IntroductionDigital technologies are central to university students’ academic, social, and personal lives, offering opportunities for learning and connection while also introducing challenges such as distraction, emotional strain, and difficulties with self-regulation. Despite increasing interest in digital well-being, there is a lack of comprehensive, psychometrically sound instruments specifically designed to assess digital well-being among university students. This study developed and validated the Digital Well-Being Scale (DWS) for use in higher education.MethodsA cross-sectional survey was conducted among 1,533 undergraduate and postgraduate students from a public university in Ghana. Scale development involved literature review, expert evaluation, pilot testing, and psychometric validation. Exploratory factor analysis (EFA) was used to identify the underlying factor structure, followed by confirmatory factor analysis (CFA) to evaluate construct validity. Reliability, convergent validity, discriminant validity, and measurement invariance across gender were also assessed.ResultsEFA supported a six-factor solution comprising Task Interference, Digital Safety and Responsible Use, Perceived Control and Satisfaction, Digital Life Balance, Emotional Regulation, and Digital Dependence and Frustration. Following CFA-based refinement, a 41-item scale was retained. The six-factor first-order model demonstrated excellent fit to the data and outperformed a higher-order model. The DWS showed satisfactory internal consistency, convergent validity, and discriminant validity across all dimensions. Measurement invariance analyses supported configural and metric invariance across gender, although scalar invariance was only partially supported.DiscussionThe DWS provides a theoretically grounded and psychometrically robust multidimensional measure of digital well-being among university students. The findings suggest that digital well-being encompasses behavioural, emotional, cognitive, self-regulatory, and responsible dimensions of digital engagement rather than representing a single, unidimensional construct. The scale offers a valuable tool for research, screening, and intervention aimed at understanding and promoting digital well-being and digital mental health in higher education settings.
Immersive Technologies in Forensic Mental Health and Prison Settings: Scoping Review
<strong>Background:</strong> The application of immersive technologies, particularly virtual reality, has expanded rapidly across health care domains, including mental health, rehabilitation, and education. These technologies enable the creation of controlled, interactive, and ecologically valid environments that can support therapeutic interventions, skill development, and behavioral assessment. Within forensic mental health services (FMHS) and prison settings, where individuals often present with complex psychological needs in restrictive and highly regulated environments, immersive technologies offer potential advantages such as safe simulation of real-world scenarios, enhanced engagement, and personalized intervention delivery. However, despite increasing interest, the evidence base remains fragmented, and questions persist regarding effectiveness, ethical implications, and feasibility of implementation in secure and resource-constrained contexts. <strong>Objective:</strong> Interest in immersive technologies in FMHS and prison settings is growing, yet their role remains unclear. This scoping review mapped current uses, highlighted opportunities, and identified key gaps and considerations for future implementation. <strong>Methods:</strong> A scoping review of English-language publications (2010-2025) was conducted using the Scopus, PubMed, and CINAHL databases. Data extraction followed the Joanna Briggs Institute framework, and thematic analysis explored benefits, drawbacks, and implementation barriers. <strong>Results:</strong> Thirty sources were identified. Primary research focused mainly on virtual reality for therapy, skill training, education, and assessment. There was evidence suggesting benefits such as increased engagement, emotional regulation, skill acquisition, autonomy, and improved clinician-patient dialogue. However, the studies were small, heterogeneous, and inconsistently reported, with limited long-term follow-up. Implementation barriers included institutional, ethical, and technical constraints and limited personalization and end user involvement. Co-design and participatory approaches surfaced as key enablers of acceptability, relevance, and safe use. <strong>Conclusions:</strong> The existing evidence base is preliminary and exploratory but indicates that immersive technologies may have potential value in FMHS and prison contexts. Current findings should be interpreted cautiously because studies are small, heterogeneous, and rarely include long-term follow-up. More robust evidence, careful implementation, and meaningful end user input are needed to support safe, relevant, ethical, and effective use. The emphasis on coproduction and guidance for safe, user-centered implementation is a novel contribution.
