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  • Will at centre of legal battle over Shakespeare’s home unearthed after 150 years | William Shakespeare

    Will at centre of legal battle over Shakespeare’s home unearthed after 150 years | William Shakespeare

    A will that has been lost for more than 150 years and was at the centre of a bitter legal battle by William Shakespeare’s family over who owned the playwright’s final home has been unearthed in an unlabelled box at the National Archives.

    The original 1642 document was made by Thomas Nash, who was married to Shakespeare’s granddaughter Elizabeth Hall. In it, he bequeathed New Place, reputedly the second grandest house in Stratford-upon-Avon, to his own cousin Edward Nash.

    However, on Thomas’s death in 1647, Shakespeare’s daughter, Susanna Hall, and granddaughter Elizabeth, Thomas’s widow, refused to honour the will, claiming Shakespeare’s own will had decreed the property be left to them and Thomas had no right to bequeath it.

    The result was chancery court proceedings, lodged by Edward against Elizabeth, to claim the valuable property.

    The Nash will has now been rediscovered in a box of unlabelled chancery documents from the 17th century and earlier by Dr Dan Gosling, a principal legal records specialist at the National Archives.

    “It was an incredible find,” said Gosling, who was sorting through the boxes, which were not catalogued or marked with dates or descriptions.

    A section of thee 1642 document. Photograph: The National Archives

    The will was known about in the mid-19th century after being seen by a Shakespeare scholar when originally held in the Rolls chapel. When documents were later sorted it ended up in the unmarked box. “It wasn’t listed, and then was left there for about 150 years or so,” said Gosling.

    Shakespeare bought New Place, a three-storied timber and brick dwelling, for £60 in 1597 and lived there until his death in 1616. It had 10 fireplaces, five handsome gables and grounds large enough to incorporate two barns and an orchard.

    Thomas Nash made the will while living at New Place with his Susanna and Elizabeth. Though Shakespeare’s will had left his land and the property to his daughter and granddaughter, “it is possible Thomas Nash was making this will in the expectation that he would outlive Susanna and Elizabeth”, said Gosling.

    “But what actually happened was he died in 1647. He was very young. Elizabeth was still only 39 and in fact remarried afterwards.” Susanna died in 1649.

    Susanna and Elizabeth created a deed of settlement confirming their rights. “Then Edward Nash takes Elizabeth to court. He argues the will of Thomas Nash was proved in the property court of Canterbury, and Elizabeth Nash, as the widow and executrix, was duty bound to abide by the terms of the will and give New Place to Edward Nash.”

    Elizabeth appeared at the chancery court to explain the lands and property were granted to her and her mother by “my grandfather William Shakespeare”. As part of proceedings she was asked to produce Thomas’s will, which is how the document eventually ended up in the chancery archives, now held by the National Archives.

    The upshot of the proceedings is not clear, but, Gosling said, it appears Edward never got to own the property. When Elizabeth died in 1670, having had no children and ending Shakespeare’s direct line of descendants, her will stipulated Edward Nash would have the right to acquire New Place.

    “She uses the words ‘according to my promise formally made to him’, which suggests some spoken procedures were made,” said Gosling. In the event, there is no recorded mention of Edward as owner of New Place, which went to the wealthy landowning Clopton family after Elizabeth’s death and was demolished in 1702.

    “It is such a lucky find,” said Gosling. “The chancery case is known about among some Shakespeare scholars and is mentioned in some Shakespeare histories but they always seem to refer back to the 19th century discovery of the will.”

    Now the original is documented, catalogued and available to the public for the first time in more than a century.

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  • Daniel Day-Lewis Returns In Film From Son Ronan

    Daniel Day-Lewis Returns In Film From Son Ronan

    Focus Features has unveiled a dark and intense first trailer for Anemone, the film bringing three-time Oscar winner Daniel Day-Lewis back to the big screen for the first time since Paul Thomas Anderson’s Phantom Thread in 2017, which looks like it could set him up for awards consideration once again.

    Marking the directorial debut of the actor’s son, Ronan Day-Lewis, the film is billed as an exploration of the complex and profound ties that exist between brothers, fathers, and sons. Its plot has been kept under wraps, and isn’t made entirely clear by the trailer, which introduces Daniel Day-Lewis as Ray Stoker, a man wrestling with his past out in a rainy and isolated, wooded location.

    The trailer largely centers on exchanges between Ray and a character played by Sean Bean.

    “All these years, the isolation. This is it. This is my life,” says Day-Lewis.

    Bean tells him that he’s “seen my share of lost souls,” but Day-Lewis insists he’s beyond his reach.

    Day-Lewis alludes to a dark history with the army, saying, The army teaches you to grin and bear it. The war was the crime and we were the phantom soldiers.”

    Bean says, “I can’t help you till he told me what happened,” to which Day-Lewis replies, “Is that a question? What do you want from me, brother? What do you want?”

    “You’re going to hell, brother,” Bean says. And Day-Lewis agrees, saying simply, “Family reunion.”

    Anemone is slated to open in limited release on October 3rd before expanding on October 10th. Ronan Day-Lewis directed from his script written with Daniel Day-Lewis, with Brad Pitt’s Plan B producing. Samuel Bottomley, Safia Oakley-Green, and Samantha Morton co-star.

    Prior to the announcement of Anemone, Daniel Day-Lewis had formally announced his retirement from acting, stating through his publicist, “Daniel Day-Lewis will no longer be working as an actor. He is immensely grateful to all of his collaborators and audiences over the many years.” Whether he’ll be back for more projects beyond Focus’ father-son collaboration isn’t yet clear.

    Other films set for an October 3 launch include A24’s The Smashing Machine, IFC Films’ buzzy dog-centric horror film Good Boy, and the horror thriller Bone Lake from Bleecker Street, to name just a few. Check out the trailer for Anemone by clicking above.

