Veni FINI: a new tool to assess functional impact in narcolepsy
Lammers GJ, Bijlenga D and de Boer J
Veni FINI: a new tool to assess functional impact in narcolepsy
Lammers GJ, Bijlenga D and de Boer J
Effect of Probiotic Supplements on Improving Symptoms of Depression, Anxiety, Insomnia, and Anorexia in Patients Living With HIV: A Pilot Randomized Controlled Trial
Zandifar A, Badrfam R, Hajaligol A, Kjorvestad T, Kaveh M, Beikmohammadi M, Vakili SS, Khodaii Z and Soleimani AR
Effect of Probiotic Supplements on Improving Symptoms of Depression, Anxiety, Insomnia, and Anorexia in Patients Living With HIV: A Pilot Randomized Controlled Trial
Zandifar A, Badrfam R, Hajaligol A, Kjorvestad T, Kaveh M, Beikmohammadi M, Vakili SS, Khodaii Z and Soleimani AR
ObjectiveIndividuals living with HIV are at increased risk for psychiatric disorders. In this pilot randomized clinical trial, the effects of probiotics on improving psychiatric symptoms among patients living with HIV was examined.MethodsA total of 50 patients living with HIV were randomly assigned to one of two groups: one group received a probiotic capsule. In contrast, the other received a placebo for 12 weeks, determined by a simple randomization method. Patients were evaluated at weeks 0, 4, 8, and 12 using the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Simplified Nutritional Appetite Questionnaire (SNAQ), and the Pittsburgh Sleep Quality Index (PSQI).ResultsCompared to the control group, HIV patients in the intervention group receiving probiotics exhibited a significantly greater reduction in anxiety symptoms and greater improvement in appetite compared to those in the placebo group (time*group interaction: F (3, 144) = 6.63, < 0.001 for anxiety symptoms; F (3, 144) = 18.74, < 0.001 for appetite).ConclusionsProbiotics may be beneficial in alleviating anxiety symptoms and anorexia in persons living with HIV. Future studies in multicenter settings with larger sample sizes and extended follow-up periods are needed to replicate these results.
Comparisons of core component delivery in cardiac rehabilitation programs by country income classification and decade based on the 2025 Global Audit Update: A survey study
Ghisi GLM, Carson RP, Turk Adawi K, Ding R, Mampuya WM, Jiandani MP, Martinez J, Cruz Rivero M, Anchique CV, van Schalkwijk DL, Gallagher J, Akinci B, Candelaria D, Champaiboon J, Quesada-Chaves DF, Norekvål TM, Szadkowska I, Jug B, Kouidi E, Supervia M, Kim WS, Mettananda C, Mbau L, Aimakova GT, Grace SL and
Comparisons of core component delivery in cardiac rehabilitation programs by country income classification and decade based on the 2025 Global Audit Update: A survey study
Ghisi GLM, Carson RP, Turk Adawi K, Ding R, Mampuya WM, Jiandani MP, Martinez J, Cruz Rivero M, Anchique CV, van Schalkwijk DL, Gallagher J, Akinci B, Candelaria D, Champaiboon J, Quesada-Chaves DF, Norekvål TM, Szadkowska I, Jug B, Kouidi E, Supervia M, Kim WS, Mettananda C, Mbau L, Aimakova GT, Grace SL and
Cardiovascular disease (CVD) remains a leading global health burden. Cardiac rehabilitation (CR) is essential to reducing morbidity and improving patient outcomes. Since the COVID-19 pandemic, CR delivery worldwide has evolved, yet these changes have not been systematically charactemkjrized. The objective of this study was to characterize globally: (1) the delivery of core CR components, including risk factors assessed, patient education practices, and program resources; (2) differences in these elements by country income classification and relative to the initial 2016 Global CR Audit.
Early Surgical Reconstruction of Severe Nasal Interface-Induced Nasal Deformity in a Preterm Infant
Al Jadeedi S and Al Hashmi SN
Early Surgical Reconstruction of Severe Nasal Interface-Induced Nasal Deformity in a Preterm Infant
Al Jadeedi S and Al Hashmi SN
Nasal continuous positive airway pressure (CPAP) is widely used in premature infants but may cause pressure-related nasal injury. Severe deformities involving structural loss can result in significant airway compromise. We report a preterm infant presenting at 3 months of age with progressive nasal deformity, near-complete unilateral nostril occlusion, and features of obstructive sleep apnea complicated by pulmonary hypertension. Early reconstruction was performed at 6 months using autologous conchal cartilage to restore the lateral crus and a helical root composite chondrocutaneous graft for columellar support. Postoperative nasal stenting was utilized. The patient demonstrated marked improvement in airway patency, respiratory function, and tolerance of respiratory support, with stable structural and aesthetic outcomes at 3 months. This case highlights that early airway-directed reconstruction in selected infants is feasible and may prevent progression of functional and cardiopulmonary sequelae.
