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The ‘shades of grey’ in research integrity—Researchers admit to questionable research practices that they do not perceive to be serious
Research misconduct practices like fabrication, falsification and plagiarism (FFP) are serious deviations from good research conduct, which have attracted attention in the literature due to the damage they can bring to science and society. However, less is known about the grey zone of researchers’ behaviours that deviate from responsible research conduct but do not fall under serious research misconduct practices. These are known as questionable research practices (QRPs), and they are believed to pose a no less serious threat to research integrity and science. Despite increasing research on the topic, the extent of the problem in different research fields and contexts is unknown. Using a sample of researchers working in Portuguese universities in six main fields of research (n = 1573), we report on QRPs that researchers admit to and how serious they perceive them to be, and on predictors of engagement in QRPs. We find that QRPs are widespread across all fields of research and seniority levels. Yet, younger, more prolific researchers, and those dismissing the seriousness of QRPs admitted to more QRPs. This suggests that some groups are at higher risk of misconduct and that there is a need for studying the motivations behind more susceptible groups to engage in QRPs.
Elevated anti-apoptotic shift in primary human aniridia limbal stromal cells following 48 hours supraphysiological glucose exposure, in vitro
Purpose Previous work demonstrated that supraphysiological glucose remodels TGF-β1 and NF-κB signaling in human limbal stromal cells (LSCs) and congenital aniridia-derived LSCs (AN-LSCs). The present study investigated whether the same metabolic stress also alters apoptotic pathways in these cells. Methods Primary LSCs (n = 12) and AN-LSCs (n = 8) were cultured for 48 hours in DMEM containing either normal (17.5 mM) or high (70 mM) glucose. Apoptosis was quantified by Annexin V/propidium iodide (PI) flow cytometry (FC). Expression levels of apoptosis-related genes—including CASP3/7/8/9/10, BCL2, BID, BAX, CDKN1A (p21), CDKN1B (p27), TNFα, XIAP, and BIRC5 (Survivin)—were assessed by qPCR. Protein levels of these markers were analyzed by FC, and TNFα protein concentrations in culture supernatants were measured by ELISA. Results High glucose significantly reduced the proportion of apoptotic cells in both LSCs (p = 0.0170) and AN-LSCs (p = 0.0181). In both cell types, CASP8 (p = 0.0448; p = 0.0171) and CASP10 (p = 0.0001; p = 0.0007) mRNA levels decreased, while XIAP (p = 0.0375; p = 0.0442) and BIRC5 (p = 0.0196; p = 0.0003) were upregulated. AN-LSCs additionally showed reductions in CASP3 (p = 0.0138) and CDKN1A (p = 0.0331), and exhibited lower BAX levels than LSCs under high glucose (p = 0.0255). Protein analysis corroborated these findings in AN-LSCs: Caspase-3 (p = 0.0154) and Caspase-8 (p = 0.0257) decreased, while Bcl-2 (p = 0.0284) and Survivin (p = 0.0467) levels increased. XIAP protein levels rose in both LSCs (p = 0.0451) and AN-LSCs (p = 0.0134). Conclusions A 48-hour exposure to 70 mM glucose induces a marked anti-apoptotic shift in human limbal stromal cells, more pronounced in cells derived from congenital aniridia patients. Together with previous evidence on TGF-β1 and NF-κB regulation, these findings suggest that limbal cells may mount an early protective response to metabolic stress, which could be harnessed therapeutically to manage aniridia-associated keratopathy through coordinated survival and stress pathways.
