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Herein, we report room temperature Cr-doping for all-inorganic perovskites that have attracted great attention in recent years due to their extraordinary optical properties, low cost, and ease of synthesis. Incorporation of Cr 3 + ions into the perovskite crystal lattices is achieved by following a facile route involving an antisolvent recrystallization method at room temperature. It is shown that both Cr-doping and formation of crystals in the CsPbBr x Cl 3 − x phase are provided by increasing the concentration of the CrCl 3 solution. It is also observed that the doping procedure leads to the emergence of three types of distinctive peaks in the PL spectrum originating from CsPbBr x Cl 3 − x domains (476–427 nm), Cr-strained host lattices (515 nm), and midgap states formed by Cr dopants (675–775 nm). It is also found that the Cr-doped perovskites emitting a dark violaceous color change their color to white with a high color rendering index (88) in 30-day time intervals. Easy-tunable optical properties of all-inorganic Cs perovskites indicate their great potential for future optoelectronic device applications. [ABSTRACT FROM AUTHOR]

We present a detailed near-infrared chemical abundance analysis of 10 red giant members of the Galactic open cluster NGC 752. High-resolution (R  ≃ 45000) near-infrared spectral data were gathered with the Immersion Grating Infrared Spectrograph, providing simultaneous coverage of the complete H and K bands. We derived the abundances of H-burning (C, N, O), α (Mg, Si, S, Ca), light odd-Z (Na, Al, P, K), Fe-group (Sc, Ti, Cr, Fe, Co, Ni), and neutron-capture (Ce, Nd, Yb) elements. We report the abundances of S, P, K, Ce, and Yb in NGC 752 for the first time. Our analysis yields solar-metallicity and solar abundance ratios for almost all of the elements heavier than the CNO group in NGC 752. O and N abundances were measured from a number of OH and CN features in the H band, and C abundances were determined mainly from CO molecular lines in the K band. High-excitation |$\rm{C\,\small {I}}$| lines present in both near-infrared and optical spectra were also included in the C abundance determinations. Carbon isotopic ratios were derived from the R-branch band heads of first overtone (2−0) and (3−1) 12CO and (2−0) 13CO lines near 23 440 Å and (3−1) 13CO lines at about 23 730 Å. The CNO abundances and 12C/13C ratios are all consistent with our giants having completed 'first dredge-up' envelope mixing of CN-cyle products. We independently assessed NGC 752 stellar membership from Gaia astrometry, leading to a new colour–magnitude diagram for this cluster. Applications of Victoria isochrones and MESA models to these data yield an updated NGC 752 cluster age (1.52 Gyr) and evolutionary stage indications for the programme stars. The photometric evidence and spectroscopic light element abundances all suggest that the most, perhaps all of the programme stars are members of the helium-burning red clump in this cluster. [ABSTRACT FROM AUTHOR]

We present near-infrared spectroscopic analysis of 12 red giant members of the Galactic open cluster NGC 6940. High-resolution (R ≃ 45 000) and high-signal-to-noise ratio (S/N > 100) near-infrared H - and K -band spectra were gathered with the Immersion Grating Infrared Spectrograph (IGRINS) on the 2.7-m Smith Telescope at McDonald Observatory. We obtained abundances of H-burning (C, N, O), α (Mg, Si, S, Ca), light odd-Z (Na, Al, P, K), Fe-group (Sc, Ti, Cr, Fe, Co, Ni), and neutron-capture (Ce, Nd, Yb) elements. We report the abundances of S, P, K, Ce, and Yb in NGC 6940 for the first time. Many OH and CN features in the H band were used to obtain O and N abundances. C abundances were measured from four different features: CO molecular lines in the K band, high excitation C  i lines present in both near-infrared and optical, CH and C2 bands in the optical region. We have also determined 12C/13C ratios from the R -branch band heads of first overtone (2−0) and (3−1) 12CO and (2−0) 13CO lines near 23 440 Å and (3−1) 13CO lines at about 23 730 Å. We have also investigated the HF feature at 23 358.3 Å, finding solar fluorine abundances without ruling out a slight enhancement. For some elements (such as the α group), IGRINS data yield more internally self-consistent abundances. We also revisited the CMD of NGC 6940 by determining the most probable cluster members using Gaia DR2. Finally, we applied Victoria isochrones and mesa models in order to refine our estimates of the evolutionary stages of our targets. [ABSTRACT FROM AUTHOR]