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  • Surgical Decision-Making Experience of Patients with Lumbar Disc Herni

    Surgical Decision-Making Experience of Patients with Lumbar Disc Herni

    Introduction

    Lumbar disc herniation (LDH) is caused by the rupture of the annulus fibrosus of the intervertebral disc and the protrusion of the nucleus pulposus pressing on the nerve root or dural sac. The primary clinical manifestations include lower back pain with radiating pain, numbness in the lower extremities, and even cauda equine syndrome.1,2 LDH – related low back pain imposes a substantial global health burden, significantly impairing patients’ work capacity and quality of life.3 Epidemiological data indicate that up 80% of the elderly population experience varying degrees of disc degeneration, with an increasing incidence among younger individuals as well.4,5

    While conservative therapies are often effective in alleviating symptoms, clinical evidence suggests that surgical intervention, particularly discectomy, remains the most effective option for alleviating persistent symptoms in refractory patients.6 Compared with non-surgical management, surgery provides more rapid pain relief,7 sustained symptom improvement,8 and accelerated return to daily activities or work earlier.9 However, for patients facing this choice, the decision to undergo surgery is not merely a medical issue, but a complex process influenced by physiological, psychological, and sociocultural factors.10 Emerging evidence reveals that patients often face psychological stress and decisional conflict while choosing surgical treatment. In addition to considering the physiological impact of the disease, they need to make comprehensive judgments in various aspects such as emotions, cognition, and social support.11–13 Studies have shown that only 63%–70% of patients express a strong preference for surgical treatment, reflecting the challenges patients face in spinal surgery.14

    In recent years, shared decision-making (SDM) has gained prominence as a core component of patient-centered care. SDM emphasizes the active involvement of patients in treatment decisions, supported by transparent communication and mutual respect.15 Particularly suitable for diseases involving multi-scheme trade-offs and value judgments, it has also been studied in spinal surgery.14,16 However, most research on spinal surgery decision-making focuses on the “patient-centered” healthcare systems in Europe and America, while relatively few studies exist for China’s physician-dominated, hierarchical healthcare system with evident characteristics.17,18 In contrast, China’s physician-dominated and hierarchical healthcare model presents significant barriers to SDM,19 including communication asymmetry, implicit deference to medical authority, and family-driven decision norms. These factors have not yet been fully explored in the existing literature.

    Furthermore, with the development of digital media, patients are increasingly inclined to obtain pre- and post-operative health information through social media and short video platforms. However, research indicates that the quality of content related to spinal surgery on such platforms varies widely. Tejas’s study reveals that the overall quality of spinal surgery-related videos on TikTok is generally low, with much of the content originating from non-professional homo sapiens individuals. Such inaccuracies may lead patients to develop false expectations, receive inappropriate recovery advice, or even negatively influence their surgical decision-making.20 Broader research has also confirmed that medical misinformation spreads rapidly on social platforms, easily triggering decision-making confusion and emotional fluctuations; moreover, patients’ unmet information needs are strongly associated with preoperative anxiety and confusion.21,22

    Although previous studies have explored decision-making in LDH using quantitative or qualitative studies,19 few have examined the deeper psychological and cultural experiences from the patient’s own perspective, particularly within the Chinese context. Quantitative methods, while valuable for assessing measurable outcomes such as satisfaction or decisional conflict, often fail to capture the nuanced, lived experiences of patients navigating high-stakes clinical choices. Considering the inherent technical complexity and emotional sensitivity of spinal surgery, phenomenological qualitative research emphasizes understanding individuals’ “lived experiences” within specific contexts, particularly focusing on their perceptions, meaning-making, and emotional responses. This approach is better suited to capturing the implicit value judgments, cultural attachments, and emotional struggles embedded in the decision-making process of spinal surgery, thereby facilitating a patient-centered reconstruction of their decision-making journey within highly uncertain medical environments.

    Therefore, the present study adopts a qualitative approach to comprehensively explore patients’ experiences and unmet needs during the decision-making. Through meticulous understanding of patients’ perceptions and needs, healthcare providers can enhance their comprehension of patients’ psychosomatic status, thereby facilitating personalized care planning and contributing to a more culturally grounded and humanized understanding of shared decision-making (SDM). The findings may inform the development of patient-centered communication strategies and decision-support tools, ultimately improving patient engagement, satisfaction, and trust in spine care.

    Material and Methods

    Study Design

    This study adopted a qualitative design grounded in phenomenological methodology to explore the decision-making experiences of patients with LDH considering surgical treatment. One-on-one, semi-structured, in-depth interviews were conducted to elicit rich narratives of participants’ lived experiences. This approach enabled a comprehensive understanding of contextual factors and emergent themes that influence decision-making in a real-world clinical setting.

    Participants and Recruitment

    A purposive sampling method was used to recruit participants. The inclusion criteria were as follows: (1) age ≥ 18 years old; (2) had MRI verified LDH; (3) considering or had undergone lumbar surgery; (4) willingness to join this study and had ability to communicate in Mandarin. The exclusion criteria were: (1) previous revision spinal surgery; (2) incomprehensible language expression; (3) presence of severe psychiatric disorders (eg, schizophrenia, bipolar disorder, or cognitive impairment that may affect informed consent or participation).

    Notably, common psychological comorbidities such as mild-to-moderate depression, anxiety, or insomnia were not grounds for exclusion, given their frequent association with LDH and chronic pain.

    Development of Interview Outline

    The interview guide was developed based on a comprehensive review of relevant domestic and international literature and in consultation with experts in orthopedics and qualitative research. The guide was pilot-tested with two patients, and refined iteratively. All questions were open-ended to encourage detailed responses. The main interview questions were as follows:

    1. Why did you choose surgical treatment for your condition?

    2. What kind of mental journey did you go through throughout the entire decision-making process? Can you describe the decision-making process?

    3. In the decision-making process, how do the opinions of others influence you?

    4. What kind of support or assistance did you wish to receive while making the decision?

    5. How would you rate the clarity of the information when a doctor explains the possible risks and benefits of a surgery to you?

    6. Before this surgery, did you have any disagreements or inconsistencies with your physician? How were they resolved? In this process, did you feel that your concerns were fully listened to?

    7. What were your expectation after opting for surgery?

    8. What were the most important factors influencing your decision to undergo surgery?

    All interviews were carefully designed and scheduled to avoid interfering with patients’ clinical care or treatment decisions. This was achieved by coordinating interview times with the clinical team and selecting periods that did not overlap with medical consultations or procedures.

    Data Collection

    Data was collected through semi-structured face-to-face interviews, creating a space for participants to openly share their views. Interviews took place either the day before or the day after surgery and lasted approximately 20–40 minutes. All interviews were conducted by a trained qualitative researcher, who had no therapeutic relationship with participants. To minimize researcher bias, reflexivity was maintained through bracketing and reflective journaling. The interview was conducted a quiet, private setting—either a clinic room or a designated interview area and recorded in Chinese. The questions were refined during the process of data collection and analysis to ensure that rich information was gathered to achieve the aim of the study. Data collection continued until data saturation was achieved after interviewing 20 participants, indicating that no new or surprising information was uncovered during further data gathering.23 Two more participants were interviewed to validate the identified themes. Finally, demographic and clinical information was obtained prior the interview.

    Data Analysis

    Audio recordings were transcribed into written text word for word within 24 hours after the interviews by one researcher, and another researcher verified both the recordings and the transcripts to ensure the accuracy of the data. Colaizzi’s 7-step method was used to analyze the interview data,24,25 which involved: (1) reading through the transcripts carefully, (2) picking out significant statements, (3) coding the important ideas, (4) organizing those codes into themes, (5) describing the themes, (6) grouping similar themes together into final concepts, and (7) going back to the participants to confirm everything. Upon completion of the data analysis, the research findings were presented to the interviewees for validation to ensure the accuracy. We also held regular meetings to discuss any disagreements.