GermVersity: A free and user-friendly interface to enhance the visualization and analysis of genebank data
Genebanks are crucial for food security and industrial applications. However, their heterogeneous nature hinders effective utilization. To address this, the GermVersity platform was developed to integrate conventional, artificial intelligence, and data science approaches to the transversal analysis of data associated with genebank accessions. GermVersity aids in the classification and prioritization of germplasm diversity, facilitating the conservation and utilization of valuable genetic resources in agriculture. The GermVersity proposal is focused on developing a user-friendly application to visualize, analyze and interpret analysis-ready data from genebanks. The application’s case study uses data from the bean genebank at Bioversity International – CIAT but can be adapted for other genebanks and broader collections. GermVersity is divided into three modules. The first module analyzes genetic diversity using phenotypic and SNP data. In this module users can prioritize morphological descriptors for efficient classification of accessions, define genetic clusters or populations, calculate basic diversity statistics per locus and per population, and estimate genetic divergence among clusters or populations. The second module implements spatial distribution modeling, allowing users to understand ecological diversity across the geographical distribution range of a set of accessions. The third module characterizes the genomic architecture of phenotypic trait variation and adaptation to ecological niches using genome-wide association implemented in prediction integrated tools (GAPIT) and Latent Factor Mixed Model (LFMM) analysis. The GermVersity platform was built using Shiny-Golem and is hosted on GitHub for free use. To access it, users can install the library and run the application through specific commands in R. Responsible use of algorithms is recommended, along with the inspection of results for biological coherence. Ultimately, GermVersity offers an integrated analytical pipeline to leverage genebank diversity as part of pre-breeding efforts.
Robust motion detection and classification in real-life scenarios using motion vectors
In dynamic settings such as security, autonomous driving, and robotics, effective motion detection and classification are crucial for accurate tracking amidst target and background movements. Traditional approaches, typically designed for static environments, face challenges in complex scenes with multiple types of motion. This research presents a robust algorithm for motion detection in fully dynamic scenarios, utilizing the macro block technique to generate motion vectors, followed by motion vector analysis to classify distinct types of motion. These include camera motion, object motion, background motion, and complex motion, where both background and foreground move simultaneously. By segmenting and categorizing these motion types, the proposed approach improves detection precision in cluttered, real-world environments. Furthermore, the algorithm adapts to lighting variations and is independent of specific sensor setups. Moreover, the high agreement with human judgment, achieving a 90% accuracy rate, underscores the model’s robustness and potential applicability in real-world scenarios where dynamic backgrounds are prevalent. This establishes a framework for future research in dynamic motion detection and classification.
The Demodifier: A tool for screening modification-induced alternate peptide taxonomy in palaeoproteomics
In palaeoproteomic research, the accuracy of taxonomic matches is crucial, as research questions frequently hinge on which species were utilised by ancient people. However, protein modifications including deamidation of glutamine and asparagine, and conversion of glutamine or glutamic acid to pyroglutamic acid, can change the sequence of peptides, leading to spurious taxonomic detections and potentially inaccurate archaeological interpretations. While a handful of examples of this phenomenon have been reported in the literature, the issue is potentially much wider reaching than currently realised. In reality, any time a peptide containing a deamidated glutamine or asparagine residue, an unmodified glutamic acid or aspartic acid residue, or a pyroglutamic acid modification is detected by proteomic search software, the sequence, and therefore potentially its taxonomy, may be incorrect, which could potentially lead to unsound archaeological interpretations. The Demodifier is a fast, open source tool which solves this issue by screening for modification-induced alternate peptide taxonomy, enabling archaeologists to make informed interpretations of the taxonomies of peptides detected in ancient samples. To assess its utility, The Demodifier is tested against an archaeological dataset containing all unique peptides reported in palaeoproteomic studies of dental calculus and vessels. The results reveal that modification-induced alternate peptide taxonomies are severely under-reported, occurring almost ten times more frequently than previously understood. Modifications were found to produce three different types of inaccurate taxonomic matches: those which yielded completely different taxonomic lowest common ancestors to the input peptide, those which were more taxonomically specific than the input peptide, and those which were less taxonomically specific than the input peptide. The Demodifier therefore enables the rapid detection of potentially inaccurate peptide taxonomies, avoiding spurious archaeological interpretations in future studies.
A monoclonal antibody raised against Acinetobacter baumannii capsular carbohydrate exhibits cross-species in vitro binding against Pseudomonas aeruginosa
The emergence of extensively drug-resistant bacterial pathogens such as Acinetobacter baumannii and Pseudomonas aeruginosa necessitates the innovation of non-small molecule therapies. Monoclonal antibodies represent a promising non-small molecule option. By exploiting shared or similar antigenic structures on these pathogens, it may be possible to develop therapeutic antibodies that target both bacterial species. Here we demonstrate that a previously developed monoclonal antibody targeting A. baumannii (MAb10) has cross-species reactivity to P. aeruginosa in in vitro assays. Despite MAb10’s distinct efficacy against A. baumannii , no efficacy was detected against P. aeruginosa in our mouse models of infection. Nevertheless, the unique carbohydrate structures targeted by MAb10 and shared by numerous bacterial species may underscore a possible strategy for developing therapeutic antibodies that can treat infections caused by multiple pathogens.
