Search Results (43,844)

Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide, mainly due to late diagnosis and high metastatic potential. Effective management requires accurate diagnostic, prognostic, and therapeutic strategies, with growing focus on molecular biomarkers. Chemokines, which are small, secreted proteins regulating immune cell migration and tissue homeostasis, shape the tumor microenvironment by promoting tumor growth, angiogenesis, immune evasion, and metastasis. In CRC, the expression of altered chemokine–receptor profiles correlates with progression and clinical outcomes. Chemokines are classified by the presence or absence of the ELR motif, which differentiates CXC subgroups. Selection focused on those consistently altered in CRC tissues or serum and involved in key oncogenic processes. CXCL1 and its receptor CXCR2 are overexpressed and linked to tumor progression, highlighting their diagnostic and therapeutic potential. CXCL8 is elevated in tissues and serum, correlating with metastasis and poor survival. The CXCL12/CXCR4/CXCR7 axis drives metastasis. CXCL13 promotes immune evasion via CXCR5, while CXCL14 is downregulated, suggesting a protective role. Moreover, CXCL16 associates with worse outcomes, whereas CXCR6 may enhance immunotherapy response. Overall, chemokines and receptors are promising blood biomarkers and therapeutic targets in CRC. Further validation is needed using large prospective studies, standardized assays, and multi-marker approaches to establish their potential as non-invasive CRC biomarkers. Full article

Objective: The study aimed to analyze the relationship between screen time (ST) duration, body weight status (BWS), and selected lifestyle behaviors in children aged 10–12. Methods: A cross-sectional study of 7763 (50.8% girls) Polish schoolchildren was conducted in 2023–2024. Data on ST, physical activity (PA), sleep duration (SD), frequency of consumption of unhealthy foods, family meals (FM), and sociodemographic data were collected using a paper questionnaire. Anthropometric data were obtained from measurements; body mass index (BMI) was used to assess BWS, and the waist-to-height ratio to measure central obesity. A logistic regression model was performed to assess the effect of unhealthy food consumption, FM, BWS, PA level, and SD on the odds of excessive ST (>2 h/day). Results: Girls were less likely to extend ST than boys (OR: 0.78; 95% CI: 0.70–0.86). Increased PA had a limiting effect on the dependent variable (moderate OR: 0.64; 95% CI: 0.53–0.77; vigorous OR: 0.37; 95% CI: 0.31–0.45). Sleeping 6–8 h per day was associated with a 41.6% increase in prolonged ST (OR: 1.42; 95% CI: 1.27–1.57). Overweight/obese individuals were 39.6% more likely to exceed ST compared to normal-weight peers (OR: 1.40; 95% CI: 1.16–1.68). Living in a village and a smaller city increased the odds of excessive ST (OR: 1.12; 95% CI: 1.07–1.41 and OR: 1.18; 95% CI: 1.03–1.34). Conclusions: Excessive body mass and unhealthy dietary habits, particularly sugary beverages, have been identified as significant risk factors for excessive ST. Optimal SD, high PA, and regular FM might have a protective effect on ST. This knowledge will contribute to designing more tailored and effective educational interventions promoting healthy lifestyles in children. Full article

Background: Caregivers of individuals with cognitive impairment face heightened emotional and psychological burdens, yet the interaction between caregiver well-being, patient characteristics, and socio-demographic factors still requires investigation. This study aimed to examine the psychological well-being of family caregivers in an urban Romanian context, focusing on the role of depressive and anxiety symptoms, education, and care-recipient cognition function. A cross-sectional study was conducted among family caregivers recruited from a neurology-psychiatry service in Bucharest. Caregivers completed Ryff’s Psychological Well-Being Scales, the Patient Health Questionnaire-9 (PHQ-9), and the COVI Scale. Cognitive status of care recipients was obtained from medical records (Mini-Mental State Examination, MMSE). Descriptive statistics, correlation analyses, and separate linear regression models were performed for each well-being dimension. Results: Caregivers reported moderate to high well-being scores, with Environmental Mastery highest (M = 38.01, SD = 8.70) and Purpose in Life lowest (M = 33.14, SD = 6.72). Depression scores averaged 18.49 (SD = 6.55), indicating moderate depressive symptoms, and anxiety scores averaged 12.14 (SD = 2.23), consistent with severe anxiety. Cognitive impairment in care recipients was marked (MMSE M = 11.47, SD = 6.99). Bivariate analyses showed that lower MMSE scores were associated with higher caregiver anxiety (ρ = −0.287, p = 0.014). Regression models (R² = 0.08–0.25) indicated that higher education was positively associated with autonomy, personal growth, positive relations, and environmental mastery, whereas older age and female gender were linked to lower well-being in several domains. Depressive symptoms were unexpectedly associated with higher autonomy and self-acceptance. Conclusions: Caregiver psychological well-being was modestly associated with depressive symptoms, education, gender, and age, while care-recipient cognitive status showed only weak links to anxiety. Education emerged as a consistent protective factor, whereas female gender and older age were associated with lower well-being. Although the Bonferroni correction eliminated significance in separate models, a complementary multivariate multiple regression confirmed global effects of education, caregiver gender, and depression across well-being domains. These findings emphasize the need for systematic psychological support for caregivers and call for larger, longitudinal studies to clarify causal mechanisms and additional protective factors. Full article