    Quality Control

    To ensure the rigor of the research, two criteria were adopted: credibility and confirmability. The credibility issue is addressed through member checks, and participants have the opportunity to review and verify the identified topics and sub-topics. The research team included experts in spinal surgery and nursing, who played a role in data analysis. They reviewed and confirmed the topics, further enhancing the credibility of the results. Any ambiguities or differences related to the theme and sub-themes have been thoroughly discussed and resolved through the collaborative efforts within the research team. To address the issue of translating from Chinese to English, we have followed a powerful translation and backtranslation process to ensure the accuracy and credibility of the data. To enhance certainty, researchers actively engage in thorough self-reflection, maintaining a high degree of honesty and openness. Throughout the research process, the researchers held group discussions to explore and exchange their thoughts and insights on this study, their behavior in the interviews with participants. In addition, researchers have received rigorous training in qualitative research methods, equipping them with the fundamental skills and knowledge to conduct reliable research and ensure the validity of the results.

    Ethical Considerations

    The study has been approved by the Ethics Committee of Shanghai Tongren Hospital (reference number: 2025-008-01), and it complies with the Declaration of Helsinki. All participants were informed of the purpose and procedures of the study and provided written informed consent including permission to publish anonymized direct quotes before the interview. To ensure confidentiality and data security, all audio recordings and transcribed files were stored on encrypted, password-protected computers accessible only to authorized research team members. No personally identifiable information was included in published results.

    Results

    Participant Characteristics

    A total of 20 patients participated in semi-structured interviews. The average age of participants was 62.6 years (range: 27–78 years), including 11 females and 9 males. The average duration of illness was 62.45 months. At the time of interview, 13 participants had already undergone surgery, while 7 were scheduled for surgery. Detailed demographic and clinical characteristics of participants are presented in Table 1.

    Table 1 The Characteristics of Participants (N = 20)

    Thematic analysis of the interview data resulted in the identification of four major themes and twelve sub-themes. These themes capture the multifaceted experiences of LDH patients in navigating the surgical decision-making process. The main themes and sub-themes are presented in Table 2.

    Table 2 Themes and Sub-Themes From Interviews and Representative Quotes

    Motivations Underlying the Surgical Decision

    Patients with LDH have different experiences of the disease, and the motivations behind surgical decisions vary.

    Ineffectiveness of Conservative Treatment

    Most participants had experienced a long duration of illness and had attempted various conservative treatments, such as traditional Chinese medicine, physiotherapy, and self-medication. However, over time, the respondents realized that traditional conservative treatments could no longer alleviate the symptoms and were not suitable for their current situation, surgery is the last possible choice to return to a normal life.

    Because I felt that conservative treatment made no difference, I’ve seen Chinese medicine doctors and tried acupuncture, but the pain hasn’t eased at all. In some ways, it’s even gotten worse. (N12)

    I’ve tried many methods to treat my back pain myself, buying many different types of plasters and patches, but none of them worked. (N4)

    Decline in Quality of Life

    Severe pain and neurological symptoms such as numbness or gait disturbances contributed significantly to patients’ perceived need for surgery. A minority of patients emphasize that disease-associated symptoms bring many inconveniences to the patients. With compromised mobility and flexibility profoundly undermining occupational performance and activities of daily living (ADLs), ultimately precipitating significant QoL deterioration through progressive loss of functional autonomy. Restoring quality of life was a critical motivator for choosing surgery.

    My back pain is so severe that I can’t even walk to the bathroom at night. I can’t walk at all. Sometimes I have to crawl back to bed. (N1)

    Because of this disease, my quality of life has been severely reduced. I can’t do my normal work or social life. I’m only in my thirties, and I don’t want to live like this anymore. I am looking forward to the surgical treatment allowing me to return to a normal life. (N13)

    I used to love playing table tennis, but now I find it difficult. When I do play, one of my lower limbs is significantly weak, and I can’t do any sports. I can’t accept this. (N10)

    I choose the proactive surgical treatment plan to improve my quality of life. (N17)

    Trust in Surgeons’ Reputation and Expertise

    Patients in our country expressed high levels of trust in the reputation skill and professional expertise of surgeons. Many viewed doctors as authority figures and relied on their recommendations without hesitation.

    I heard that the Central Hospital of xxx is good at treating lumbar spine issues and has a good reputation, so I made an appointment to see. After the professor looked at the scans, he told me that my condition required surgery, so I followed his advice. (Didn’t you discuss it with your family?) There was nothing to discuss. If the professor says surgery is needed, they have so much experience, their judgment must be right. (N6)

    I learned from the internet that Director Ye is very professional and excellent in the field of lumbar spine. (N19)

    Decision-Making Dilemmas Arising From Insufficient Patient Information

    Patients Lack Knowledge About Surgery and the Disease

    Most patients with LDH are elderly. Their medical knowledge reserves are inadequate. They do not know much about their condition and have little understanding of treatment information. This knowledge gap led to an unquestioning reliance on physicians’ recommendations, with patients perceiving themselves as passive participants in the decision-making process.

    I’m definitely going to follow the doctor’s advice; whatever the doctor says, that’s what I’ll do. Since I’ve come to him for treatment, I trust him 100%. (N9)

    I’m from the countryside and know nothing about this area, I just listen to whatever the doctor says” (N20)

    Information Overload and Patients are Unable to Filter Useful Information Online

    In the era of information explosion, a wide array of information media and fragmented information are omnipresent. This situation enables individuals to access information resources with relative ease. Although digital access to health information is widespread, patients reported difficulties in discerning accurate, trustworthy resources. The overwhelming volume of conflicting online messages contributed to confusion and indecision. Besides, considering the limited medical resources in our country, patients frequently struggle to obtain professional information guidance.

    I try to search for information related to my own diseases online, but the quality of the information cannot meet my needs. I couldn’t tell which information was reliable. (N8)

    There’s too much information on the internet. It’s hard to tell what’s true, and it just made me more anxious. (N12)

    Limited Communication Time with Physicians

    Many participants mentioned that they wished they had more time to discuss things with their doctors, but acknowledged how packed the doctors’ schedules were.

    Doctors are busy with surgeries every day, and there’s not much time to talk. I don’t want to disturb them. (N3)

    Communicating with several doctors in a really short time. It’s just an awful experience. I’m bombarded with all sorts of information simultaneously, and it’s overwhelming. (N10)

    The Multi-Dimensional Factors Influencing Decision- Making

    Perceived Severity of the Condition

    The extent to which patients perceived their illness as severe directly influenced their willingness to undergo surgery. Many participants reported that earlier mild symptoms were tolerable, but as pain and dysfunction progressed, surgery became increasingly justified in their minds.