A knowledge graph construction method for compliance review of water conservancy project reports
To break through the efficiency and accuracy bottlenecks of manual mode in the compliance review of water conservancy project reports and promote the digital transformation of “Smart Water Conservancy”, this paper proposes a knowledge graph construction method for the compliance review of water conservancy project reports. Firstly, based on natural language processing technology, the BERT-BiLSTM-CRF model is used for named entity recognition to accurately locate key entities such as engineering parameters and normative clauses. Secondly, the context-free grammar (CFG) is used to parse the logical relationships between entities, and the normative clauses are transformed into “head entity + relationship + tail entity” triples through a semantic label system to achieve structured expression of knowledge in the water conservancy field. Finally, the Neo4j graph database is used to store the knowledge graph, and the Py2neo toolkit is used to complete the efficient import and dynamic update of triple data. The research takes the actual review of water conservancy project reports as a case to verify the feasibility of the method. Practice has proved that this method effectively improves the efficiency and accuracy of the compliance review of water conservancy project reports, providing technical support and practical reference for the digital transformation of water conservancy projects, and is of great significance for promoting the intelligent development of the water conservancy industry.
Impacts of gender disparities in mental health and quality of life: A cross-sectional study of Brazilian physicians
Background Physicians are a professional group at high risk of impaired quality of life (QoL) and mental health due to heavy workloads, exposure to suffering, and structural inequalities. In Brazil, rapid feminisation of the medical workforce has not eliminated gender and regional disparities, and nationwide evidence on physicians’ QoL remains scarce. Methods This is a nationwide, cross-sectional, web-based survey of licensed physicians in Brazil between July and August 2024. Eligibility required active registration with a Regional Medical Council and prior use of a digital health platform. QoL was assessed using the WHOQOL-BREF, complemented by items on lifestyle, burnout, depression, and anxiety. Post-stratification weighting aligned the sample with the 2025 Brazilian Medical Census across sex and region. Weighted least squares regression models estimated unique contributions of sex, age, region, career stage, and mental disorders to QoL domains. Results A total of 2,005 physicians participated (56.1% women). Weighted WHOQOL-BREF scores post-stratification were 62.2 in the physical, 55.5 in the psychological, 56.5 in the social, and 63.6 in the environment domains, with a global score of QoL (defined as the mean of 0-100 four domains score) of 59.5. Women reported significantly higher prevalence of mental disorders (46.8% vs. 33.5% in men), particularly depression (25.3% vs. 17.7%) and anxiety (39.9% vs. 25.1%). QoL displayed a U-shaped trajectory across the life course, with lower scores in early and mid-career and recovery at older ages. Mental disorders were strongly associated with lower scores across all domains (–9 to –10 points in psychological and QoL, p < 0.001, large effect sizes). Multivariable models identified mental disorder as the dominant predictor of psychological and QoL perception outcomes, while sex explained variance in social relations, and region and age modestly contributed to physical and environment domains. Conclusions Brazilian physicians report lower QoL than both the general Brazilian population and international physician cohorts, with particular vulnerability in psychological well-being. Gender disparities persist, with women experiencing greater psychiatric morbidity despite higher social relations scores. Structural inequalities, workload, and dissatisfaction with the health system emerged as key stressors. Interventions should combine structural reforms, gender equity policies, and lifestyle-promoting strategies to support physician well-being.