Objective: Isolated tubal torsion in pregnancy is a rare condition we want to present this case. Case(s): In our study, we present a 23-year-old woman primigravida at 37 weeks of gestation with acute right lower abdominal pain. The clinical and Magnetic resonance imaging (MRI) findings led to diagnosis of acute appendicitis. Emergency exploratory laparotomy and cesarean section were performed. A twisted right Fallopian tube and Morgagni’s cyst was noted and right salpingectomy was performed. Conclusion: Although isolated tubal torsion during pregnancy is very rare, it should be included in the differential diagnosis of acute abdomen in pregnancy. Early surgical intervention will decrease obstetric morbidity.

We present the high-resolution (R ≈ 60 000), high signal-to-noise ratio (S/N ≃ 120) spectroscopic analysis of 12 red giant members of the Galactic open cluster NGC 6940. We applied Yonsei–Yale isochrones to the colour–magnitude diagram, which suggested an age of 1.1 Gyr for the cluster with a turn-off mass of 2 M⊙. Atmospheric parameters (Teff, log g, [Fe/H], and ξt) were determined via equivalent widths of Fe i, Fe ii, Ti i, and Ti ii lines. Calculated mean metallicity of the cluster is 〈[Fe/H]〉 = 0.04 ± 0.02. We derived abundances of α (Mg, Si, Ca), Fe-group (Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn), and n-capture (Y, La, Nd, Eu) elements to be about solar. Light odd-Z elements Na and Al are slightly enhanced in MMU 108 and MMU 152 by ∼0.34 and ∼0.16 dex, respectively. Abundances of light elements Li, C, N, O, and 12C/13C ratios were derived from spectrum syntheses of the Li i resonance doublet at 6707 Å, [O i] line at 6300 Å, C2 Swan bandheads at 5164 and 5635 Å, and strong 12,13CN system lines in the 7995–8040 Å region. Most carbon isotopic ratios are similar to those found in other solar-metallicity giants, but MMU 152 has an unusual value of 12C/13C = 6. Evaluation of the LiCNO abundances and 12C/13C ratios along with the present theoretical models suggests that all the red giants in our sample are core-helium-burning clump stars. [ABSTRACT FROM AUTHOR]

We present detailed chemical compositions of 10 red giant star members of the Galactic (open) cluster NGC 752, derived from high-resolution (R ≈ 60 000), high signal-to-noise (S/N ≥ 140) spectra. We confirmed cluster memberships by measuring the stellar radial velocities, and by deriving model atmosphere parameters (Teff, log g, [Fe/H] and ξt) from equivalent widths of Fe i, Fe ii, Ti i, and Ti ii lines. The metallicity we obtained for NGC 752 ([Fe/H] = −0.02 ± 0.05) is in good agreement with previous studies. We derived abundances of α (Mg, Si, Ca), light odd-Z (Na, Al), Fe-group (Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn), n-capture (Y, La, Nd, Eu), and p-capture (Li, C, N, O) species for each star. Furthermore, we also derived abundances of the LiCNO p-capture element group and carbon isotopic ratios, using synthetic spectrum analyses of the Li i 6707 Å resonance doublet, the [O i] line at 6300 Å, the CH G-band features near 4311 and 4325 Å, the C2 bandheads at 5160 and 5631 Å, and 12,13CN red system lines in the 7995-8040 Å region. By applying recent isochrones to NGC 752 photometry, and comparing the colour-magnitude diagram information to our Li abundances and 12C/13C ratios, we suggest that the 10 observed red giants can be separated into three first-ascent, six red-clump and one red horizontal branch star. [ABSTRACT FROM AUTHOR]

