Access to Healthcare Services for the Deaf: A Scoping Review of Reviews

ABSTRACT Background Cultural and linguistic minorities are at a higher risk of poorer health, poorer health outcomes, and poorer quality of care, in part due to a lack of access to healthcare services. Inequities in access to healthcare services have been found in several Deaf populations and are associated with poorer physical and mental health outcomes. Objective This review aims to describe the breadth, scope, and nature of the literature on access to healthcare services for Deaf adults. Methods A scoping review was conducted according to Arksey and O'Malley. Ten scientific databases and grey literature were searched for reviews published between 2000 and 2025 in English, French, American Sign Language, and Quebec Sign Language. A chart form was created for extraction. Results were analyzed using narrative synthesis and the Levesque et al. conceptual framework of access to healthcare. Research priorities were identified during a deliberative workshop with members of the Deaf community in Québec, Canada. Results Eighteen reviews were included in this study. All dimensions of the conceptual framework have been explored (approachability, ability to perceive, acceptability, ability to seek, availability and accommodation, ability to reach, affordability, ability to pay, appropriateness, and ability to engage). Our analysis revealed new factors influencing access that need to be considered: cultural competence, communication barriers, sociodemographic characteristics, and technological support. We also identified that the social inclusion of the Deaf impacts multiple dimensions in a cross‐sectional manner. Conclusion The Deaf face barriers to accessing healthcare services at every stage of their pathway. This review has identified several areas of access where further research is needed to address the disparities experienced by Deaf communities. There is an urgent need to involve the Deaf community in shaping the research on their access to healthcare services. Patient or Public Contribution A Deaf patient partner contributed as a co‐researcher to the study design, the conduct of the review, and the interpretation of the data. This collaboration helped to contextualise and interpret the findings of the review.

Transcription factor‐based subtype assignment in pulmonary large cell neuroendocrine carcinoma

Aims Pulmonary large cell neuroendocrine carcinoma (LCNEC) can be difficult to diagnose due to histological overlap with small cell lung carcinoma (SCLC). SCLC comprises multiple transcription factor‐based subtypes. We aimed to evaluate the clinicopathological significance of transcription factor‐based subtyping in pulmonary LCNEC. Methods and results We identified a consecutive series of 117 patients in 2010–2024 with samples diagnosed as pulmonary LCNEC ( n  = 70) or high‐grade neuroendocrine carcinoma with combined or intermediate morphology ( n  = 47). Cytomorphological score was assessed as a weighted average from two areas. Immunohistochemistry (IHC) for ASCL1, NeuroD1, POU2F3, YAP1, and HNF4A was evaluated using H ‐scores, with subtype assignment based on the highest H ‐score. Next‐generation sequencing (NGS) was performed in selected cases. IHC subtyping identified 73 (62%) ASCL1‐dominant, 20 (17%) YAP1‐dominant, 9 (8%) NeuroD1‐dominant, 7 (6%) POU2F3‐dominant, 2 (2%) HNF4A‐dominant, and 6 (5%) quintuple‐negative samples. While YAP1 was often co‐expressed with other subtypes and HNF4A was frequently co‐expressed with ASCL1, POU2F3 was mutually exclusive from ASCL1/NeuroD1/HNF4A. Unlike ASCL1/NeuroD1/POU2F3, YAP1 and HNF4A H ‐scores each correlated with large‐cell morphology—both across the entire cohort and in the lung resection subgroup. NeuroD1 dominance was more common in tumours with combined/intermediate morphology than LCNEC. Some of the tumours with intermediate morphology straddling between prototypical LCNEC and SCLC harboured POU2F3 dominance, or EGFR or other non‐ KRAS driver mutations. In 19 patients with multiple samples (including nine with paired pre‐ and post‐treatment samples), all showed concordant subtypes after accounting for codominance. Conclusion YAP1 and HNF4A expression correlated significantly with large‐cell morphology.