Development and validation of the HPV-WAK questionnaire for assessing women’s awareness and knowledge in Iran
Background Evidence indicates that knowledge about Human Papillomavirus remains limited in Iran. This study aimed to develop and psychometrically validate the Human Papillomavirus-related women’s awareness and knowledge (HPV-WAK) questionnaire for Iranian women. Methods A mixed-methods study was conducted. First, an item pool was created through a rapid scoping review. Subsequently, the questionnaire’s psychometric properties were assessed, including face validity, content validity (CVR/CVI), and hypothesis testing for construct validity (known groups comparison). Reliability was evaluated via internal consistency (KR-20) and inter-rater reliability (kappa). A cut-off score was determined using ROC analysis. Results From an initial 551 items, 122 were selected for the item pool. Following translation and cultural adaptation, a 50-item version underwent face validity assessment, leading to revisions of 5 items. The final 29-item questionnaire showed strong content validity (S-CVI/Ave = 0.97; S-CVI/UA = 0.83) after eliminating 21 items with low CVR (<0.62). construct validity was confirmed via known groups comparison (P < 0.001). The questionnaire demonstrated moderate internal consistency (KR-20 = 0.757) and excellent inter-rater reliability (Kappa = 0.854). The optimal cut-off score was 26. Conclusions The HPV-WAK is a valid and reliable questionnaire with strong psychometric properties, making it suitable for use by public health professionals to assess HPV knowledge, identify gaps, and evaluate interventions among Iranian women of childbearing age.
SkelFormer: An adaptive hierarchical transformer-based approach on skeleton graphs for human action recognition in video sequences
Human skeleton-based action recognition represents a pivotal field of study, capturing the intricate interplay between physical dynamics and intentional actions. Current research primarily focuses on extracting structural and temporal information from static skeleton-based graphs, but it grapples with a myriad of challenges. These include 1) an absence of hierarchical structure in encoding the skeleton-based graphs. 2) A requirement for substantial prior knowledge to interpret the diverse spatial dynamics within singular action labels. 3) An intricate task of representing the multifaceted temporal dynamics of individual actions. To address these challenges, we propose SkelFormer, a novel framework that captures spatiotemporal variations in skeleton-based graphs extracted from video sequences. The proposed SkelFormer incorporates the SKT Block as a central element, effectively facilitating information exchange through node concentration and diffusion across both structural and temporal dimensions. This design enables the extraction of hierarchical representations without relying on handcrafted rules, thereby improving the understanding of complex action patterns. Our rigorous experimental evaluations further substantiate SkelFormer’s supremacy, outperforming several state-of-the-art benchmarks in skeleton-based action recognition and achieving accuracy rates of 92.8% on the NTU RGB+D 60, 89.4% on the NTU RGB+D 120 (cross-subject split), and 96.1% on the NW-UCLA dataset.
Research on thermo-mechanical coupling behavior of plasma-sprayed mullite ceramic coatings on concrete surfaces
This study systematically investigates the thermo-mechanical coupling behavior of plasma-sprayed mullite ceramic coatings on concrete surfaces through integrated finite element simulation and experimental verification. A three-dimensional thermo-mechanical coupling model was developed on the ANSYS Fluent platform to simulate temperature field distribution, residual stress evolution, and their impacts on interfacial bonding strength during the spraying process. Experimental data calibration confirmed the model accuracy with <5% deviation. Results demonstrate that spraying power and stand-off distance critically influence coating temperature gradients. Optimized parameters reduced interfacial residual stress to <50 MPa while decreasing porosity to 8.3%. SEM-EDS and X-CT analyses revealed the correlation between pore distribution and stress concentration. Thermal expansion coefficient mismatch was identified as the primary cause of interfacial delamination. Process optimization enhanced interfacial bonding strength by 38.7%, establishing a reliable predictive model for coating thermo-mechanical performance. The findings provide theoretical guidance for plasma spraying parameter optimization and establish a validated framework for concrete surface protection coating design. This research advances the fundamental understanding of substrate-coating interactions under thermal-mechanical loads and offers practical solutions for infrastructure durability enhancement.