Follicular development is recognized as a highly complex biological process regulated by multiple factors. Thyroid hormone (TH) is considered one of the key regulators of female reproduction, and its dysregulation can significantly impair follicular development. Epigallocatechin gallate (EGCG), the main active component of green tea, possesses strong antioxidant properties. Numerous studies have demonstrated that EGCG positively influences reproductive function in both humans and animals. However, whether EGCG directly affects follicular development under conditions of TH dysregulation remains poorly understood. The primary objective of this study was to investigate the impact of hyperthyroidism on ovarian development, examine whether EGCG could mitigate the adverse effects of TH dysregulation, and elucidate the underlying molecular mechanisms. In the T₄-induced hyperthyroidism rat model, ovarian tissues were serially sectioned for Hematoxylin-Eosin (HE) and Masson’s trichrome staining to assess morphological changes, and follicle numbers were quantified at each developmental stage. Granulosa cell (GC) viability, proliferation, and apoptosis induced by T₃ were evaluated using CCK8, EdU, and TUNEL assays, respectively. Antioxidant enzyme activity was measured, and the expression levels of related proteins were analyzed via Western blotting. Results showed that hyperthyroidism altered ovarian structure, significantly increasing the number of atretic follicles. Levels of antioxidant enzymes, including Superoxide Dismutase (SOD), Glutathione Peroxidase (GSH-PX), and Catalase (CAT), were markedly decreased, whereas the lipid peroxidation product malondialdehyde (MDA) was significantly elevated. Furthermore, all ERS-related proteins, phosphorylated Eukaryotic Initiation Factor 2 Alpha (p-eIF2α), Activating Transcription Factor 4 (ATF4), C/EBP homologous protein (CHOP), and Caspase-3, were upregulated, accompanied by decreased glucose-regulated protein 78 (GRP78) expression. Treatment with EGCG alleviated these detrimental effects of hyperthyroidism. At the cellular level, high concentrations of T₃ reduced GC viability and proliferation while increasing apoptosis. Reactive oxygen species levels were elevated, and GRP78 expression was decreased. Notably, all T₃-induced effects were reversed by EGCG treatment. In summary, this study demonstrates that hyperthyroidism induces oxidative stress in GCs, which triggers endoplasmic reticulum stress via the eIF2α/ATF4 pathway and leads to apoptosis. EGCG mitigates apoptosis by enhancing antioxidant capacity, thereby preserving ovarian function. These findings establish EGCG as a protective agent for maintaining ovarian health and fertility. Full article

