Alignment of qualitative and quantitative focus of attention assessment of stone delivery among high-level Canadian curlers

To understand the alignment of current focus strategies of high-level Canadian curlers and to investigate if the focus of attention theory differentially affects draw and takeout deliveries, a mixed-methods approach was used. Eleven high-level Canadian curlers ( N  = 11) delivered draws and takeouts of both handles (in-turn/out-turn) under control, internal focus, and external focus conditions. To prevent knowledge of performance and results, the curlers vision and hearing were occluded post-delivery. Pre-experiment questions pertained to the focus strategy. Post-experiment questions pertained to focus preference. Open-ended questions were analysed via thematic analysis. Draw radial error, absolute constant error, and variable error scores were analysed via separate repeated measures ANOVA with Tukey’s Honestly Significant Difference post-hoc test. Takeout end-point accuracy (hit/miss) were analysed by handle via a one-way Cochrane Q test with McNemars test as a post-hoc. Curler’s self-regulated focus strategy used a multifaceted focus approach with multiple internal and external foci. For draws, regardless of handle, an internal focus increased radial error compared to control. In contrast with actual performance, athletes favoured an internal focus due to the perceived importance placed on “touch”. Conversely, athletes preferred an external focus for out-turn takeouts which increased hitting rate over an internal focus, and was favoured for the increased sensation of “line maintenance” which aligned with performance. Draw and takeout end-point accuracy were differentially affected by focus. A multifaceted attentional approach should be considered to align perception and performance.

‘You just want the right person for the right job’: ‘race neutral’ and ‘race conscious’ rationales for the implementation of positive action measures in sports coaching

In recent years, a small number of sports bodies in the UK have developed new interventions designed to address racialised inequities in sports coaching. This article draws on interviews with CEOs and Youth Academy Managers ( n  = 14) to examine their approaches to conceptualising and operationalising one such positive action measure in men’s professional football in England. With particular respect to; (i) the ways in which these organisational actors adhere to ‘race-neutral’ or ‘race-conscious’ understandings of the racial equality landscape of football coaching, (ii) how such understandings inform and mediate their conceptual opposition or support for positive action measures, and (iii) how such rationales underpin the non-implementation or implementation of such measures in practice. Finally, the authors utilise Critical Race Theory (CRT) to draw linkages between the underpinning philosophies, rationales and implementation of such measures, and broader neo-liberal ideologies, notions of interest convergence, and the normative power of Whiteness in such settings.

Role of multimodality imaging in cardiac implantable electronic devices related infection and infective endocarditis

Infective endocarditis (IE) is a serious and increasingly recognized condition, associated with significant morbidity and mortality. The diagnosis of IE is more challenging in patients with implanted cardiac devices such as cardiac implantable electronic devices, left ventricular assist devices, and left atrial appendage occlusion devices. This review focuses on the contemporary roles and applications of multi-modality imaging in the evaluation of patients with cardiac implantable electronic devices related infection and IE. The role of multi-modality imaging in the diagnosis of patients with native or prosthetic valve IE is beyond the scope of this review. A literature search of the PubMed database was performed between 1 June 2024, and 30 June 2025. Relevant articles on the subjects of ‘infective endocarditis,’ ‘multi-modality imaging,’ and ‘implanted cardiac devices’ were utilized in our review. The growing utilization of cardiac implanted electronic devices (CIED) demands improvement in the detection of CIED-related infections. Contemporary guidelines have considered utilizing multimodality imaging to diagnose IE. The incremental value of multimodality imaging remains to be rigorously examined. Large observational studies from tertiary centers might serve as the starting point toward building a strong evidence base.