Dynamic interdependence between consumer confidence and housing prices: Evidence from bootstrap rolling window causality tests
This paper examines the bidirectional relationship between consumer confidence (CC) and housing prices (HP) using a bootstrap sub-sample rolling causality test. The results show that CC and HP interact dynamically, with the direction of causality depending on economic conditions and participants’ behaviors. On one hand, rising CC can stimulate housing demand, pushing HP upward. Conversely, when economic uncertainty rises, housing may serve as a hedge asset, attracting investment even amid weak CC, which further drives HP growth. Meanwhile, HP fluctuations also asymmetrically impact CC. Higher HP can boost household wealth and CC, but excessive HP growth may strain affordability, increasing mortgage burdens and reducing CC. These findings highlight the time-varying, reciprocal nature of CC-HP linkages, emphasizing the need for adaptive policy responses to stabilize both markets during economic turbulence.
Redundancy of macrobenthic functional traits boosts resilience to a simulated heatwave
Climate change is affecting ecosystems worldwide. Ocean temperature is increasing, leading to more frequent and intense extreme weather events such as heatwaves (HWs) and marine heatwaves (MHWs). These extreme temperature events can affect marine biodiversity, the relative success of different life history strategies, and the structure and function of whole ecological communities. Understanding the effects of HWs on marine communities and the mechanisms that enable marine communities to resist and recover from heat stress has become a research priority. Here, we investigated the effects of a simulated HW on macrobenthic communities and their functional traits in intertidal estuarine sediments using a novel in-situ seafloor warming experiment with two heatwave duration treatments. Our results revealed that the simulated HW influenced macrobenthic abundance and diversity, yet, functional traits and functional metrics were less affected. This suggests resilience to the simulated HW related to redundancy of macrobenthic functional traits. The idiosyncratic responses observed in our study reflects the complex and context-dependent macrobenthic responses to thermal extremes. Our findings suggest that maintaining functional trait diversity and redundancy could be key for boosting ecosystem resilience under increasing climatic extremes.
Egg quality characteristics of South African Potchefstroom Koekoek and commercial Lohmann brown layer chickens: A comparative study
Egg quality is an important feature in egg production and is affected by many factors, including the genetic makeup of the bird. However, the influence of the chicken genotype on egg quality traits is limited and inconclusive. Therefore, this study aimed to highlight the influence of genotype on the external and internal egg quality traits of the Potchefstroom Koekoek and Lohmann Brown layers. A total of 600 eggs (300 eggs per genotype) was used, and a cross-sectional experimental design was used. The findings displayed that all external egg quality traits were significantly (P < 0.05) affected by the genotype, except for the unit shell surface weight (P ≥ 0.05). The outcomes also displayed that the genotype significantly (P < 0.05) affected all internal egg quality traits. The most affected traits favored the Lohmann Brown over the Potchefstroom Koekoek chickens. In conclusion, the outcomes showed significant differences in the external egg quality traits such as the egg length, shell weight, eggshell index, egg width and shell ratio, and the significant differences in the internal egg quality traits such as yolk/ albumen, yolk weight, albumen weight, albumen ratio and yolk ratio between the Potchefstroom Koekoek and Lohmann Brown chickens.
Vinyl chloride oligomers: On the road to understand the potential toxicity of PVC nanoplastics
On the road to understand the toxicity of nanoplastics, it is important to determine their capacity to interact with other molecules, as this is the first condition that must be met. In particular, polyvinyl chloride (PVC) is a versatile plastic widely used in construction. It can be degraded producing micro and nanoplastics, which can be formed when PVC pipes are cut during the manufacturing of products. PVC is considered to be one of the most toxic plastics, so it is important to analyze potential detrimental effects. This is the main aim of this research. On the basis of Density Functional Theory calculations, we investigated different vinyl chloride oligomers (as models of PVC nanoplastics). Degradation energies, electron donor acceptor capacities to analyze possible oxidation reactions, and interaction energies with different molecules were calculated. The vinyl chloride oligomers used in this investigation are saturated and monounsaturated. This is important since monounsaturated variant is dominant in experimental conditions. We found that none of the oligomers are good electron donors or acceptors. We also investigated different oligomers interacting with ciprofloxacin and •OOH. The interaction energies with ciprofloxacin and •OOH are negative or less than 13 kcal/mol, indicating weak interactions. This theoretical investigation indicates that vinyl chloride oligomers are not expected to be reactive or toxic, considering the electron transfer and the interaction energies with other molecules.