Background/Objective: Neonatal respiratory distress syndrome (RDS) is a leading cause of morbidity and mortality in preterm infants. Interleukin-10 (IL-10) and endothelial nitric oxide synthase (eNOS, also known as NOS3) regulate inflammation and vascular tone, and genetic variants may influence the risk of RDS. To investigate the association between IL-10 rs1800872 (c.-149+1984T>G), IL-10 rs1800896 (c.-149+2474T>C), and NOS3 rs2070744 (c.-149+1691C>T), NOS3 rs1799983 (c.894T>G) variants and the risk of RDS in a Romanian cohort of preterm neonates. Methods: This case–control study included 340 preterm neonates (113 with RDS, 227 controls) born at <36 weeks of gestation. Genotyping was performed using TaqMan SNP assays. Logistic regression adjusted for gestational age and sex estimated odds ratios (ORs) and 95% confidence intervals (CIs). ROC analyses evaluated predictive performance. Results: No significant differences in genotype or allele distributions were observed between RDS and control groups for any variant. Haplotype analysis also revealed no association with RDS susceptibility or severity. NOS3:c.894T>G variant was associated with reduced risk of severe RDS after correction (adjusted p = 0.009), though survival analysis showed no significant genotype-specific effects. Epistatic genotype interaction was observed for the IL-10 T/G + T/C, present only in RDS (p = 0.0026). ROC analysis revealed a clinical prediction of RDS (AUC = 0.996), while the addition of genetic variants improved discrimination for severity (AUC = 0.865; 95% CI: 0.773–0.957) and mortality (AUC = 0.913; 95% CI: 0.791–1.000). Conclusions: IL-10 and NOS3 variants were not individually associated with overall RDS susceptibility. The observed epistatic interactions and the potential protective effect of NOS3:c.894T>G against severe forms can suggest modulatory roles in disease progression. Larger, ethnically homogeneous cohorts are needed to confirm these findings and assess their potential for informing personalized care for neonates. Full article

Land use and land cover change (LUCC) is central to regulating human–land relationships and crucial for urban planning and sustainable development in arid oasis cities. As a typical oasis city in Xinjiang, Shihezi City faces the triple challenges of agricultural protection, urban expansion, and ecological conservation. Taking Shihezi City as the research object, this study used the 30 m resolution China Land Cover Dataset and applied the land use dynamic degree, comprehensive index of land use degree, transfer matrix, Geodetector, and PLUS model to analyse the spatiotemporal dynamics of LUCC from 2002 to 2022, identify driving mechanisms, and predict the land use pattern from 2027 to 2032. The results showed that (1) from 2002 to 2022, farmland decreased by 86.1075 km², man-made surfaces increased by 63.7389 km² (annual expansion rate of 2.86%), grassland slightly increased by 24.5592 km², and other land types remained stable; (2) the dynamics of land use showed a phased characteristic of “growth–equilibrium–acceleration”, and the land use degree index rose to 2.8639; natural factors (elevation, soil, temperature) dominated LUCC, and most interactions among factors showed enhancement effects; (3) the PLUS model predicted that by 2032, farmland would decrease to 224.347 km² and man-made surfaces would increase to 111.941 km². This study clarifies the laws of LUCC in Shihezi, demonstrates driving analysis and simulation prediction, and provides scientific support for balancing urban development, agricultural protection, and ecological security in arid oasis regions. Full article

The Hengduan Mountains, a global biodiversity hotspot, harbor numerous endemic plant species shaped by complex topography and microclimatic variation. However, increasing habitat fragmentation due to human activities threatens narrowly distributed species such as Cycas panzhihuaensis. To investigate its habitat suitability and inform conservation, we applied the MaxEnt model, Geodetector, and Zonation to predict potential distribution, identify key environmental drivers, and delineate priority conservation areas. Our results show that only 18.36% of the region constitutes suitable and highly fragmented habitat, primarily concentrated along the dry–hot valleys of the Jinsha and Yalong Rivers, and it is shrinking while shifting southward and southeastward under climate change. Elevation emerged as the dominant driver (q = 0.45), with strong interaction effects among topographic, climatic, soil, and anthropogenic factors, highlighting the role of environmental synergies in shaping habitat heterogeneity. Priority conservation areas covered 32% of suitable habitat and overlapped only 6.17% with existing protected areas, indicating a spatial conservation gap. These findings emphasize the need to incorporate microhabitat heterogeneity and environmental interactions in conservation planning and support the adoption of micro-reserve strategies to complement existing reserves. Our study provides a practical framework for protecting vulnerable montane species and offers insights into plant distribution dynamics in topographically complex regions. Full article

