BackgroundAnxiety and poor sleep quality have always caused problems for nursing students. Today, self-foot massage is considered adjunctive therapy for reducing anxiety and improving sleep quality. This study aimed to evaluate the effects of self-foot massage on anxiety levels and sleep quality among nursing students with high anxiety. MethodsAn experimental study with pre-test and post-test control groups, included 40 first-year nursing students who met the inclusion criteria (intervention= 20, control= 20). The students were randomized into intervention and control groups using block randomization. A block size of four was employed to maintain equal group sizes. State Anxiety Inventory (SAI) and Pittsburgh Sleep Quality Index (PSQI) were used to collect the data. In the self-foot massage group, subjects attended foot massage sessions at the same time every day for 10 days. Independent t-test and Chi-square method was used to analyze the data. ResultsThe intervention group performing self-foot massage demonstrated significantly lower mean scores for PSQI (7.70 ± 1.5) and SAI (34.10 ± 4.82) compared to the control group, whose mean scores were 8.00 ± 2.65 and 38.80 ± 3.04, respectively (p=0.03; p=0.021). These differences indicate improved sleep quality and reduced anxiety in the intervention group. Subjective sleep quality was also found to be better among participants in the intervention group. However, no significant differences were observed between the groups in the PSQI subcomponents (p>0.05). ConclusionSelf-foot massage can be considered as a potential therapeutic intervention that improves sleep quality and reduces anxiety among nursing students with high level anxiety.

Background Methotrexate (MTX) is the firstline therapy for rheumatoid arthritis (RA). However, 30–40% of RA patients exhibit poor response. Identifying early factors associated with persistent disease activity is critical to guide treatment. This study aimed to identify predictors of persistent high disease activity (DAS28-ESR >3.2) after six months of MTX therapy in RA patients. Methods A retrospective cohort study was conducted involving 204 RA patients who had completed six months of MTX therapy. The primary outcome was DAS28-ESR score at six months. Independent variables included baseline erythrocyte sedimentation rate (ESR), cumulative doses of MTX and low-dose methylprednisolone (LDM), and rheumatoid factor (RF) status. Simple and multiple logistic regression was used to analyze the data. Results Significant differences in ESR and cumulative MTX dose were observed between low and high disease activity groups. Multivariate analysis identified four independent predictors of persistent high disease activity (DAS28-ESR >3.2) after six months of MTX therapy: disease duration >11 months (AOR =0.45; 95% CI 0.23–0.89; p=0.025); age at onset >50 years (AOR 0.48; 95% CI 0.24–0.94; p=0.038); cumulative MTX dose >85 mg (AOR 4.75; 95% CI 1.55–14.64; p=0.006); ESR >66 mm/hr (AOR 2.32; 95% CI 1.11–4.89; p=0.026). Conclusion Greater cumulative methotrexate dose (>85 mg) was the most influential predictor of persistent high disease activity (DAS28-ESR >3.2) after six months of MTX therapy in RA patients. These findings may assist clinicians in identifying patients at risk for poor MTX response and support timely therapeutic adjustments.

Galectins, a family of β-galactoside-binding proteins, play critical roles in tumor progression, angiogenesis, and immune evasion, making them significant therapeutic targets in cancer treatment. By binding β-galactoside containing glycoconjugates, galectins modulate immune responses, apoptosis, and tumor development. The increasing recognition of their oncogenic roles has led to the development of carbohydrate- and peptide-based inhibitors that competitively bind to the carbohydrate recognition domain (CRD), disrupting galectin-mediated immune evasion, T-cell apoptosis, and angiogenesis. Given their intricate functions in the tumor microenvironment, a comprehensive evaluation of galectin inhibitors is warranted. This review synthesizes recent advancements in galectin-targeted therapies, including their mechanisms of action, efficacy in preclinical models, and potential synergy with chemotherapeutic agents and monoclonal antibodies. Despite promising developments, challenges remain in optimizing treatment regimens, overcoming resistance mechanisms, and identifying predictive biomarkers for patient stratification. Patient stratification, based on molecular or genetic profiles, is essential for enhancing therapeutic efficacy and ensuring personalized treatment approaches. A systematic literature search (2014–2024) was conducted using Google Scholar, ProQuest, Science Direct, and Scopus databases, with key terms including galectin inhibitors, cancer therapy, tumor microenvironment, immune evasion, and targeted therapy. This review highlights the role of galectin-1 and galectin-3 in breast cancer therapy, emphasizing their impact on tumor progression, immune modulation, and resistance to conventional treatments. Further translational research is necessary to refine clinical applications, optimize combination strategies, and establish biomarkers that enhance the integration of galectin inhibitors into existing treatment paradigms.

Background Hospitalization disrupts children’s lives and can produce feelings of anxiety, fear, or pain. Playing is an important part of children’s lives.It is necessary for nurses to provide holistic and quality care, including therapeutic play, which contributes to the recovery of children by relaxing them both physically and emotionally. The aim of this study was to determine the level of knowledge of pediatric nurses about therapeutic play and find out the relations of therapeutic play with nurses’age, educational level, marriage status, and length of employment. MethodsThis cross-sectional study was conducted with 126 pediatric nurses working in the pediatric service of a training and research hospital. The data of the study were collected with the “Nurse Introductory Information Form” and “Questionnaire for Determining the Level of Knowledge of Therapeutic Play”. Descriptive statistical tests and nonparametric tests were used to analyze the data. Statistical significance was set at p<0.05. ResultsIn this study, 88.1% of the nurses stated that they did not receive training in therapeutic play, and 79.4% stated that they wanted to receive training in therapeutic play. The nurses’ level of knowledge about therapeutic play significantly decreased with age and increased with educational level (p<0.05). ConclusIonsThe knowledge level of the nurses participating in the study about therapeutic play is above average, but is low regarding the integration of therapeutic play into care. It is recommended that nurses receive in-service training in therapeutic play.