Evaluation of cerebrovascular reactivity using transcranial Doppler in patients with influenza
Influenza is primarily a respiratory disease but can cause a broad spectrum of complications, including those affecting the cerebrovascular system. The aim of this study was to evaluate cerebrovascular reactivity in patients during and after influenza infection. A total of 92 participants, mean age 43 years, were enrolled; 46 patients with confirmed influenza infection and 46 healthy controls. Cerebrovascular reactivity was assessed using transcranial Doppler in combination with the breath-holding test and quantified by the breath-holding index (BHI). The influenza group demonstrated significantly lower cerebral blood flow velocities in the middle cerebral artery both at rest (PSVrest, MVrest, p < 0.001) and after the breath-holding test (PSVmax, MVmax, p < 0.001) compared to healthy controls. The BHI was also significantly reduced in the influenza group ( p < 0.001), indicating impaired cerebrovascular reactivity. Among participants reassessed three months post-recovery, blood flow velocities after the breath-holding test were significantly higher than during the acute phase (PSVmax, MVmax, p < 0.001), and BHI also improved ( p < 0.001), suggesting restoration of cerebrovascular function. These findings suggest that influenza may transiently impair cerebrovascular reactivity, providing new insights into potential mechanisms influencing cerebrovascular function and hemodynamics.
Myeloid Fmr1 deficiency in mice results in reduced serum cholesterol and altered bile pathway gene expression
Fragile X Syndrome (FXS) is a genetic disorder caused by increased CGG repeats in the Fragile X Messenger Ribonucleoprotein 1 (FMR1) gene which encodes an RNA-binding protein that can alter mRNA processing, translation and stability. Among the effects of FMRP deficiency is the modulation of metabolic pathway gene expression resulting in reduced cholesterol. In this report, the role of Fmr1 in modulating serum cholesterol of mice fed Western diet was investigated. Fmr1-KO mice had reduced serum cholesterol that occurred even as LDLR expression was reduced, suggesting a non-LDLR pathway of cholesterol clearance. Hepatic bile synthesis gene expression was altered in the Fmr1-KO mice. Given the reports of myeloid cell modulation of liver function, myeloid specific Fmr1 deficiency was investigated. Reduced serum cholesterol was replicated in myeloid-specific deficiency of Fmr1. Myeloid-specific deficient Fmr1 female mice had significantly increased Cyp27a1 while male mice had significantly increased Cyp7b1, yet no differences were observed in serum bile acid levels. Evaluation of bile transporter expression demonstrated that female mice with myeloid Fmr1 deficiency had significantly increased expression of Ntcp and Slco1b2, while myeloid Fmr1 deficient male mice had significantly increased Slco1a1. The sulfonating enzyme Sult2a8 was increased in both female and male mice suggesting some commonality in the pathway, but over-expression of Sult2a8 in Western diet fed wild type mice did not alter serum cholesterol. However, liver expression of the bile acid membrane G protein coupled receptor Tgr5 was significantly increased in myeloid Fmr1 deficient mice suggesting a novel interaction between the Fmr1 gene and Tgr5.
A bi-objective robust optimization model for location-transportation under uncertainty with psychological costs
After an earthquake, it is often difficult to obtain accurate information on the number of casualties in the disaster area, which brings significant uncertainty to emergency rescue logistics. In addition to physical injuries, victims often suffer from severe psychological trauma, further hindering the effectiveness of rescue efforts. As such, incorporating the psychological condition of casualties is essential to developing an effective rescue strategy under uncertainty in casualty numbers. Building on this, this paper proposes a bi-objective robust optimization model to determine the optimal locations of medical facilities and the transportation plans for the casualties within a three-tier rescue chain comprising disaster areas, temporary hospitals, and comprehensive hospitals. The Injury Severity Score (ISS) is employed to classify casualties into three categories and to give the dynamic evolution of the deterioration rate of casualties over time. The model also considers factors such as limited medical resources, casualty classification, uncertainty in casualty numbers, and psychological conditions. The objective is to minimize the total ISS and psychological cost. We use the robust optimization method to derive the robust counterpart model of the proposed stochastic model. The bi-objective model is solved using the ε − constraint method. Extensive computational experiments and sensitivity analyses based on the Yushu earthquake were conducted, and the main findings are as follows. The greater the uncertainty in casualty numbers, the more significant its impact on the total ISS. While greater attention to the psychological condition of casualties can improve humanitarian care, it may reduce rescue efficiency, and decision-makers need to make a trade-off based on actual preferences. The treatment needs of serious casualties deserve greater attention than those of moderate or mild ones. Moreover, expanding the capacity of temporary hospitals is more effective in improving rescue efficiency than comprehensive hospitals. Finally, the robust optimization model performs better than the deterministic model when expanding the problem size.