    I’ve known about this condition for over ten years. At first, I didn’t worry since there were no symptoms and it didn’t affect my life. So, I thought surgery wasn’t necessary. However, recently, the situation gotten much worse, the pain is affecting my walking. I can’t tolerate it anymore, so I’ve decided on surgery. (N4)

    The pain is truly excruciating. As long as I can get rid of this torture, I’m willing to have the surgery, regardless of the risks involved. (N11)

    Anxiety About Surgical Outcomes

    Although participants are convinced of the efficacy of surgery, they expressed concerns about potential complications and the recurrence of the condition. These apprehensions accompany them throughout the preoperative decision – making process.

    My concerns mainly revolve around the risks of surgery-what if I lose mobility and need daily care? (N9)

    I don’t know how long the surgery’s effects will last. I’m very scared the herniation occurring again after the surgery. (N6)

    Influence of Others’ Experiences

    Patients were highly influenced by the experiences and opinions of family members, friends, or peers with similar conditions when making decisions about their medical treatment. The experiences of other patients often play a significant role in shaping the surgical choices of the interviewees.

    Getting a second opinion really helped. It gave me more confidence. At first, I didn’t want surgery. But my neighbor had the same problem and recovered well after surgery. Since he could do it, I thought I could too. So, I decided to have the surgery to solve the problem once and for all. (N18)

    I saw posts on TikTok and Xiaohongshu. Some said they recovered well, but a few said they regretted it. This makes me indecisive about whether to have the operation. (N17)

    Patients Express Unmet Peri-Operative Needs

    The Importance of Psychological Care

    Many patients described experiencing anxiety, fear during the perioperative period, particularly when they must to make surgical decisions in a short time. They expressed a strong desire for empathetic communication and psychological reassurance from healthcare professionals.

    I’m having surgery soon and I’m extremely nervous. I’ve always been kind of sensitive. Just thinking about the surgery gives me the jitters. I really wish the nurses or doctors would spend more time talking with me and show me some care. This interview is actually comforting. It’s great to have someone who’s willing to listen to me and let me be myself. (N13)

    I hope my doctor and nurse not only focus on the surgical outcomes, but also really care about how I’m feeling. (N2)

    Patients’ Expectations of Personalized Guidance on Home Rehabilitation Exercises From Relevant Departments to Meet Healthcare Needs

    Patients emphasized a lack of clarity regarding postoperative rehabilitation. They emphasized the need for professional advice from healthcare providers, ideally to create a rehabilitation plan for themselves to help address issues that arise during home rehabilitation.

    The doctor told me a lot before the operation, but I still need to talk to them. I I still need to consult again after surgery. I want to know what to do and what to avoid during recover. (N19)

    They told me to stay in bed unless necessary. But I want to know how long, when I can start walking, and how to exercise while bedridden. (N5)

    When I’m discharged, I’d like to have the therapist’s contact information. That way I know who to call if something goes wrong during recovery at home. (N10)

    Desire for Clear and Accessible Preoperative Information

    Participants emphasized the importance of receiving straightforward, comprehensible, and sufficient information prior to surgery. If surgeons can give patients clear, straightforward, and thorough information, the patients’ stress will be significantly reduced. Several respondents reported difficulty understanding the medical terminology used during consent discussions, contributing to feelings of pressure and confusion.

    “The doctor’s explanation before surgery really helped. It gave me peace of mind and a positive outlook”. (N16)

    During the preoperative conversation, the doctor mentioned a lot of professional knowledge, and before I could fully understand, I was asked to sign. It would be wonderful if the medical staff could explain things in simpler and more accessible language. (N12)

    Discussion

    This study revealed the complex and multifactorial nature of surgical decision-making among patients with LDH. Pain, disability, and the decline in quality of life were identified key factors driving patients’ decisions.26 Consistent with the qualitative research results of Lin,27 surgery was often accepted as the only way to relieve their pain.

    Furthermore, this study also identified areas that were lacking in previous research. The findings indicate that in the context of traditional Chinese culture, patients exhibit a high level of trust in the authority of doctors during the decision-making process.28 A similar phenomena is observed in other East Asian countries with Confucian cultural backgrounds, such as Japan and South Korea. Studies suggest that patients in these regions tend to rely on doctors’ professional assessments rather than actively expressing their personal preferences.29,30 This model contrasts sharply with the decision-making culture of “informed autonomy” advocated by Western countries. For example, in countries like the United States and Canada, patients tend to actively participate in treatment decisions after obtaining information.31,32 This cultural difference suggests that the local promotion of the Western SDM model in China urgently needs to undergo localization transformation. To improve the adaptability of SDM in the hierarchical medical system, we suggest establishing a “culturally adaptive SDM model”, that takes into account both patients’ trust in authority and their need to express their personal will. This model should integrate the cultural background of patients, the tendency to respect authority and the tradition of family negotiation. Specific strategies include introducing “intermediary communicators” (such as nurses or patient educators), setting up patient support groups and using visual information assistance tools, thereby gradually achieving the transition from “passive compliance” to “active participation”, and enhancing the transparency and satisfaction of decision-making. This proposition echoes the current development status of SDM in China and the demand for cultural integration.28

    Our study also show the critical role of health information accessibility in patients’ surgical decisions. Respondents generally reported that in the process of obtaining disease information, they often felt confused due to the fragmentation and self-contradiction of online information, and found it difficult to assess the credibility of digital content, thus showing obvious information anxiety. Research have shown that 60% of Chinese people will use the Internet to search for information related to health, medical care and diseases.33 However, digital health literacy varies greatly, especially among the elderly, which leads to difficulties for some patients in information screening and understanding, thereby affecting the quality of their decision-making. This phenomenon also exists in international research. A British study shows that about 47% of elderly patients are unable to effectively distinguish the authenticity of online health content.34 It reflects the widespread challenges to digital health literacy on an international scale. In response to this issue, Europe and America have explored methods such as “doctor-patient joint screening content platforms”, where medical institutions and patients jointly determine authoritative information sources and enhance the accessibility and pertinence of information through targeted delivery. Studies show that such practices can help alleviate information misguidance and decision-making anxiety.35 In contrast, China has not yet established a unified health information release system led by authoritative institutions. Social media and commercial platforms still dominate information dissemination. There is a lack of interconnection and interoperability among the internal information systems of hospitals, presenting a distinct fragmented feature. This leads patients to often wander, feel anxious and even misjudge among non-standard information. Therefore, the study suggests that the government or large medical institutions take the lead in building a health information platform that is hierarchical, classified, structurally clear and visually presented. The platform should be customized based on the audience’s educational level, age and information needs to enhance the efficiency of information screening and comprehension ability. On the other hand, supervision over online platforms should be strengthened, the release of information on social media should be standardized, and disease science popularization knowledge that has been reviewed and certified by authoritative institutions should be disseminated to help patients establish correct diagnosis and treatment concepts.