Effect of a digital mindfulness intervention for mild-to-moderate late-life depression: A randomized controlled trial
Zhu K, Hu M, Liu C, Wang Y, Guo C, Shen H, Ding N, Wang X, Ren L and Zhang Q
Effect of a digital mindfulness intervention for mild-to-moderate late-life depression: A randomized controlled trial
Zhu K, Hu M, Liu C, Wang Y, Guo C, Shen H, Ding N, Wang X, Ren L and Zhang Q
Late-life depression (LLD) is a growing public health concern in aging populations. Although digital mindfulness interventions show promise for depression, anxiety, and insomnia, their efficacy and electroencephalogram (EEG) correlates in older adults with LLD remain unclear. This study evaluated the FocusZen Mindfulness Stress Reduction System, a digital mindfulness intervention with EEG feedback, in mild-to-moderate LLD.
Testing the mediating role of negative affect, affect intolerance, and dissociation in the relationship between sleep loss and psychotic experiences
Johnson MR, Bower JL and Reeve S
Testing the mediating role of negative affect, affect intolerance, and dissociation in the relationship between sleep loss and psychotic experiences
Johnson MR, Bower JL and Reeve S
Sleep disturbances are known to causally contribute to psychotic experiences, with negative affect indicated as a mediator in previous research. However, other plausible related mechanisms such as affect intolerance and dissociative experiences have not been tested. We hypothesised that sleep restriction would increase psychotic experiences, with effects mediated by increases in negative affect, affect intolerance and dissociative experiences.
Real-time impacts of air pollution on the health, well-being, and daily life of children and young people in Delhi and Dhaka
Bwire C, Bonnet G, Bonell A, Juel R, Milner J, Yeung S and Hughes R
Real-time impacts of air pollution on the health, well-being, and daily life of children and young people in Delhi and Dhaka
Bwire C, Bonnet G, Bonell A, Juel R, Milner J, Yeung S and Hughes R
Air pollution is a major global health threat, with children and young people (CYP) among the most vulnerable. Delhi (India) and Dhaka (Bangladesh) are two of the world's most polluted cities, with persistently high levels of fine particulate matter (PM2.5). This study aimed to generate CYP-centered evidence on the real-time impacts of air pollution in these cities by comparing health, well-being, and daily activities during periods of high air pollution and good air quality, while also capturing CYP's ideas for air quality management. A cross-sectional, real-time digital survey was conducted in Delhi on January 9-10 and 15 March 2025, and in Dhaka on January 21-22 and March 13-16, 2025. For both cities, the January dates correspond to a period with high air pollution (PM2.5 > 55.5 µg/m3) and the March dates to good air quality (PM2.5 ≤ 35.4 µg/m3). Participants included CYP aged 13-29 years and parents of children under 18. Recruitment was carried out online. Data on health symptoms, well-being (general feelings and sleep quality), and daily activity disruptions were analyzed using descriptive statistics, chi-square tests, and regression models adjusted for demographics. Responses to open-ended questions were thematically coded. A total of 814 eligible responses were collected (Delhi = 365; Dhaka = 449). High-pollution days were associated with significantly higher reports of itchy eyes, respiratory difficulties, headaches, skin irritation or rash, diarrhoea or vomiting, low mood, anxiety or stress, and difficulty concentrating. These associations remained significant after adjusting for demographics. Disruptions to daily activities also increased, including reduced physical activity and greater odds of being late or missing school or work, meetings, social events, and healthcare, as well as a greater need for family assistance (adjusted odds ratios approximately 3.8 to 4.8). In Delhi, changes were more pronounced across most outcomes, particularly a sharper drop in physical activity. In Dhaka, the same pattern was observed, along with additional increases in sore throat, cough, food insecurity, and difficulty accessing clean water. Participants' suggestions clustered around five themes: cleaner environments, stronger communities, improved healthcare and education, pollution and technology solutions, and other ideas. High air pollution was linked to widespread impacts on health, well-being, and daily routines among CYP. Their proposed solutions offer insights for participatory and equitable approaches to urban air quality management.