Introduction of Nurse-Led Rehabilitation Services for Patients With Stroke After Discharge to Improve Self-Care Management in Bangladesh: Pilot Randomized Controlled Trial
<strong>Background:</strong> Stroke is a leading cause of disability and death, resulting in a clinical, social, and economic burden upon families and the health system worldwide. <strong>Objective:</strong> This study aimed to introduce nurse-led rehabilitation services for patients after stroke to improve functional independence for self-care management. <strong>Methods:</strong> A pilot, open-label, 2-arm (1:1), randomized controlled trial was conducted at the National Institute of Neuroscience & Hospital in Bangladesh between March and August 2025. A total of 64 patients with stroke were enrolled using simple randomization. In the intervention group (IG), patients received rehabilitation education and assistive devices to improve activities of daily living. The control group (CG) received usual hospital care for stroke. Data were collected through a structured questionnaire. After discharge from the hospital, study nurses enrolled patients after stroke after a face-to-face assessment and provided rehabilitation education at the hospital and monthly rehabilitative education at home for 3 months. The study outcomes were improvement of functional independence, self-efficacy, social participation and reduction of caregivers’ burden. <strong>Results:</strong> Among 64 participants, 47 (73%) completed the study. Results depict an increase in self-care capacity, self-efficacy, social involvement and a decrease in care burden in both groups from baseline to end line; nevertheless, there was no statistically significant difference between IG and CG (<i>F</i><sub>2, 44</sub>=0.113; <i>P</i>=.74). Functional Independence Measure mean scores (IG: mean 78.4, SD 37.6; CG: mean 74.3, SD 35.4; <i>P</i>=.70; 95% CI –25.16 to 18.14), self-efficacy (IG: mean 27.0, SD 6.9; CG: mean 26.6, SD 7.1; <i>P</i>=.83; 95% CI –3.6 to 4.6), social participation (IG: mean 30.4, SD 21.4; CG: mean 28.2, SD 17.2; <i>P</i>=.61; 95% CI –9.33 to 13.61), and care burden (IG: mean 24.9, SD 13.6; CG: mean 25.2, SD 12.6; <i>P</i>=.83; 95% CI –8 to 7). In qualitative analysis, we noticed enhanced self-care capacities of patients with poststroke disabilities after rehabilitative intervention, as indicated by participants’ perceptions. <strong>Conclusions:</strong> In this study, patients’ self-care capability was improved after the intervention from baseline, and improvements were noted by using assistive devices based on patients’ perceptions and responses. The study findings demonstrated the importance of early self-care management for patients with poststroke disabilities. Future research should focus on long-term, community-integrated strategies that involve primary care, enhanced technological support, and caregiver-focused disability adjustment programs to achieve better outcomes. <strong>Trial Registration:</strong> ClinicalTrials.gov NCT06786559; https://clinicaltrials.gov/search?id=NCT06786559
Effects of Social Media Narratives on Affective and Behavioral Responses to Menopause Content: Randomized Online Experimental Study
Background: Social media is an increasingly prominent channel for communicating menopause information and experiences, yet the affective and behavioral consequences of different narrative framings remain unclear. Objective: We examined how distress, normalizing, and transformative narratives influenced women’s immediate responses to menopause content online, drawing on established narrative framings of menopause as normality, distress, and transformation. Methods: In an online experiment, UK women aged 40 to 83 years who were perimenopausal or postmenopausal were recruited via Prolific, a widely used online recruitment platform for behavioral and social science research. A total of 737 women were randomly assigned to view 4 anonymized and standardized social media posts from a pool of 12 reflecting 1 of 3 narratives: <i>normal</i> (n=248, 33.6%), <i>distress</i> (n=241, 32.7%), or <i>transformative</i> (n=248, 33.6%). Participants then reported affective reactions, expected behavioral responses, and perceptions of the posts using 5-point ordered response scales. Ordinal logistic regression models tested demographic predictors and condition effects controlling for demographic factors. Results: Participants who viewed distress-framed posts reported greater levels of worry (β=.910; <i>P</i><.001), confusion (β=.818; <i>P</i><.001), and anxiety (β=.817; <i>P</i><.001) and lower levels of reassurance (β=−.970; <i>P</i><.001), optimism (β=−.708; <i>P</i><.001), and empowerment (β=−.540; <i>P</i><.001). Distress framing also increased perceived knowledge of menopause (β=.564; <i>P</i><.001) despite participants feeling more negatively toward the posts. Neither distress nor transformative narratives influenced expected behavioral intentions to like, share, save, comment on, search for, or discuss social media posts compared with normalizing narratives. Postmenopausal status (β=−.630; <i>P</i><.001) and older age (β=−.492; <i>P</i><.001) were independently associated with less worry and anxiety. Participants rated distress (β=−.806; <i>P</i><.001) and transformative posts (β=−.968; <i>P</i><.001) as less representative of health professionals than normalizing posts; transformative posts were also judged to be less representative of newspapers or television (β=−.687; <i>P</i><.001). Conclusions: Narrative framing shaped immediate affect but not intended engagement with menopause content. Because this study assessed short-term responses to controlled, standardized posts, future research should examine whether these effects persist over time and how they operate in more ecologically valid social media environments. As public discussion expands, diverse, balanced narratives may help reduce stigma and temper the disproportionate salience of negative framing. This study advances understanding of how narrative framing shapes responses to health content online.