The advent of robotic-assisted systems has revolutionized orthopedic surgery. By enhancing precision in bone registration and resection, this technology minimizes manual errors and soft tissue damage, promising more accurate implant positioning and improved postoperative outcomes. This editorial explores the technical nuances of robotic-assisted TKR, its clinical implications, and the long-term potential for transforming patient care.

BackgroundThe endometrial preparation phase preceding embryo transfer assumes pivotal significance in achieving optimal endometrial receptivity and ensuring the success of pregnancy. The natural cycle (NC) and artificial cycle (AC) are the preferred methods for many in vitro fertilization (IVF) specialists. The objective of this study was to compare the difference between NC and AC in women undergoing frozen-thawed embryo transfer (FET) after IVF. MethodsA cross-sectional study was conducted involving 150 adult women who underwent FET with a single autologous blastocyst stage embryo in a 5-year period (2014-2019). Bivariate analysis was conducted to discern implantation and pregnancy rates associated with NC and AC for endometrial preparation. Multiple logistic regression was used to assess the association between endometrial preparation and clinical outcomes while adjusting for potential confounders. ResultsOf the 150 subjects meeting study criteria, 19 underwent NC, while 131 underwent AC for endometrial preparation. Natural cycle exhibited a higher biochemical pregnancy rates compared to AC (89.5% vs. 53.4%; p=0.003). Artificial cycle is a significant determinant for biochemical pregnancy rates compared to NC (aOR: 0.132;95% CI: 0.028 – 0.623; p=0.010) ConclusionIn women undergoing FET, NC resulted in higher biochemical pregnancy rates compared to AC. However, clinical pregnancy rates and ongoing pregnancies rates did not exhibit significant disparities between NC and AC. Future studies will hopefully further illuminate which protocol is most suitable for the individual patient. Further multi-center randomized clinical trials are needed to confirm the relationship between biochemical pregnancy rates and NC.

Dysmenorrhea, or primary dysmenorrhea (PD), marked by menstrual cramps in the lower abdomen, is a common but often overlooked condition affecting a considerable number of women. The impact of dysmenorrhea extends beyond physical pain, often causing considerable disruption to daily activities, work, and social interactions. It significantly affects the quality of life, often causing absenteeism from school or work. Increased intrauterine prostaglandin secretion is linked to pelvic pain in PD. Diagnosis relies mainly on clinical assessment, considering symptoms and physical examination, with treatment aimed to enhance the quality of life. These menstrual cramps are frequently accompanied by other symptoms, such as headaches and nausea, which are believed to be due to prostaglandins released as the endometrium breaks down. A literature search using the keywords dysmenorrhea, menstrual pain, and hormonal contraceptives was done using the following databases: Google Scholar, ProQuest, ScienceDirect, Web of Science, Pubmed, and Scopus for articles published from 2015 to 2024. The literature study was done to find the connection of dysmenorrhea and menstrual pain with hormonal contraceptives. Common treatments include nonsteroidal anti-inflammatory drugs, hormonal contraceptives, and non-pharmacological interventions. This review provides an in-depth analysis of recent treatment advancements for dysmenorrhea, focusing on its pathophysiology, clinical diagnosis, and impact on women's quality of life. It evaluates current and emerging treatments, including pharmacological interventions, non-pharmacological therapies, surgical approaches, hormonal treatments, and investigational drugs, aiming to identify improvements in efficacy and side effects.

Background Having the highest obesity prevalence and physical inactivity among its South East Asian counterparts, it is important for Malaysia to understand the factors contributing to this epidemic. Because low neighbourhood safety is linked to physical inactivity, the objective of this study was to explore perceived neighbourhood safety from traffic and crime with its effects on adults’ travel- and leisure-time physical activities. Methods This cross-sectional study was conducted on 256 adults. Six items on a 4-point Likert scale from the Neighbourhood Environment Walkability Scale (NEWS) and WHO’s GPAQ questionnaires to record weekly minutes of physical activity were used to measure the variables. Forty-three neighbourhoods from Johor Bahru district were categorised into higher and lower socio-economic status by median housing price per square feet. Structural equation modelling (SEM) was used to analyse the data. Results Among 256 adults, males were found to be more physically active than females. SEM showed that for every 1 unit increase in neighbourhood socioeconomic status, males’ perceived neighbourhood environmental safety increases by 0.23 unit (p=0.006); however, this does not explain their physical activities. For the females, regardless of neighbourhood socioeconomic status, every 1 unit increase in perceived neighbourhood environmental safety from traffic and crime encourages physical activity to increase by 0.47 unit (p=0.006), especially for leisure purposes. Both genders perceived that street lighting at night and pedestrian visibility are important safety features of the neighbourhood environment. Conclusion The study outcomes facilitate understanding of causal factors of physical activity through perceived neighbourhood environmental safety, especially among females. Keywords: Neighbourhood environment safety, neighbourhood socioeconomic status, physical activity, gender, adult