Background/Objectives: While some dietary indices have been developed to assess diet quality and chronic disease risk, their comparative effectiveness within the same population remains unclear due to methodological limitations in observational studies. This study employs a causal inference framework to compare nine dietary indices for reducing all-cause and cardiovascular mortality, while investigating inflammatory pathways through multiple mediation analysis. Methods: Using dietary data from 33,881 adults (aged ≥ 20 years, median follow-up 92 months), we applied a causal directed acyclic graph to identify the minimum sufficient adjustment set and implemented generalized propensity score matching to address confounding. Robust Cox proportional hazards regression assessed associations between nine dietary indices—Dietary Inflammatory Index (DII), Composite Dietary Antioxidant Index (CDAI), Healthy Eating Index 2015/2020 (HEI-2015/2020), Alternate Healthy Eating Index (AHEI), Alternate Mediterranean Diet (aMED), Mediterranean Diet Index (MEDI), and Dietary Approaches to Stop Hypertension (DASH/DASHI)—and mortality outcomes. Multiple additive regression trees (MART) algorithm was used for multiple mediation analysis to examine inflammatory markers (PAR, SII, NPR, TyG, LMR, PLR, ELR, CRP) as mechanistic mediators. Results: Among 33,881 participants (mean age 47.07 years, 51.34% women), 4,230 deaths occurred, including 827 cardiovascular deaths. Under the causal inference framework, higher DII scores increased both all-cause (HR: 1.07; 95% CI: 1.02–1.12) and cardiovascular mortality risk (HR: 1.07; 95% CI: 1.04–1.10) by 7%. The aMED demonstrated the strongest protective association, reducing all-cause mortality by 12% (HR: 0.88; 95% CI: 0.80–0.97) and cardiovascular mortality by 11% (HR: 0.89; 95% CI: 0.80–0.98), followed by MEDI with similar magnitude effects. Other healthy dietary indices showed modest 1–3% risk reductions. Multiple mediation analysis revealed that inflammatory markers, particularly neutrophil-to-platelet ratio (NPR) and systemic immune-inflammation index (SII), significantly mediated diet–mortality associations across all indices, with C-reactive protein (CRP) serving as the most frequent mediator. Conclusions: Using causal inference methodology, the Mediterranean dietary pattern (aMED) shows the strongest causal association with reduced mortality risk, with inflammatory pathways serving as key mediating mechanisms. These findings provide robust evidence for prioritizing Mediterranean dietary patterns in public health interventions and clinical practice, while highlighting inflammation as a critical therapeutic target for dietary interventions aimed at reducing mortality risk. Full article

Tanshinone IIA (T-IIA), a fat-soluble diterpene quinone extracted from Salvia miltiorrhiza, is widely recognized for its multiple pharmacological properties, including anti-inflammatory, antioxidant, anti-fibrotic, and anti-tumor effects. Recent studies have highlighted its great potential in treating bone metabolic disorders, especially osteoporosis and bone damage repair. Bone health depends on the dynamic balance between osteoblast-mediated bone formation and osteoclast-mediated bone resorption. Disruption of this balance can lead to diseases such as osteoporosis, which is often diagnosed after a fracture, seriously affecting the quality of life and increasing the medical burden. Early identification of high-risk groups and appropriate treatment are essential for preventing fracture recurrence. Studies have shown that T-IIA can promote osteoblast differentiation and inhibit osteoclast activity, targeting key signaling pathways such as NF-κB, PI3K/Akt, and Wnt/β-catenin, all of which are closely related to bone metabolism. T-IIA has a dual role in regulating bone formation and bone resorption, making it a potential drug for the treatment of osteoporosis. In addition, T-IIA has neuroprotective, hepatic, renal, cardiac, and cerebral effects, which enhance its therapeutic effect. Despite the remarkable efficacy of T-IIA, its clinical application is limited due to poor solubility and low bioavailability. Recent advances in drug delivery systems, such as liposome formulations and nanocarriers, have improved their pharmacokinetics, increased absorption rate, and bioavailability. Combination therapy with growth factors or stem cells can further enhance its efficacy. Future studies should focus on optimizing the delivery system of T-IIA and exploring its combined application with other therapeutic strategies to expand its clinical application range. Full article