Opinion: What the 20th-century war on smog tells us about today’s wildfire smoke
As wildfires burn millions of acres across Canada, smoke has descended upon cities across the United States, with air quality plummeting to unhealthy levels. In New York City, emergency room visits for asthma exacerbations jumped by 31% by the end of the first day. The timing could not have been worse for a city already in the throes of the second major heat wave of the season.
Extreme weather events represent the cyclical and compounding relationship between fossil fuel combustion, a warming climate, natural disasters, and related illnesses. Some may view them as proof the climate crisis has already become insurmountable. However, history teaches us to never let a health-related environmental crisis go to waste.
Genetic Study Links Excessive Sweating to Neurological Dysfunction
Data from a new study suggest that a form of hyperhidrosis, or excessive sweating, may be due to genetic mutations that result in the overstimulation of the nerves that control the sweat glands. These findings, which are reported in Science Advances, could open a door to targeted treatments for the condition using existing medicines. Full details of the findings are provided in the paper titled “A neurocutaneous NaV1.8 channelopathy underlies a genetic subtype of primary idiopathic hyperhidrosis.” The international study is led by scientists at Vrije Universiteit Brussel.
Excessive sweating, which affects roughly two to five percent of the population, causes more than just discomfort. The impact of the condition on the daily lives of people living with it can be very severe. Patients often sweat so profusely that they have to change clothes several times a day. Many avoid social contact, experience shame, and develop depression. Yet the condition is often seen as a superficial skin problem and patients often do not receive appropriate care.
That could change thanks to the findings from this study which is the culmination of 10 years of research done by scientists in the lab of Frank Bosmanbs, PhD, at Vrije Universiteit Brussel and their collaborators at Johns Hopkins University. To pinpoint a genetic basis for hyperhidrosis, the scientists analyzed the DNA of more than 180 patients. They discovered defects in the Nav1.8 ion channel, which normally functions as a biological gate that regulates electrical signals in the nervous system.
Specifically, in patients with hyperhidrosis, the gate is left too wide open due to a genetic predisposition. As a result of this, the nerves are constantly overstimulated and in a state of activity, which results in excessive sweating often triggered by emotional or stress-related stimuli. To dig deeper into their theory, the scientists developed an experimental mouse model. Because mice only sweat from their paws, the team developed a microscopic measurement method to count sweat droplets using an iodine-starch mixture.
They found that mice that had the same genetic defect as hyperhidrosis patients also sweated excessively. Furthermore, once the scientists administered a substance that blocked the overactive nerve signals, their symptoms decreased significantly and reversibly. However the genetic picture is more complex. Bosmanbs and his team found a patient who had inherited an inhibitory nerve mutation but still sweated excessively due to a separate mutation in a local water channel within the sweat gland. It suggests that there are different biological pathways that can lead to the same overstimulation that results in hyperhidrosis.