A colloidal oat‐containing baby wash is gentle and effective for atopic‐prone skin

Abstract Objective Despite accumulating data supporting the effectiveness of colloidal oatmeal‐based moisturizers in improving mild‐to‐moderate atopic dermatitis (AD), evidence in paediatric populations is limited. This study evaluated the tolerability and effectiveness of a colloidal oatmeal‐containing baby wash formulation in babies prone to AD, based on clinical and parental assessments. Methods In this 4‐week, single‐centre, nonrandomized study of babies (3–36 months) prone to AD (per an AD‐prone skin recruiting questionnaire developed in‐house), parents/legal guardians used the baby wash on their babies ≥3 times per week (no more than once daily), each bath lasting ≤20 min. The overall skin condition (scored from 0/excellent to 3/poor) and cutaneous tolerance scoring of dryness, redness/erythema, rash/irritation and tactile roughness on the baby's face, arms, legs and torso (each scored from 0/none to 3/severe) were assessed clinically at baseline, Week 1 and Week 4. Cutaneous tolerance scoring of burning/stinging and itching on those body sites was evaluated by the parent per the latter scale at all visits. At study end, the parental questionnaire evaluated the level of agreement/disagreement with statements regarding the baby wash. Safety measures included adverse events and changes in health (per the parents or clinicians). Results Of 29 infant‐parent pairs enrolled, 24 (82.8%) completed the study. All 24 babies were White/Caucasian; 13 (54.2%) were male. The overall skin condition mean score showed no statistically significant change from baseline (0.54) at Weeks 1 (0.33) and 4 (0.29). Per the investigator‐rated cutaneous tolerance scores, >87% of body sites exhibited no dryness, redness/erythema, rash/irritation or tactile roughness at Week 4. For each parameter, significant improvements from baseline were observed at Week 4 for the combined skin sites ( p  < 0.05). Per the parent‐rated cutaneous tolerance scores, nearly all sites had no burning/stinging or itching at Week 4. Itching for the combined sites demonstrated significant improvements from baseline at Week 4 ( p  < 0.05). The parental questionnaire revealed statistically significantly more favourable experiences with the baby wash than unfavourable experiences. Four babies experienced five mild, treatment‐unrelated adverse events. Conclusion The study findings indicate that the colloidal oatmeal‐containing baby wash was well tolerated and effective when used in babies with AD‐prone skin.

Bacterial porphyrins in healthy skin: Microbiota components impact melanogenesis and age‐related processes leading to Porphyr'ageing

Abstract Objective Porphyrins are ubiquitous metabolites and are constitutive of the bacterial metabolome of healthy skin. Their consideration has until now been limited to their pro‐inflammatory activity in acne vulgaris . The present work suggests a new role for these molecules in the onset of skin ageing. Methods A mixture of coproporphyrin III and protoporphyrin IX, representative of skin microbiota metabolites, was defined and applied in different skin models. Finally, an in vivo study was conducted to determine the association between porphyrin's abundance and ageing signs. Results Bacterial porphyrins penetrated stratum corneum and reached living epidermal cells. The porphyrin mixture increased IL‐8, ROS and melanin contents. Porphyrin‐induced melanin synthesis appeared to be regulated by translocator protein TSPO/PBR. In fibroblasts, bacterial metabolites down‐regulated a set of transcripts involved in extracellular matrix architecture and associated with ageing, which was confirmed by a decrease of type I pro‐collagen. Finally, the clinical study established positive and significant correlations between porphyrin abundance and the severity of ageing signs, including invisible spots, brown spots and wrinkles length. Conclusion In summary, porphyrins could play unexpected roles in skin's premature ageing process, a phenomenon we propose to call Porphyr'ageing, that promotes hyperpigmentation, inflammation, oxidative stress and fibroblast cell ageing, leading to dermal matrix weakening.

Role of thermal history in the formation of commercial‐scale, infrared glass‐ceramics

Abstract The ability to translate melt properties and performance of small volume optical glass melts (i.e., melt sizes less than a few hundred grams) to manufacturable, commercial size melts (typically greater than 1 kg) requires a variety of processing optimization steps. Such melt size scale‐up often involves issues related to thermal properties of the composition and thermal history of the glass upon quenching, impacting the thermal, mechanical, and optical property homogeneity. In the present effort, we assess the viability of a complex, well‐studied, functional glass composition,20 GeSe 2 − 60 As 2 Se 3 − 20 PbSe $20\text{GeSe}_2 - 60\text{As}_2\text{Se}_3 - 20\text{PbSe}$ (GAP‐Se) to evaluate the likelihood that commercial melts can be made to exhibit optical performance comparable to past lab‐scale melts. Such confirmation of property/performance metrics is required to satisfy the rigors of optical designer demands that can enable new solutions for infrared optical designs. We demonstrate that for GAP‐Se bulk glass subjected to controlled crystallization, measurable modification to the optical composite's effective refractive index can be achieved. Employing these data, we present viable mid‐wave infrared optical design results implementing a methodology suggesting how gradient refractive index elements from this material can be made with equivalent or improved size, weight, power, and cost.