Nano-icilin–driven TRPM8 activation elicits immunogenic exosomes with antitumor effects

Transient receptor potential melastatin 8 (TRPM8) is a cold-sensing cation channel that regulates calcium (Ca2+) levels in cells. Its overexpression is linked to tumor development and progression. TRPM8 activation by specific agonists leads to increased Ca2+ influx, causing stress and apoptosis. This stress can enhance the production and release of exosomes, which have antitumor immunity properties. We hypothesize that activating TRPM8 with nano-icilin can stimulate immune responses when administered peritumorally. 4T1 cancer cells were treated with icilin nanoparticles and hypothermia to evaluate cytotoxicity, apoptosis, calcium flux, and exosome extraction. Isolated exosomes were characterized and tested in vivo for antitumor immune response in a mouse model. Tumor growth, cytokines (IL-2, IL-12, IL-10, and IL-1β), and immunohistochemistry (IHC) were assessed. Data were analyzed using ANOVA and Duncan’s test (P ≤ 0.05). TRPM8 activation by icilin nanoparticles triggers apoptosis and calcium influx in 4T1 cells. Exosomes from treated cells exhibited altered size, charge, and increased levels of DAMPs (HMGB1, HSP70). Administering these exosomes significantly inhibited tumor growth, increased CD4+/CD8+ T cells, and elevated IL-2 and IL-12, while reducing IL-10 and PD-L1, thus preventing lung metastasis. Activation of TRPM8 by icilin or cold can induce immunogenic exosomes, enhancing T cell infiltration, proinflammatory cytokines, and tumor suppression, offering a new strategy to boost immune responses against cancer.

Antibacterial efficacy and adaptive proteomic strategies of antibiotic-resistant pathogens on nanostructured copper surfaces

To evaluate the antibacterial activity of nanostructured copper oxide surfaces synthesized by hot water treatment (HWT) and to elucidate the underlying mechanisms of copper-induced stress responses in antibiotic-resistant Citrobacter freundii CF51 and Staphylococcus aureus HAR12. Copper sheets were subjected to HWT to generate Cu 2 O/CuO nanostructures. Antibacterial and antibiofilm activities were assessed using viability and biofilm assays. Cellular morphology was examined by FESEM. Whole-proteome and KEGG pathway analyses were performed to identify bacterial adaptive responses. Nanostructured copper rapidly inactivated C. freundii and eliminated S. aureus with longer exposure. FESEM imaging showed membrane disruption, deformation, and lysis, with more severe damage on nanostructured surfaces. Proteomic analysis revealed species-specific regulation of pathways related to energy metabolism, transcription, ion transport, and cell envelope biogenesis. ABC transporters were upregulated in C. freundii but downregulated in S. aureus. The Staphylococcus aureus infection pathway was markedly suppressed. Efflux transporters (CorA, MdtF, YhiI) were consistently upregulated in both species, indicating conserved copper-detoxification mechanisms. Nanostructured copper oxide surfaces demonstrate potent antibacterial and antibiofilm activity and induce distinct proteomic stress responses. These findings support the potential of nanostructured copper as an effective antimicrobial surface against antibiotic-resistant pathogens.

The evolving management of endocrine disorders induced by checkpoint inhibitors: insights from the CIITED group

Immune checkpoint inhibitor (ICI) induced endocrinopathies are a commonly encountered immune-related adverse event during cancer treatment. Several oncology and endocrinology groups have put together guidelines on the management of these adverse events. However, the management is evolving as we learn more about the natural history of these entities. A thorough literature search for articles pertaining to ICIs and endocrinopathies was performed and supplemented by expert opinions of the authors. Additionally, we present unanswered questions that need further research including ICI-mediated effects on diabetes and bone health. While there is a consensus on the management of endocrinopathies caused by ICI, there is a lot unknown. While ICI can be safely continued, conditions like adrenal insufficiency, primary hypothyroidism, and diabetes resulting from ICI require lifelong hormone replacement. However, there are several questions unanswered. Hence, the endocrinologists at our cancer center have come together as a working group to explore ‘checkpoint inhibitor induced toxic endocrinopathies and diabetes’ (CIITED). Future directions intended to explore are the long-term sequelae of ICI endocrinopathies as well as possible role for immune modulating therapies in their management.