Though the genetic picture is a complex one, the scientists believe that their findings offer the prospect of better treatments for this condition. Currently, some severe forms of hyperhidrosis are treated by severing the sympathetic nerve pathways in the chest. While effective, this treatment is both invasive and can have unwanted side effects. With a deeper understanding of the genetic basis of the condition, scientists may be able to better predict which patients are likely to get the most benefit from localized treatment of the sweat glands, systemic medication or nerve-targeted therapies. Another potential treatment avenue is drug repurposing, which is supported by the evidence from the mouse studies. However, further testing via controlled clinical trials is required.
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Why Microbot Medical thinks it can win the stroke telesurgery race
Microbot Medical says it has what it takes to win the race to treat stroke patients with a future version of its fully disposable, single-use endovascular navigation surgical robot, Liberty. Liberty earned FDA 510(k) clearance in September 2025 for “use in the remote delivery and manipulation of guidewires and catheters, and remote manipulation of guide…
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Quitting smoking is hard. A Medicare change may push doctors to give more help
Pretty much everyone who cares about public health agrees that it’s a good idea to help people quit smoking, the No. 1 cause of preventable death in the U.S. Doctors may soon get some extra encouragement to lend a hand, thanks to proposed changes in Medicare’s physician fee schedules.
Physicians who offer counseling on quitting cigarettes or other tobacco products during visits with patients would get a 19% increase in reimbursement, according to a few paragraphs buried in the 1,592-page document released this week. The same adjustment would also apply to assessments of, and interventions for, alcohol and substance misuse during doctors’ visits.
“Given the evidence supported role these services play in preventing and managing chronic disease […] we believe that valuation should more accurately reflect the clinical intensity and work associated with these time-based services,” the proposal from the Centers for Medicare and Medicaid Services explains. Comments on the proposal are due Sept. 14.
“The prioritization of cessation as a service is long overdue, and we’re very excited about it,” said Anne DiGiulio, the American Lung Association’s senior director of nationwide tobacco cessation and health policy.
<![CDATA[Learn how clinicians manage bipolar disorder in women who may become pregnant—safer meds, contraception counseling, and relapse prevention.]]>
Dendritic Cells Identified as Key Organizers of Anti-Tumor Immune Hubs
Not all immune activity inside a tumor is disorganized. In some patients, tumors contain tertiary lymphoid structures, or TLSs: organized clusters of immune cells that resemble lymph-node-like sites of local immune coordination. Their presence has been associated with improved survival and better responses to immunotherapy in several cancers, making them an increasingly important feature of the tumor microenvironment.
A new study published in Science identifies a specialized immune cell population that helps build and sustain these structures. Researchers at the Icahn School of Medicine at Mount Sinai and collaborating institutions found that type 1 conventional dendritic cells, or cDC1s, act as central organizers of TLSs in cancer. The work helps explain how local anti-tumor immune responses are maintained within tumor tissue and points to potential strategies for improving immunotherapy.
Why TLSs matter in cancer immunity
TLSs are not normal anatomical lymph nodes. They arise in chronically inflamed tissues, including tumors, and can contain organized T-cell zones, B-cell follicles, germinal center-like regions, plasma cells, and specialized stromal networks. In cancer, their presence is often interpreted as evidence that the immune system is not only infiltrating the tumor but organizing a sustained local response.
Many tumors contain immune cells, but not all immune infiltrates are functionally productive. TLSs may provide a site where antigen presentation, T-cell activation, B-cell maturation, and antibody responses occur close to malignant cells. This could help explain why TLS-positive tumors are often associated with more favorable outcomes and greater sensitivity to immune checkpoint blockade.
Until now, however, it has been less clear what drives TLS formation and, just as importantly, what keeps these structures functional once they are established.
cDC1s as local immune architects
Dendritic cells are best known for antigen presentation: they capture tumor antigens and prime T-cell responses. This study expands that role. The researchers found that cDC1s do not only initiate anti-tumor immunity; they help organize the physical and functional immune architecture inside tumors.
“Our goal was to understand how these immune structures develop and persist inside tumors,” said lead author Raphael Mattiuz, PhD. “We found that a distinct subset of dendritic cells acts as the organizer, bringing together different immune cells and keeping the local anti-cancer response active.”