Ischemic stroke is a multifactorial cerebrovascular disease that remains a leading cause of long-term disability and mortality worldwide. Despite advances in acute treatment, recurrence rates remain high, and nearly half of survivors experience persistent neurological deficits. Therefore, identifying genetic biomarkers that contribute to early diagnosis, risk prediction, and therapeutic improvement is increasingly important. MicroRNAs, small non-coding RNAs involved in gene regulation, have been recognized for their critical roles in vascular development and angiogenesis. This study investigated the association between angiogenesis-related miRNA gene polymorphisms and ischemic stroke risk using a population-based case–control design. Genotyping and statistical analysis revealed that miR-21 rs13137 A > T and miR-126 rs4636297 G > A were significantly associated with stroke susceptibility. The TT genotype of miR-21 rs13137 demonstrated a protective effect (p = 0.019); the AA genotype of miR-126 rs4636297 was associated with increased risk (p = 0.006), along with its dominant model (p = 0.007). Additionally, deep learning models were utilized to evaluate gene–gene and gene–environment interactions, enhancing predictive accuracy and identifying synergistic effects between miRNA polymorphisms and clinical risk factors. In summary, specific miRNA variants may serve as novel biomarkers for ischemic stroke, providing valuable insight into genetic susceptibility and supporting the advancement of precision medicine strategies. Full article

Sewer systems are essential for sustainable infrastructure management, influencing environmental, social, and economic aspects. However, sewer network capacity is under significant pressure, with many systems overwhelmed by challenges such as climate change, ageing infrastructure, and increasing inflow and infiltration, particularly through groundwater infiltration (GWI). Current research in this area has primarily focused on general sewer performance, with limited attention to high-resolution, spatially explicit assessments of sewer exposure to GWI, highlighting a critical knowledge gap. This study responds to this gap by developing a high-resolution GWI assessment. This is achieved by integrating fuzzy-analytical hierarchy process (AHP) with geographic information systems (GISs) and machine learning (ML) to generate GWI probability maps across the Dawlish region, southwest United Kingdom, complemented by sensitivity analysis to identify the key drivers of sewer network vulnerability. To this end, 16 hydrological–hydrogeological thematic layers were incorporated: elevation, slope, topographic wetness index, rock, alluvium, soil, land cover, made ground, fault proximity, fault length, mass movement, river proximity, flood potential, drainage order, groundwater depth (GWD), and precipitation. A GWI probability index, ranging from 0 to 1, was developed for each 1 m × 1 m area per season. The model domain was then classified into high-, intermediate-, and low-GWI-risk zones using K-means clustering. A consistency ratio of 0.02 validated the AHP approach for pairwise comparisons, while locations of storm overflow (SO) discharges and model comparisons verified the final outputs. SOs predominantly coincided with areas of high GWI probability and high-risk zones. Comparison of AHP-weighted GIS output clustered via K-means with direct K-means clustering of AHP-weighted layers yielded a Kappa value of 0.70, with an 81.44% classification match. Sensitivity analysis identified five key factors influencing GWI scores: GWD, river proximity, flood potential, rock, and alluvium. The findings underscore that proxy-based geospatial and machine learning approaches offer an effective and scalable method for mapping sewer network exposure to GWI. By enabling high-resolution risk assessment, the proposed framework contributes a novel proxy and machine-learning-based screening tool for the management of smart cities. This supports predictive maintenance, optimised infrastructure investment, and proactive management of GWI in sewer networks, thereby reducing costs, mitigating environmental impacts, and protecting public health. In this way, the method contributes not only to improved sewer system performance but also to advancing the sustainability and resilience goals of smart cities. Full article

During periodontitis, Porphyromonas gingivalis and its lipopolysaccharides (LPS) may translocate into the bloodstream and alter adipocyte function, aggravating obesity-related disorders. This study aimed to evaluate the inflammatory and metabolic effects of P. gingivalis in obese db/db mice, and to decipher the molecular mechanisms targeted by P. gingivalis or its LPS in 3T3-L1 adipocytes. Then, we determined the ability of three major dietary polyphenols, namely caffeic acid, quercetin and epicatechin, to protect adipocytes under LPS conditions. Results show that obese mice exposed to P. gingivalis exhibited an altered lipid profile with higher triglyceride accumulation, an enhanced pro-inflammatory response and a reduced antioxidant SOD activity in the adipose tissue. In adipose cells, P. gingivalis and LPS induced the TLR2-4/MyD88/NFκB signaling pathway, and promoted IL-6 and MCP-1 secretion. Bacterial stimuli also increased ROS levels and the expression of NOX2, NOX4 and iNOS genes, while they deregulated mRNA levels of Cu/ZnSOD, MnSOD, catalase, GPx and Nrf2. Interestingly, caffeic acid, quercetin and epicatechin protected adipose cells via antioxidant and anti-inflammatory effects. Overall, these findings show the deleterious impact of P. gingivalis on inflammation, oxidative stress and lipid metabolism in obese mice and adipose cells, and highlight the therapeutic potential of polyphenols in mitigating periodontal bacteria-mediated complications during obesity. Full article