Nipocalimab for the treatment of moderate-to-severe Sjögren’s disease: a plain language summary of the DAHLIAS study

What is this summary about? This is a plain language summary of an article published in the Lancet in 2025. It describes results from the phase 2 DAHLIAS study. The DAHLIAS study measured the efficacy and safety of an investigational medicine called nipocalimab to treat moderate-to-severe Sjögren’s disease . Nipocalimab is a type of biologic treatment called a monoclonal antibody . Scientists designed nipocalimab to reduce harmful immunoglobulin G (IgG) autoantibodies by blocking the neonatal fragment crystallizable receptor (FcRn) . IgG autoantibodies called anti-Ro and anti-La are elevated in the majority of patients with Sjögren’s disease. DAHLIAS is the first controlled clinical trial of an FcRn blocker in Sjögren’s disease. What were the results? The DAHLIAS study included 163 participants who had moderate-to-severe, active Sjögren’s disease and a positive blood test for anti-Ro IgG autoantibodies. Of these, 53 participants received intravenous nipocalimab 5 mg/kg, 54 participants received intravenous nipocalimab 15 mg/kg, and 56 participants received intravenous placebo every 2 weeks for 22 weeks. At Week 24, on average, participants who received nipocalimab 15 mg/kg every 2 weeks had greater improvements in their Sjögren’s disease signs and symptoms than those who received placebo. Blood tests showed treatment with nipocalimab also reduced levels of IgG autoantibodies. The safety of nipocalimab was comparable to placebo. The most common side effects with both nipocalimab and placebo were infections, including COVID-19, the common cold, urinary tract infections, and conjunctivitis (pink eye). What do the results mean and why do they matter? This is the first study to show that nipocalimab has beneficial effects in patients with Sjögren’s disease. Based on these results, nipocalimab will be studied in larger, phase 3 studies in patients with Sjögren’s disease. If those studies are successful, nipocalimab could become the first treatment for Sjögren’s disease that may slow down or stop disease progression by reducing the harmful IgG autoantibodies.

Deciphering the mechanisms of impaired decision-making

The emerging roles of intestinal organoid models in inflammatory bowel disease research

The chronic immune mediated gastrointestinal disease, Inflammatory Bowel Disease (IBD), is increasing in prevalence. However, IBD pathogenesis remains unclear despite decades of research. Therefore, new methods and models of disease are required to gain further insights into IBD pathogenesis. Recent advances in stem cell culture technology now allows for the routine in vitro culture of stem cells derived from an individual. These in vitro stem cells can differentiate into cell-types and cell clusters that resemble the tissue origin of the stem cells. These cell clusters have been termed organoids. Following review of recent available literature, the goal of this review was to specifically focus on intestinal organoids and provide basic methodology of organoid derivation. The review will also discuss the current and potential applications of intestinal organoid models in Gastroenterology research including IBD pathogenesis, host-microbiome interactions, therapeutic response and drug discovery, very-early onset IBD, organ-on-a-chip and bioprinted models. Organoids offer tangible benefits for improved patient outcomes, particularly with respect to personalized medicine approaches to IBD management.

Clinical perspective on non-sleepy obstructive sleep apnea; to treat or not to treat?

Excessive daytime sleepiness has traditionally been regarded as the hallmark symptom of obstructive sleep apnea (OSA), yet nearly half of individuals with OSA do not report significant sleepiness. While treatments are well established for sleepy patients, their role in non-sleepy individuals remains relatively underexplored. This review discusses the limitations of current tools used to measure sleepiness, evaluates the evidence for various treatment options for OSA in non-sleepy populations, and outlines key considerations for shared decision-making. We examine noninvasive therapies including positive airway pressure (PAP), oral appliance therapy, and weight loss interventions only. Randomized controlled trials have not demonstrated cardiometabolic benefits of PAP therapy in non-sleepy individuals with OSA, though these studies are limited by poor PAP adherence and imprecise tools for identifying high-risk patients. As such, a pragmatic trial of PAP may be a reasonable strategy in non-sleepy people with moderate-to-severe OSA, cardiovascular comorbidities, or other OSA-related complications; provided patients are counseled about the challenges of adherence and the uncertain benefits in this population. Looking ahead, management of non-sleepy OSA will likely be guided by individualized, risk-based approaches incorporating physiological endotyping, objective biomarkers of cardiovascular risk, and patient preferences.