    Another common problem is the limited time for doctor-patient communication. Studies have shown that approximately 50% of patients believe that their communication time with doctors is insufficient.36 Such communication limitations often lead to patients’ insufficient understanding of the disease and treatment plans, which in turn affects their decision-making confidence and compliance. Existing evidence shows that when clinicians provide detailed explanations of the surgical procedures and postoperative rehabilitation paths before the operation, patients’ confidence will significantly increase.37,38 Given the current tight medical human resources and limited average consultation time in our country, we suggest developing a surgical decision-making assistance tool that is “nurse-led and involves family members”. By integrating text, images, videos, frequently asked questions and postoperative rehabilitation processes, continuous and comprehensive information support is provided for patients and their families, making up for the communication gap caused by insufficient doctor-patient communication time. This helps patients better complete preoperative preparations and psychological construction, thereby reducing decision-making conflicts. International research shows that such digital tools can help reduce decision-making conflicts and improve postoperative satisfaction, and to a certain extent, optimize the allocation of medical resources.39,40

    Another finding is the impact of social support on patients’ decision-making. This study found that many patients are easily influenced by friends, family members or those with similar conditions when making decisions. Especially when there are successful cases around, patients are more inclined to undergo surgical treatment. This phenomenon is called “residual effects of others’ surgeries”, and it is not unique to China. A study in Germany on treatment options for prostate cancer also pointed out that nearly half of the patients believed that the influence of “familiar experience” was greater than that of professional explanations from doctors.41 This discovery suggests that in clinical practice, the “patient experience narrative” module can be moderately introduced. By presenting the treatment experiences of real patients, it helps new patients build a sense of identification at the emotional level, thereby enhancing their acceptance of the treatment plan. We suggest introducing a “patient story” section in outpatient consultations or preoperative education, making real cases emotional anchors. This will enhance the effective transmission of clinical information through emotional identification, thereby creating a warmer decision-making environment.

    Moreover, the psychological vulnerability demonstrated by the patients has strengthened the call for incorporating mental health support into the surgical approach. Common psychological burdens during the perioperative period, including preoperative anxiety, decision-making conflicts, and concerns about surgical complications, have become widespread clinical manifestations. At the same time, patients’ concerns about the postoperative rehabilitation effect also significantly reflect the absence of psychological intervention in the current surgical management process. Most patients expressed the need for professionals so that they could contact them in time if they encountered problems after returning home. Multiple references42,43 have pointed out this demand, and the implementation of digital therapies with personalized exercise programs may meet these demands while reducing the cost of medical resource consumption. Therefore, we suggest embedding systematic psychological intervention strategies in the surgical management pathway and enhancing accessibility and operational convenience through digital means. Specifically, preoperative emotional assessment, postoperative psychological counseling, personalized rehabilitation plans and multi-disciplinary support services can be provided through the mobile health platform (mHealth).

    Ultimately, these research results indicate that surgical decision-making is not only a rational and evidence-based process but also deeply influenced by emotional, informational and socio-cultural factors. A patient-centered approach should be adopted, providing personalized health education based on patients’ conditions, encouraging them to participate in joint decision-making, and integrating digital tools to make the communication and treatment process more efficient and convenient.

    Strengths and Limitations

    This study employs qualitative research method to explore their real experiences during the surgical decision-making process from the patients’ perspectives. An in – depth exploration was conducted into the difficulties and needs that patients with lumbar disc herniation encounter during the surgical decision – making process. Through in-depth, semi-structured interviews, this study captured rich, first-person narratives that reveal the emotional, cognitive, and contextual factors influencing patients’ choices. This patient-centered approach provides valuable insights for improving shared decision-making and tailoring perioperative care strategies.

    However, this study still has certain limitations. First, the samples were sourced from a single center, with relatively monotonous sample composition, failing to fully cover the perspectives of all age groups and lacked the inclusion of non-surgical patients, thus limiting its universality. At the same time, only including the patient’s perspective limits the comprehensive understanding of the decision. Second, all interviews were conducted within a relatively short time frame and did not include longitudinal follow-up, which restricts our understanding of how perceptions may evolve over time. Third, interviewer bias and interpretive subjectivity are inherent risks in qualitative research, although we minimized these through reflexivity and peer debriefing. Finally, some interviews were conducted during the postoperative phase, which may introduce recall bias and affect patients’ accurate expression of their preoperative psychological state and information acquisition process. Future research should incorporate mixed-methods to assess the prevalence and intensity of decision-making conflict across diverse age groups and clinical settings. Longitudinal studies are also necessary to evaluate how decision-making experiences influence postoperative recovery and satisfaction over time. Meanwhile, expand the sample size to include populations of “surgery refusal” or “secondary medical consultation” Homo sapiens, enriching the comparative dimensions.

    Conclusion

    This study delineates the complex psychological and social influcing factors underlying surgical decision-making processes in lumbar disc herniation (LDH) patients, covering motivation-driven, information dilematism, emotional and family intervention, as well as lack of perioperative support. These topics reveal the complexity of surgical decisions. To improve the decision-making experience and clinical outcomes, healthcare providers should actively engage patients in open dialogue, provide individualized information support, address emotional concerns, and guide family members to actively participate in appropriate situations. Meanwhile, digital tools can effectively extend support outside the hospital by providing convenient and interactive information resources, enhancing the continuity and accessibility of decision-making.

    This study highlights the critical need for a patient-centered decision-support system that integrates psychosocial support, culturally informed communication, and tailored educational strategies-ultimately empowering patients with LDH to make informed surgical decisions aligned with their values and needs.

    Data Sharing Statement

    Data sharing is not applicable to this article as no data were created or analyzed in this study.

    Acknowledgments

    The authors are grateful to all the patients who participated in this study.

    Funding

    This work was supported by the Medical-engineering crossover project of Shanghai Jiao Tong University (No. YG2022ZD030) and National Health Commission of the People’s Republic of China (No. WKZX2023WX0141).

    Disclosure

    The authors report no conflicts of interest in this work.