Learning English in China: The Earlier, the Better?

ABSTRACT This study examined the relationship of university students’ English proficiency to the age at which they started learning English in mainland China. With the data collected from 4530 students in 50 universities in 24 different provinces or municipalities, we employed a multiple regression model to investigate (a) whether the tested English score in the national entrance exam was predicted by the age at which the students started learning English and (b) whether the start age of English learning influences the association between time invested and learning outcome. Our results found that students who began learning English in third grade predicted significantly lower scores than those who started in kindergarten. However, no such significance of “advantage” was observed in earlier starts from kindergarten over Grade 1. Although the main effect of total learning duration was not significant, its interaction effect suggests that students who start learning later benefit more from longer durations of English input and tend to catch up quickly and show faster growth. These findings conflict with the ‘the earlier, the better’ assumption in language learning and further raise the question to what degree foreign language education should prioritize starting early versus focusing on quality and positive affect.

Conflicted by Faith, Drawn to Pleasure: How Religious Self‐Discrepancy Shapes Product Choices

ABSTRACT This research examines how the reversed form of religious self‐discrepancy influences consumer preferences for non‐religious and hedonic products. Specifically, it investigates how discrepancies between outward religious practices and secular aspirations shape product choices through perceived control, and how these effects vary by intrinsic religiosity and private versus public consumption settings. Six experiments ( N  = 959 participants) were conducted to test the proposed relationships across varied manipulations, product categories, and consumption settings. Results show that the reversed religious discrepancy increases preference for non‐religious products (Study 1: Δ M  = 0.92, d  = 0.45) and for hedonic products (Study 2A: Δ M  = 1.19, d  = 0.57). Reversed religious discrepancy also reduces perceived control, which has a significant mediation effect on hedonic preference. This mediated effect is stronger among individuals with low intrinsic religiosity, whereas private consumption contexts moderate the relationship between reversed religious discrepancy and hedonic preference. By redefining the actual‐ideal mapping from sacred to secular ideals, this research extends self‐discrepancy and compensatory consumption theories and offers practical guidance on a new tool for market segmentation.

Standardization of Electronic Medical Record Documentation Improves Hospitalist Communication in Drug Reaction With Eosinophilia and Systemic Symptoms

Representation of Skin of Color in Cutaneous Oncology Publications: A Decade of Trends and Disparities

Exonic Variation in HLA‐C , CFB , and TAP2 Associated With Increased Risk for Comorbid Crohn's Disease and Psoriasis

ABSTRACT Background Psoriasis (PS) and Crohn's disease (CD) are chronic immune‐mediated inflammatory diseases with overlapping immunologic mechanisms. Although comorbidity is rare, epidemiologic and genetic studies have highlighted a significant association between PS and CD. Methods We performed a focused exome‐wide association study (ExWAS) comparing individuals with comorbid PS and CD to healthy controls (case–control design) and to individuals with PS or CD alone (within‐cases design) in the UK Biobank (UKB) and performed validation analyses in the All of Us (AoU) Research Program. Results The exonic architecture of comorbid PS and CD more closely resembles that of PS alone. Three protein‐coding variants, including two putatively functional variants and one proxy variant, were significantly associated with comorbidity: a missense variant in HLA ‐C (Asn104Lys), a missense variant in CFB (Gly252Ser), and a synonymous variant in TAP2 . A significantly greater proportion of individuals with comorbid disease harbored at least one risk variant in all three genes (trigenic risk variant) compared to controls and PS‐only individuals in both the UKB (odds ratio [OR] = 4.52, 95% confidence interval [CI] = 1.55–10.30, p  = 5.8 × 10 −4 ) and the AoU (2.44, 95% CI = 1.07–4.81, p  = 0.02). Conclusions This study identifies novel exonic, protein‐coding genetic variation associated with the comorbidity of PS and CD, in addition to identifying an association between combined carriage of three risk variants with comorbid disease compared to controls and PS alone in multiple datasets. These risk variants may serve as prognostic biomarkers and guide personalized biologic treatment strategies in affected individuals.