometabolic risk. Tirzepatide, semaglutide, cagrilintide and their combination (CagriSema) have demonstrated efficacy in clinical trials; however, no direct head-to-head studies have compared all advanced anti-obesity medications. This network meta-analysis examines their comparative efficacy and safety. Methods We systematically searched PubMed, Scopus and Cochrane Central for randomized controlled trials comparing these medications with placebo in adults with overweight or obesity. Outcomes included changes in percent body weight, absolute weight, waist circumference, BMI, patients achieving ≥ 5% to ≥ 20% weight loss, HDL-C and safety outcomes (AEs, serious AEs, gastrointestinal AEs and treatment discontinuation). Random-effects model and network meta-analysis methods were employed. Results Twenty-five trials involving 12 interventions met the inclusion criteria. Tirzepatide 15 mg resulted in the greatest percent weight reduction (MD -17.97%), followed by CagriSema (MD -17.84%) and semaglutide 7.2 mg (MD -14.66%). At the ≥ 20% weight-loss threshold, CagriSema demonstrated marked superiority (RR 27.82), followed by tirzepatide 15 mg (RR 23.70). Gastrointestinal adverse events increased with all treatments (RR 1.33-1.91), and treatment discontinuation was highest with semaglutide 7.2 mg (RR 3.09). Serious adverse events remained comparable to placebo across all regimens. Conclusion Tirzepatide 15 mg and CagriSema achieve the greatest weight reduction, including ≥ 20% body weight loss. Gastrointestinal adverse events rise with treatment intensity, while serious adverse events remain comparable to placebo. These findings support dual-pathway and combination incretin therapies as preferred options for patients requiring substantial weight loss. Treatment selection should be individualized based on comorbidity burden, tolerability and weight loss goals, recognizing that ≥ 5% weight loss improves metabolic parameters while ≥ 10% is needed for meaningful comorbidity reduction. Future head-to-head trials are needed.

Medicine

Identification of SNPs Associated With mRNA Expression Differences of the Complement Receptor Type 1-Like Gene in Landrace Weaned Piglets.

Yin W et al. · Jul 1, 2026

Objective The aim of this study is to investigate the association between single nucleotide polymorphisms (SNPs) of porcine complement receptor 1-like (CR1-like) gene and its mRNA expression. Methods SNP identification, qRT-PCR absolute quantification, linkage disequilibrium analysis and dual-luciferase reporter assay were performed using 392 forty-day-old Landrace weaned piglets. Results 28 SNPs were identified, 4 loci were significantly correlated with CR1-like expression (p Conclusion CR1-like gene polymorphisms regulate its expression via disrupting transcription factor binding, which provides a theoretical basis for porcine disease-resistant breeding.

Immunology and Microbiology

A subset of high-grade sarcomas with myogenic differentiation are associated with recurrent FGFR fusions.

Yeung MC et al. · Jul 1, 2026

Recurrent fusions involving FGFR1-4 genes have been previously described in rare subsets of mostly benign chondroid and mesenchymal neoplasms involving bone and soft tissue. However, a more comprehensive analysis of sarcomas associated with FGFR fusions, including their incidence and histotypes, has not been performed. Triggered by an FGFR1-rearranged unclassified high-grade sarcoma with myogenic differentiation, we investigated our molecular database for sarcomas with FGFR gene fusions to assess their recurrent potential and morphologic spectrum. A total of six unclassified sarcomas were identified, occurring in five females and one male, with a median age of 66.5 years. Tumors were located in the uterus and retroperitoneal/trunk soft tissue. Histologically, all tumors were high grade, composed predominantly of spindle cell morphology with variable cytologic atypia, high mitotic activity, and areas of necrosis. By immunohistochemistry, all tumors demonstrated evidence of myogenic differentiation, with focal or diffuse positivity for one or more markers (desmin, h-caldesmon, smooth muscle actin). However, none of the cases displayed diagnostic features of leiomyosarcoma or other known pathologic entities. Molecular studies revealed recurrent fusions involving FGFR1 (n = 3), FGFR2 (n = 1), and FGFR4 (n = 2), retaining the kinase domain. Additional recurrent genomic alterations included TP53 mutations, CDKN2A homozygous deletions, and RB1 alterations. Most patients followed an aggressive clinical course, including metastases and disease-related mortality. These findings expand the spectrum of sarcomas driven by FGFR gene fusions, underscoring the importance of molecular testing for accurate diagnosis and potential targeted therapy in high-grade sarcomas with myogenic features.

Medicine

Mental Health Outcome Trends in a Nationally Representative Sample of Canadian Migrant Adolescents From 2014 to 2022.

Ji D et al. · Jul 1, 2026

Background Migrant youth are at disproportionate risk of mental health challenges. Overcoming barriers to accessing services requires large-scale data to inform policies and interventions. This study maps mental health outcome trends of migrant youth over 8 years. Methods Canadian Health Behavior in School-aged Children study data from 2014, 2018, and 2022 were analyzed for mental health outcome trends. Age-adjusted logistic regressions examined health across years stratified by migrant status, separately by sex. Using nonmigrants as the referent group and 2014 as the referent year, contrasts for disparities were examined across migrant status to test widening, narrowing, or stability in differences of outcome prevalences between migrant and nonmigrant youth. Results Health worsened from 2014 to 2022 among migrants, especially migrant girls. Compared to 2014, life satisfaction, health, and self-confidence for migrant youth dropped in 2022. Health complaints and feeling sad/hopeless increased in 2022 among girls. Migrant youth reported fewer health complaints than nonmigrants in 2018 and 2022. Implications Investment in free/affordable, culturally safe/relevant, confidential school-based mental health supports with avenues for community collaboration are recommended. Conclusions Mental health outcomes worsened from 2014 to 2022, especially among migrants and girls; however, migrant youth exhibit resilience to adversity.

Psychology

Crossing Borders of Care: The Professionalization of Women in Nursing and China-US Collaboration at Xiangya, 1909-1926.

Tang Y et al. · Jul 1, 2026

This article examines the development of modern nursing education in China through a case study of the Xiangya School of Nursing in Changsha between 1909 and 1926. Founded in 1911 by the Yale-in-China Association, a non-denominational mission, Xiangya was among the earliest nursing schools in China to promote undergraduate nursing education and public health nursing. Drawing on archival materials, published primary sources, and Chinese and English historiography, we analyze the cultural, political, and gendered challenges that shaped the school's development under the leadership of American nurse Nina Gage. While Gage initially sought to implement an Americanized model of nursing education, she and her colleagues adapted admission policies, educational goals, and curricula to local social and cultural conditions. Recognizing the need for Chinese nursing leadership, they prioritized the establishment of a Bachelor of Science degree to prepare nurses for teaching, administration, and public health roles. By 1926, Xiangya had trained approximately 16% of China's qualified nurses and had become one of only two schools in China offering university-level nursing education. This history highlights the interplay of transnational influence, cultural adaptation, and gendered reform in the professionalization of nursing in early 20th-century China.

Nursing