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  • Chicago Bulls Announce Derrick Rose Jersey Retirement Night – January 24, 2026 – NBA

    Chicago Bulls Announce Derrick Rose Jersey Retirement Night – January 24, 2026 – NBA

    1. Chicago Bulls Announce Derrick Rose Jersey Retirement Night – January 24, 2026  NBA
    2. WATCH: Bulls release video telling Derrick Rose his No. 1 will be retired  sportingnews.com
    3. Chicago Bulls to retire Derrick Rose’s jersey: Date, reasons, and everything you need to know  Mint
    4. Bulls set date to retire Derrick Rose’s jersey: Former MVP to become fifth player honored in franchise history  CBS Sports
    5. Chicago Bulls Make Big Derrick Rose Announcement on Thursday  Sports Illustrated

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  • Governor Kundi highlights KP’s challenges, national unity in Belgium

    Governor Kundi highlights KP’s challenges, national unity in Belgium

    Governor Khyber Pakhtunkhwa Faisal Karim Kundi has urged the international community to recognize that developing countries like Pakistan are paying the highest price for terrorism and climate change, despite the crisis being caused largely by developed nations.
     
    He said this while addressing a luncheon hosted in his honor by Pakistan Peoples Party (PPP) Belgium President Malik Ajmal, attended by a large number of Pakistani community members residing in Belgium on Thursday.
     
    In his speech, Governor Kundi said that after decades of terrorism, Khyber Pakhtunkhwa is now facing the devastating impacts of climate change and floods.
     
    “The world must realize that developing countries like Pakistan are suffering the most because of the actions of developed nations,” he stressed.
     
    He lauded the Sindh government for always standing by KP in difficult times, adding that it was once again extending support to flood-affected families.

    He said that as head of the Red Crescent Society, he was personally monitoring relief activities across the province.

    Criticizing deforestation, Governor Kundi said natural disasters had worsened due to the unchecked cutting of forests. “I could not find the so-called Billion Tree Tsunami anywhere today,” he remarked.
     
    Turning to security, he said peace could not be restored without intelligence-based operations, as terrorists do not recognize dialogue.
     
    “Terrorists are equipped with modern weapons; the police alone cannot fight them,” he said, recalling that peace in Swat was achieved during the PPP government through a military operation.
     
    He accused the previous government of bringing back militants, who are now again taking up arms.
     
    Highlighting financial issues, he said that although KP received Rs. 700 billion under the NFC Award, the provincial government had failed to answer where the funds were spent.
     
    He reminded that at the time of FATA’s merger, it was promised that Rs. 100 billion would be spent annually, but the commitment was never fulfilled, leaving the former tribal districts deprived of basic facilities.
     
    Governor Kundi reiterated that peace was the province’s foremost challenge, accusing militants of receiving support from India and Afghanistan.
     
    He said Pakistan was trying to resolve issues with Afghanistan at all levels through dialogue, while urging anti-state elements to lay down their arms.
     
    On social welfare, he said that more than 10 million people were benefiting from the Benazir Income Support Programme (BISP), which, he said, embodied the slogan of “Roti, Kapra aur Makaan.”
     
    Discussing politics, Governor Kundi said that Parliament was being weakened by politicians themselves.
     
    He said that the Chief Election Commissioner had been appointed by the previous government, adding that political differences should be settled through politics, not by targeting state institutions.
     
    Speaking on foreign relations, he said India was humbled by Pakistan’s armed forces and praised PPP Chairman Bilawal Bhutto Zardari for effectively presenting Pakistan’s case on the international stage. “PPP can never forget the Kashmir cause,” he emphasized.
     
    He also recalled that despite not having a majority, PPP succeeded in passing the NFC Award and the 18th Amendment through consensus.
     
    “In the new NFC, we will fight for a greater share for Khyber Pakhtunkhwa,” he vowed, expressing optimism that Pakistan was moving in the right direction.
     
    Governor Kundi acknowledged the valuable role of overseas Pakistanis, saying they had always stood with the country in testing times.


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  • Billions Lost as 5G Spectrum Auction Faces Delays

    Billions Lost as 5G Spectrum Auction Faces Delays

    The delay in Pakistan’s 5G spectrum auction has cost the exchequer billions in potential revenue. An Auditor General audit flagged indecision and weak coordination between PTA and MoITT.

    The main reason for the delay is uncertainty over the proposed PTCL–Telenor Pakistan merger. The Competition Commission of Pakistan (CCP) is yet to decide, citing incomplete documentation from PTCL.

    Minister for IT and Telecommunication Shaza Fatima Khawaja said the ministry cannot influence the CCP. She stressed that the body is independent and must complete its review.

    The 5G Spectrum Auction Advisory Committee, led by the finance minister, will act only after the CCP delivers its verdict.

    A senior IT Ministry official said the auction design depends on the number of operators post-merger. He explained that the terms vary if there are four or three players.

    Pakistan currently has four telecom operators. Jazz holds a 37% share, Zong 26%, Telenor 22%, and Ufone—PTCL’s subsidiary—13%.

    Officials added that PTCL’s submissions were unclear and required further clarification. This has further prolonged the CCP’s decision-making process.

    Concerns remain due to Ufone’s consistent financial losses, unlike the profitable performance of Jazz, Zong, and Telenor.

    A PTCL-Ufone spokesperson did not respond to media queries despite repeated requests.

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  • expert reaction to observational study looking at GLP-1 receptor agonists and associated cancer risk in adults with obesity

    An observational study published in JAMA Oncology looks at GLP-1 receptor agonists and cancer risk in adults with obesity. 

     

    Prof Paul Pharoah, Professor of Cancer Epidemiology, Cedars-Sinai Medical Center, said:

    “GLP1 receptor agonists are a fairly new class of agents that can be used to treat type 2 diabetes and help in the management of obesity.  Obesity is known to be associated with an increased risk of several different types of cancer, though whether these associations are causal for all cancers is not clear.  So it is a reasonable hypothesis that drugs that help reduce weight might also reduce the risk of obesity related cancers.  The authors of this study have used a large database of healthcare records of over 20 million individuals in the USA.  They identified 44,000 individuals who had been prescribed a GLP1 receptor agonist.  These individuals were ‘propensity score matched’ to the same number of individuals who had not been prescribed these drugs.  Over an eight year follow-up the incidence of cancer in the individuals who had been prescribed these drugs was 17% lower than the incidence in individuals who had not been prescribed the drugs.  This figure is a relative risk reduction – the absolute risk reduction was 2.8 per 1000 person per year.  The biggest reduction was observed for ovarian cancer.

    “While these results suggest that GLP1 receptor agonist have an effect on cancer risk the presence of an association does not mean that the association is a causal one.  While propensity score matching does reduce the chance of bias affecting the results, the study design is still an observational one and there is still the potential for differences between the groups for factors that have not been included in the propensity score.  An observational study, no matter how carefully conducted, cannot replicate a randomised controlled trial, which would be regarded as gold standard to evaluate the effects of a drug.