Innovative screening for OSAS in patients with head and neck cancer using the apneal application: Protocol for a prospective single-centre study
Baluta L, Humbert M, Babin E, Morello R and Micault E
Innovative screening for OSAS in patients with head and neck cancer using the apneal application: Protocol for a prospective single-centre study
Baluta L, Humbert M, Babin E, Morello R and Micault E
OSAS is a common yet underdiagnosed condition, particularly among patients with head and neck cancers (HNC). Anatomical changes caused by the tumor or its treatments-surgery, radiotherapy, or chemotherapy-can promote the onset of OSAS. However, fatigue in these patients is often attributed solely to the cancer treatment itself, which may delay appropriate diagnosis and management.
Protocol for the DREAMER study: Design and methodological framework of a multicenter trial-ready cohort of individuals with isolated REM sleep without atonia
Ferri R, Puligheddu M, Figorilli M, Plazzi G, Pizza F, Ferini-Strambi L, Marelli S and Lanza G
Protocol for the DREAMER study: Design and methodological framework of a multicenter trial-ready cohort of individuals with isolated REM sleep without atonia
Ferri R, Puligheddu M, Figorilli M, Plazzi G, Pizza F, Ferini-Strambi L, Marelli S and Lanza G
Isolated rapid eye movement sleep behavior disorder is a strong clinical marker of future alpha-synucleinopathy, but earlier stages of this risk pathway remain insufficiently characterized. Rapid eye movement sleep without atonia is the polysomnographic substrate of this disorder and may also be detected in individuals without clinical dream-enactment behavior. Whether isolated rapid eye movement sleep without atonia is a benign finding or an early risk state for future rapid eye movement sleep behavior disorder and neurodegeneration remains unknown. DREAMER is a multicenter, prospective, observational cohort protocol designed to identify adults without clinical rapid eye movement sleep behavior disorder who show isolated rapid eye movement sleep without atonia during full-night laboratory video-polysomnography. Four Italian sleep centers will use harmonized eligibility criteria, standardized clinical and sleep assessment, quantitative REM Atonia Index scoring, secure web-based data capture, and planned longitudinal follow-up. Adults aged 40 years or older undergoing video-polysomnography will be screened. Participants with prior rapid eye movement sleep behavior disorder or technically inadequate REM sleep/chin electromyographic data will be excluded. Isolated rapid eye movement sleep without atonia will be defined in participants without clinical rapid eye movement sleep behavior disorder using a REM Atonia Index threshold of <0.85. The target recruitment is more than 500 participants over 18 months, with an expected enriched subgroup of approximately 85 individuals with isolated rapid eye movement sleep without atonia. Ancillary neurophysiological assessments and blood sampling for future biomarker studies will be obtained when feasible. DREAMER is intended to create a harmonized, trial-ready cohort for evaluating isolated rapid eye movement sleep without atonia as a potential early risk marker for incident rapid eye movement sleep behavior disorder and subsequent neurodegenerative outcomes. The study is registered at ClinicalTrials.gov as DREAMER, ClinicalTrials.gov Identifier NCT06140511.
Design and validation of an integrated meta-instrument for nursing assessment in home hospitalization: A study protocol
Barrué-García P, Llagostera-Reverter I, Cervera-Gasch Á, Esteve-Clavero A, Valero-Chillerón MJ, Ortiz-Mallasén V, Aquilué-Ballarín M, Luna-Aleixos D, Sánchez-Galán M, González Chordá VM and
Design and validation of an integrated meta-instrument for nursing assessment in home hospitalization: A study protocol
Barrué-García P, Llagostera-Reverter I, Cervera-Gasch Á, Esteve-Clavero A, Valero-Chillerón MJ, Ortiz-Mallasén V, Aquilué-Ballarín M, Luna-Aleixos D, Sánchez-Galán M, González Chordá VM and
Hospital-at-home (HaH) programs provide an effective and safe alternative to conventional hospitalization, particularly for patients with multimorbidity or complex chronic conditions. In this setting, nursing assessment plays a key role, given the intermittent nature of care and the limited presence of other professionals. However, nursing documentation in HaH remains challenging because of organizational heterogeneity, fragmented records, and the coexistence of multiple assessment tools that create redundancy and compromise information quality. The overall objective of this study is to develop and validate a meta-instrument (VALENF-HAD) that integrates the assessment of functional capacity, pressure injury risk, fall risk, frailty, nutritional status, and sleep quality in patients admitted to hospital-at-home units on the basis of the analysis of other validated measurement instruments used in nursing assessment.