Earthen archaeological sites are particularly vulnerable to rain and winds, whose effects may compromise their integrity. The Huaca Chotuna (HC; 8th–16th Century AD) is an adobe platform in Peru’s semi-arid Lambayeque region, and it is in an area with exposure to rain and winds associated with the El Niño Southern Oscillation (ENSO) events. Here we present the results from an orthophotogrammetric and morphometric study aimed at quantifying the effects of erosion and deposition at the HC. The novelty of our approach consists of merging topographic, hydrological, and wind parameters to recognize the sector of the HC with exposure to potentially damaging natural climatic phenomena. We identify zones affected by erosion and deposition processes. Results of a diffusion model aimed to estimate the HC sectors where these processes will act in the next century are also presented. Gully erosion from rainfall indicates a vertical erosion rate of approximately 0.2 m/century, demonstrating the low preservation potential of the HC. Rainwater also deteriorates adobe bricks and triggers water/mud flows. Conversely, sediment-laden winds contribute to the partial burial of the HC. The findings highlight significant hazards to the HC’s structural integrity, including gravity instability. The interdisciplinary methodology we adopt offers a key framework for assessing and protecting other earthen sites globally against the escalating impacts of climate change. Full article

Low-density lipoprotein receptor-related protein 5 (LRP5) is a multifunctional transmembrane coreceptor that plays a pivotal role in development and disease. Wnt/β-catenin signaling is the primary downstream signaling pathway activated by LRP5. Furthermore, some LRP5 functions are mediated by noncanonical pathways, such as AKT/P21 and TGF-β/Smad signaling. Pathologically, both loss-of-function and gain-of-function mutations in LRP5 produce distinct phenotypes, ranging from osteoporosis-pseudoglioma syndrome to high bone mass disorders. Beyond the skeletal system, LRP5 has emerged as a key regulator of retinal angiogenesis, vascular integrity, renal tubular function, neurodevelopment, and lipid metabolism. Its physiological functions are highlighted by its ability to influence adipocyte differentiation, insulin sensitivity, and neuronal synaptic plasticity. Moreover, LRP5 displays a dual role in development and disease progression. Although it plays a protective role in acute injuries such as myocardial infarction and acute kidney injury, LRP5 also contributes to chronic pathologies such as tubulointerstitial fibrosis, polycystic kidney disease, and atherosclerosis through fibrotic and inflammatory pathways. Recent therapeutic interest has focused on modulating LRP5 activity using agents such as anti-Dickkopf-related protein 1 antibody, sclerostin inhibitors, polyclonal antibodies, CRISPR/Cas9 knockout, and some natural products. This review discusses the current understanding of LRP5's physiological and pathological roles across organ systems and highlights its therapeutic potential, emphasizing the need for targeted approaches considering its context-dependent effects. Full article

Background: The Nursing Work Environment (NWE) plays a critical role in determining the quality of care, staff well-being, and organizational performance, particularly in oncology settings. Despite increasing attention, a comprehensive synthesis of organizational factors shaping oncology NWEs has been lacking. This scoping review aimed to describe the key features of oncology NWEs and to explore the outcomes associated with these characteristics. Methods: A scoping review was conducted following the Joanna Briggs Institute guidelines. Peer-reviewed studies published in English or Italian were included without time restrictions. Literature searches were performed in MEDLINE via PubMed, CINAHL, and Scopus between January and April 2025. Results: Twenty studies met the inclusion criteria. Key organizational characteristics of oncology NWEs were grouped into the following four domains: leadership and organizational support; workload and resource availability; ethical climate and collegial relationships; and physical and structural conditions of care settings. Across the studies, a positive NWE was frequently reported to be associated with improved nurse-related outcomes and, to a lesser extent, with patient-related outcomes. However, these associations should be interpreted with caution due to the heterogeneity of contexts and the predominance of cross-sectional designs. Conclusions: The NWE is a strategic element in delivering effective, safe, and sustainable oncology care. Practical actions for nurse managers and healthcare leaders include implementing leadership training programs, ensuring adequate staffing and resource allocation, fostering open communication, and promoting interdisciplinary collaboration. These measures are essential to protect staff well-being and guarantee high-quality, patient-centered care. Full article