    “There is one particular feature of the results that makes me particularly cautious in interpreting them.  Figure 2 in the paper shows the cancer risk over time in the two groups.  The difference in risk occurs within one year of the start of treatment with GLP1 receptor agonists – after the first year the two lines are completely parallel.  This pattern is unlikely if GLP1 receptor agonists had a causal relationship with cancer risk. Such a pattern could easily be explained by increased health surveillance occurring in the months/years before individuals are prescribed these drugs.”

     

    Dr Stephen Lawrence, Associate Clinical Professor, University of Warwick, said:

    General Comment:

    “The study suggests that using GLP-1 drugs is linked to a lower risk of obesity-related cancers, particularly benefiting certain women’s cancers. However, it did observe a slight increase in kidney cancer cases among GLP-1 users, which was not statistically significant.  Further research is needed before drawing any firm conclusions. For most people, the benefits clearly outweigh these relatively minor concerns. The science is promising, but more research will be important to confirm these findings as more individuals begin these treatments.”

     

     What Did the Study Do?

    “Trial emulation: instead of a gold-standard randomised trial, clever researchers in Florida, Georgia and Alabama re-created one using real-life health records for over 86,000 adults living with obesity or excess weight.

    “Groups compared: about half started on a GLP-1 medicine; the other half did not.”

     

     The Headlines:

    “General cancer risk: people taking GLP-1 medications saw slightly fewer cancer diagnoses than those who did not. To put numbers on it: 83 cases per 10,000 patients per year for users, versus 91 per 10,000 for non-users. In practical terms, for every 1,250 people on the medicine, there was one fewer new case of cancer each year.

    “Women’s cancers: the study found fewer cases of womb (endometrial), ovarian and certain brain tumours (meningioma) among those taking GLP-1 medicines. Long story short, if you’re using these drugs, your odds dip further when it comes to these specific cancers.

    “Other cancers: there were hints of an associated benefit for some other cancer types, like breast and bladder, but not enough to warrant a standing ovation.

    “Kidney cancer: this result requires nuance. There was a slight uptick among users—two cases per 1,000 patients per year compared with 1.3 per 1,000 for non-users. That’s about six extra cases for every 10,000 patients treated over a year. Not ideal, but still a drop in the ocean against other health benefits.”

     

    Why Take All This With A Pinch of Salt?

    “This was an observational study, despite sophisticated matching and adjustment, it’s not quite as robust as a true randomised trial. Lifestyle factors, severity of obesity, and even how often a GP orders tests could tilt the results.

    “Weight loss is a confounder. The drop in cancer might be simply thanks to weight loss itself, not the medicine doing anything fancy. The presence of obesity increases the risk of some cancers.

    “There was a short follow-up for cancer. Cancer can brew quietly for years and the study may be too brief to capture very long-term effects.

    “Some cancers (like ovarian) had very few cases, making the findings less certain.”

     

     Implications for Patients and the Public:

    “For patients: GLP-1 drugs not only help shed pounds and lower blood sugar, but might add a modest bonus by being slightly associated with reducing overall cancer risk, especially for specific women’s cancers. The small associated increase in kidney cancer cases is worth monitoring—not panicking.

    “For clinicians: The overall health gains from GLP-1 medications remain far greater than these faint risks. Regular review, patient discussion and ongoing vigilance are key.

    “For the wider public: With millions now eligible for GLP-1 therapy, even small shifts in risk matter at scale. Nonetheless, these medicines remain widely safe, with a reassuring cancer profile—and only a whisper of concern about an associated increase in kidney cancer.”

     

    What Needs More Scrutiny?

    “1. Longer follow-up: to properly track cancer trends, much longer studies are needed.

    “2. Lab work: Is it the drug itself, or just the slimmer waistlines? Laboratory boffins have their work cut out.

    “3. **International ** Do results hold beyond the US? British and European populations may differ.

    “4. Cancer survivors: Are these drugs safe for those who’ve already had cancer?

    “5. Proper randomised trials: this gold standard remains worth pursuing—one for the wish-list.”

     

     

    ‘GLP-1 Receptor Agonists and Cancer Risk in Adults With Obesity’ by Hao Dai et al. was published in JAMA Oncology at 16:00 UK time on Thursday 21 August 2025. 

     

    DOI: 10.1001/jamaoncol.2025.2681

     

     

    Declared interests

    Dr Stephen Lawrence: ‘I declare that I have no competing interests. I hold no financial, professional, or personal relationships that could inappropriately influence, or be perceived to influence, the comments I have provided in relation to this review. This declaration is made in the interests of transparency and in keeping with standard academic and professional best practice.’

    Prof Paul Pharoah: No conflicts of interest.

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  • Premier League predictions: Chris Sutton v Wolf Alice bassist Theo Ellis

    Premier League predictions: Chris Sutton v Wolf Alice bassist Theo Ellis

    I didn’t feel Arsenal’s performance was there against Manchester United but still, at least they found a way to win.

    All the talk in this game is going to be about Viktor Gyokeres and whether he can get off the mark. There was such an overreaction after he didn’t score against Man United.

    He’s been written off as a dud in some quarters already! That’s the modern game, you can get written off after your first hour of playing in the Premier League.

    Not me though, no, I think he’ll come good.

    Leeds played with such intensity against Everton, although the penalty they won was slightly harsh.

    Will Daniel Farke’s side show that same level of bravery at the Emirates? Probably, and if so it’ll cost them.

    Sutton’s prediction: 4-0

    Theo’s prediction: 2-0

    Theo on Arsenal’s title hopes: It feels like the pressure is unbearable at our club. I don’t think we handle pressure well and we constantly want to win absolutely everything. But of course I think we can win the league this season. I feel like if it’s going to happen any time, then it will be now.

    I am glad Leeds are back in the Premier League. I miss Marcelo Bielsa Leeds, when they played chaos-ball – that was my favourite. But, look, I am an Arsenal fan so we are going to win this. Declan Rice to open the scoring from a long way out and Ethan Nwaneri to get the other in the 73rd minute. 2-0

    AI’s prediction: 4-1

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  • Waste from carbon capture helps extract critical minerals

    Waste from carbon capture helps extract critical minerals

     

    Today’s world runs on critical minerals. The elements are the building blocks of batteries, electronics, and a slew of other technologies and are often key to the economic and national security of a nation. In the US, most of these elements are imported, and researchers have been working for years to find domestic sources of these minerals to avoid supply chain disruptions.

    At the American Chemical Society Fall 2025 meeting, Pacific Northwest National Laboratory (PNNL) scientist Chinmayee Subban explained how she and her team extract critical minerals using the waste from a technology capable of tweaking ocean chemistry, to lower the costs of both processes.

    Critical mineral recovery processes almost always use acid-base chemistry; it’s precipitation chemistry at scale, Subban said. But industrial acids and bases can be expensive to manufacture and store, so “it’s always valuable if you can find low-grade waste chemicals that you could use for the extraction,” she said.