The team analyzed tumor samples from patients with lung, liver, colorectal, kidney, and ovarian cancers using multiplex imaging and spatial gene-expression approaches. These methods allowed them to map where dendritic cells were located, which immune cells surrounded them, and how those local neighborhoods related to TLS organization.
Across tumor types, mature dendritic cells accumulated within TLSs. The mechanistic work then focused on a mouse model of non-small cell lung cancer designed to reproduce mature TLS formation seen in human tumors. In this model, cDC1s were required both during the establishment of TLSs and later for their maintenance.
More than T-cell priming
The study suggests a two-stage role for cDC1s. Early in tumor development, TLS formation depended on IFNγ-driven maturation of cDC1s, migration to tumor-draining lymph nodes, and recruitment of primed T cells back into the tumor. As tumors progressed, however, the biology changed. TLSs could persist even when egress of T cells from tumor-draining lymph nodes was impaired, while cDC1s became retained within intratumoral stromal hubs enriched in CCR7 ligands.
This is clinically interesting because it positions cDC1s as tissue-resident coordinators of ongoing immunity, not merely transient antigen couriers. The researchers found that timed depletion of cDC1s after TLSs had formed disrupted TLS maintenance. Blocking their localization to stromal hubs had a similar effect.
The function of these cells also depended on antigen presentation. Genetic ablation of both MHC class I and II on cDC1s impaired TLS maintenance, T follicular helper cell preservation, germinal center formation, tumor-specific IgG production, and differentiation of progenitor exhausted CD8-positive T cells.
“We were surprised to see that these rare cells become permanent organizers within the tumor itself,” Mattiuz said. “They don’t just activate cancer-killing T cells. They also help coordinate antibody responses, allowing multiple parts of the immune system to work together where they’re needed most.”
Implications for immunotherapy
Checkpoint inhibitors have changed cancer care, but durable responses remain limited to a subset of patients. One reason is that reinvigorating T cells may not be enough if the tumor lacks the local immune organization needed to sustain productive responses. TLS biology offers a complementary framework: the issue may not only be whether immune cells are present, but whether they are organized into functional niches.
This study suggests that cDC1-directed therapies could help strengthen those niches. Potential strategies might include increasing cDC1 abundance, enhancing cDC1 maturation, improving their recruitment or retention in tumors, or combining cDC1 activation with checkpoint blockade, vaccines, radiotherapy, or other immune-modulating approaches.
The findings also add nuance to biomarker development. TLS presence is already being studied as a prognostic and predictive feature, but TLS quality may matter as much as TLS quantity. A tumor with cDC1-rich, antigen-presenting, germinal center-supporting TLSs may behave differently from a tumor with less mature or poorly maintained immune aggregates.
For medical oncology, this could eventually refine how TLSs are interpreted in pathology and translational studies. Rather than treating TLSs as a binary histological feature, future assays may need to assess their cellular composition, dendritic cell state, B-cell organization, and proximity to effector T-cell populations.
Still early, but mechanistically important
The work is not yet a clinical intervention. It does not show that activating cDC1s in patients will reliably generate TLSs or improve immunotherapy outcomes. Tumor type, antigenicity, stromal architecture, prior therapy, and immunosuppressive pathways will likely influence whether this biology can be therapeutically exploited.
Nevertheless, the study provides a clearer mechanistic target in a field that has often treated TLSs as useful but poorly controlled biomarkers. If cDC1s are required to form and maintain functional TLSs, then therapies aimed at dendritic cell biology may become a way to convert poorly organized tumor immune infiltrates into more coordinated anti-tumor responses.
The broader message is that effective cancer immunity is spatial as well as cellular. It is not only about having T cells, B cells, antibodies, or dendritic cells inside the tumor. It is about arranging them in the right place, in the right state, and for long enough to sustain pressure on malignant cells.
By identifying cDC1s as organizers of tumor-associated TLSs, the study offers a more concrete path toward therapies that help the immune system build its own infrastructure inside cancer.
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