Highly significant correlation between rates of adverse childhood experiences (ACE) in youth survivors of child sexual abuse (CSA) and their biological mothers
Background Adverse Childhood Experiences (ACE) have been associated with poor long-term mental health outcomes. Measuring ACE scores in youth undergoing treatment, as well as their caregiver(s), may help inform treatment approaches and practice. This novel study examined a unique sample to attempt to help elucidate the relationship of trauma histories between youth survivors of child sexual abuse (CSA) and their biological mothers. Secondarily, we aimed to examine the distribution of ACE scores in order to evaluate if they demonstrate common underlying factors. Materials and methods Children and adolescent CSA survivors aged 8–17 who were enrolled into a comprehensive multimodal 1-year treatment program for their abuse completed the Center for Youth Wellness ACE Questionnaire (CYW ACE-Q). Secondarily, a caregiver of each child was asked to complete the original 10-item ACE questionnaire (ACE-Q). Based on the available data, we report findings from a convenience sample of biological mothers of the CSA survivors. Biological mother ACE scores were statistically compared to determine if their trauma histories were associated with their child’s ACE score. Secondarily, a Principle Factor Analysis (PFA) was conducted to assess any underlying common factors among reported ACE scores. Results A statistically significant moderate positive correlation was found between the biological mother and their child CSA survivor in terms of their ACE scores (r(107) = 0.56, p < 0.0001). Examining the underlying factor structure of the ACE scores, two factors (which we labelled neglect and abuse ) accounted for the most variance in our sample (41.7%). Conclusions The results of this study demonstrate a surprisingly strong, and highly statistically significant, correlation in the rates of high ACE scores between child CSA survivors and their biological mothers. These results strongly support the need for trauma-informed approaches when working with CSA survivors, and in particular all treatment approaches should also consider parental trauma histories. The findings of this study suggest that a family-centered, trauma-informed care approach should be considered, instead of only programming which is focused on the impacted child.
“On paper it was a surgical success, but the reality was very different”: A qualitative interview study using narrated casuistry to explore patient context in specialist care
Objective Approaches such as shared decision-making emphasize effective patient-provider communication to ensure that patient preferences are integrated into clinical practice. However, they often overlook crucial aspects of patient context, which can affect the appropriateness and feasibility of care planning. Applying a contextual care model addresses this gap, yet the extent to which relevant patient context is considered in routine clinical practice remains largely unknown. Previous studies have primarily focused on the United States, leaving a gap in understanding how care is contextualized in Europe. This study explored how medical specialists in the Netherlands interpret, perceive and incorporate patient context into care planning. Methods A qualitative interview study was performed with 18 medical specialists from 11 specialties working in academic and peripheral hospitals. Open coding was applied to explore how specialists defined and perceived patient context. Directed content analysis, based on the 4C coding process, was applied to analyze narrated case examples of contextualized and non-contextualized care. Results All participants acknowledged the importance of patient context for providing appropriate care, though they differed in how broadly they defined it – from physical and cognitive abilities, to social, emotional and environmental circumstances. Context was considered most relevant for making treatment decisions and, by half of the participants, for ongoing monitoring of treatment. Participants also described cases where contextualization developed over time or was shared among team members. Key challenges included distinguishing context from patient preferences and sufficiently probing red flags to inform care planning. Conclusion Medical specialists emphasized the essential role of patient context in enabling personalized and efficient decision-making, enhancing care monitoring, and ultimately improving clinical outcomes. However, systematic and continuous integration of contextual information into decision-making remains challenging. Addressing this requires proactive exploration, improved communication training, and organizational support to embed contextualized care in routine practice.