    Electrochemical ocean alkalinity enhancement, or OAE—a process wherein scientists increase the pH of seawater to draw carbon dioxide from the air and counter ocean acidification—offers one such source of acid. Through a public-private partnership with Ebb Carbon, PNNL scientists have deployed an OAE system developed by the company. The system uses electricity and a specialized membrane to separate ocean water into streams of acidic, basic (alkaline), and partially deionized water. But “the benefits of the ocean alkalinity are limited to the alkaline stream,” Subban said. “There’s a lot of acid that’s generated.”

    That waste acid can be used to extract minerals from another waste stream: the salty brine left over from desalination, which is the first step of the electrochemical OAE system. “Think of it as Lego blocks,” Subban said. If the steps are in the correct order, scientists can generate a couple of mineral coproducts depending on the starting feed water and local industrial ecology, she explained.

    So far, Subban’s team has demonstrated that waste acid can pull lithium from the salty brine produced during desalination. Her team has also pulled uranium from the water, and her future work will focus on extracting strontium, she said.

    They’ve also shown that waste acid can extract nickel from locally sourced olivine minerals, flipping the economics of domestic nickel extraction. The scientists showed that, even without accounting for any revenue from CO2 removal credits, “we were able to get sufficient net positive benefits” on the dollar per ton, she said. In fact, the waste acid digests the olivine faster than a commercial equivalent, Subban said, likely because the low grade acid contains a small amount of salt.

    To “take something that is a waste and [use it] to improve aspects of the lithium and nickel extraction will be incredibly beneficial down the road,” said Tyler Bridges, a graduate researcher at Virginia Tech and attendee of the presentation. “There’s a lot of exciting work that’s being done in that field right now,” he added.

    Chemical & Engineering News

    ISSN 0009-2347

    Copyright ©
    2025 American Chemical Society

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  • Midkine protein plays a preventive role against Alzheimer’s disease

    Midkine protein plays a preventive role against Alzheimer’s disease

    (MEMPHIS, Tenn. – August 21, 2025) Scientists at St. Jude Children’s Research Hospital demonstrated for the first time that the protein midkine plays a preventative role against Alzheimer’s disease. Midkine is known to accumulate in Alzheimer’s disease patients. Now, researchers have connected it with amyloid beta, a protein that accumulates in the brain, causing assemblies that are a hallmark of Alzheimer’s.

     

    In work published today in Nature Structural & Molecular Biology, the researchers revealed that midkine prevents amyloid beta from sticking together, and, consequently, Alzheimer’s disease models lacking midkine show more amyloid beta accumulation. The findings lay the groundwork to better understand the disease-preventing mechanism of midkine and subsequent drug discovery pathways.

     

    Midkine blocks Alzheimer’s amyloid assembly growth

     

    Midkine is a small, multifunctional growth factor protein found abundantly during embryonic development but also involved in normal cell growth. Its role in cell growth means that midkine is often overexpressed in cancer, making it a valuable biomarker. However, beyond some preliminary studies showing its increase in Alzheimer’s, midkine’s link to the neurodegenerative disease has been poorly understood.

     

    Corresponding author Junmin Peng, PhD, Departments of Structural Biology and Developmental Neurobiology, and his team utilized fluorescence assays, circular dichroism, electron microscopy and nuclear magnetic resonance with disease models that replicate amyloid beta accumulation to investigate the role of midkine in Alzheimer’s thoroughly. They found that midkine and amyloid beta have a similar pattern at the protein level.

     

    “We know that correlation is not causative, so we wanted to demonstrate convincingly that real interactions are occurring between the two proteins,” Peng explained.

     

    The researchers used a fluorescent sensor for amyloid beta assemblies, called thioflavin T, to show that the assemblies were broken up in the presence of midkine. Modeling of those data revealed that midkine inhibits amyloid beta elongation and secondary nucleation, two specific phases during assembly formation. Nuclear magnetic resonance confirmed this finding.

     

    “Once the amyloid beta assemblies grow, the signal becomes weaker and broader until it disappears because the technique can only analyze small molecules,” said Peng. “But when we add in midkine, the signal returns, showing that it inhibits the large assemblies.”

     

    Additionally, the researchers used Alzheimer’s disease mouse models that have increased amyloid beta and demonstrated that removing the midkine gene resulted in even higher levels of amyloid beta assemblies. These results point to the protective role the protein has against Alzheimer’s disease.

     

    The researchers have opened a potential avenue for drug discovery by identifying the apparent protective role of midkine. “We want to continue to understand how this protein binds to amyloid beta so we can design small molecules to do the same thing,” said Peng. “With this work, we hope to provide strategies for future treatment.”

     

    Authors and funding

     

    The study’s other co-corresponding authors are Yang Yang, Van Andel Institute, and Ping-Chung Chen, St. Jude. The study’s first authors are Masihuz Zaman, Shu Yang and Ya Huang, St. Jude. The study’s other authors are Geidy Serrano and Thomas Beach, Banner Sun Health Research Institute; Gang Yu, University of Texas Southwestern Medical Center; and Jay Yarbro, Yanhong Hao, Zhen Wang, Danting Liu, Kiara Harper, Hadeer Soliman, Alex Helphill, Sarah Harvey, Shondra Pruett-Miller, Valerie Stewart, Ajay Singh Tanwar, Ravi Kalathur, Christy Grace, Martin Turk, Sagar Chittori, Yun Jiao, Zhiping Wu, Anthony High, and Xusheng Wang, St. Jude.

     

    The study was supported by the National Institutes of Health (R01AG053987, RF1AG064909, RF1AG068581, U19AG069701, P30CA021765, U24NS072026, P30AG019610, P30AG072980), the Arizona Department of Health Services, the Arizona Biomedical Research Commission, the Michael J. Fox Foundation for Parkinson’s Research and the American Lebanese Syrian Associated Charities (ALSAC), the fundraising and awareness organization of St. Jude.

     

    St. Jude Media Relations Contact

    Chelsea Bryant

    Desk: (901) 595-0564

    Cell: (256) 244-2048

    [email protected]

    [email protected]

     

    St. Jude Children’s Research Hospital 

    St. Jude Children’s Research Hospital is leading the way the world understands, treats, and cures childhood catastrophic diseases. From cancer to life-threatening blood disorders, neurological conditions, and infectious diseases, St. Jude is dedicated to advancing cures and means of prevention through groundbreaking research and compassionate care. Through global collaborations and innovative science, St. Jude is working to ensure that every child, everywhere, has the best chance at a healthy future. To learn more, visit stjude.org, read St. Jude Progress, a digital magazine, and follow St. Jude on social media at @stjuderesearch.


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