Salvia hypargeia Fisch. et Mey. (Lamiaceae) root extract, among 16 Salvia extracts, showed the highest activity against the human ovarian cancer cell line. Bioactivity-guided fractionation of this plant extract has yielded four abietane-type diterpenes [5,6-didehydro-7-hydroxytaxodone (1), 14-deoxycoleon U (= 6-hydroxysalvinolone) (2), demethylcryptojaponol (3), and salvicanaric acid (4)] two triterpenes (lupeol and lupeol-3-acetate), and a fatty acid mixture consisting mainly of palmitic acid (51.6%) and palmitoleic acid (6.4%). Compounds 2 and 3 were found to be active against A2780 human ovarian cancer cell line with IC50 values of 3.9 and 1.2 μ g/mL, respectively, and the fatty acid composition was the most active part of the extract (IC50 = 0.6 μ g/mL). [ABSTRACT FROM AUTHOR]

Objective: To evaluate the worldwide use of FIGO's two systems for the classification of causes and contributors to nongestational abnormal uterine bleeding in the reproductive years by obstetrics and gynecology professionals worldwide, to identify knowledge gaps, and explore barriers to implementation., Methods: An electronic survey was developed by members of FIGO's Menstrual Disorders and Related Health Impacts (MDRHI) Committee to assess knowledge of abnormal uterine bleeding (AUB) and the two FIGO AUB systems among obstetricians and gynecologists. The survey was conducted online from February 28 to June 30, 2023, and comprised demographic questions, educational content inquiries, and a knowledge assessment. Available in English, Spanish, French, and Mandarin, the survey was disseminated through representatives of the World Association of Trainees in Obstetrics and Gynecology (WATOG), as well as through digital platforms and trainee-focused Facebook groups., Results: Out of 1317 initial participants from 65 countries, 1114 completed the survey. The highest representation was from China (42.6%), where both trainees and clinicians participated. Participation varied across FIGO regions, with Asia-Oceania contributing the most (n = 602) and North America the least (n = 62). Most participants were in hospital-based residency programs (73.9%), graduating around 2012 with 3 years of postgraduate medical education. Nearly 70% reported being familiar with FIGO systems, while over 93% were familiar with PALM-COEIN. About one-third reported frequent use of FIGO systems by faculty, except among French-speaking respondents. Higher composite FIGO systems knowledge scores correlated with familiarity with FIGO AUB systems and PALM COEIN. Language did not significantly affect scores., Conclusion: FIGO's systems for nongestational AUB are widely used but gaps persist. Targeted strategies focusing on faculty development and research are needed to improve awareness and proficiency. This study highlights the necessity for interventions in medical education to enhance trainees' understanding and utilization of standardized nomenclature., (© 2024 International Federation of Gynecology and Obstetrics.)

Objectives: The objective of this study was to evaluate the performance of a seed drill for seeding barley and vetch mixtures having different ratios and to determine their impact on plant emergence, yield and feed quality of component crops., Methods: The laboratory and field experiments were conducted to determine the performance of the seeder using pure barley, common vetch, and their mixtures in ratios, namely 100:0, 0:100, 75:25, 50:50, 25:75. The seed flow and distribution uniformity across the rows were determined within laboratory conditions, while other response variables were assessed in the field conditions., Results: The coefficient of variation values of flow evenness for barley and vetch were found to be 1.0-5.5% and 0.3-2.1%, respectively. Seed distribution uniformity of each row unit were also determined ranging from 4.2% to 10.7% and from 0.4% to 1.4% for barley and vetch, respectively. The goodness criteria values ranged between 66.4%-86.0% for the laboratory tests while the corresponding values had a range of 78%-86% for field samples. Based on the findings in this work, the overall ranges of variation factor values were 0.43-1.28 and 0.36-0.77 for laboratory and field evaluations, respectively. Furthermore, the maximum yield was 42,620 kg ha -1 , whereas the minimum dry material ratio was 16.93% recorded for pure barley crop., Conclusions: It appears that the results in this work demonstrated that the seed drill could have a great potential to be used effectively for the seeding of barley as well as vetch mixtures as a function of various ratios to enhance the overall yield of the crop., Competing Interests: The authors declare there are no competing interests., (©2025 Yazgi et al.)

Objectives: To evaluate the feasibility and acceptability of an emotional support programme for newly diagnosed people with multiple sclerosis., Design: Three-arm, mixed methods, randomised controlled trial comparing usual care, versus usual care plus nurse-specialist support, versus usual care plus nurse-specialist support plus peer support., Participants: Community-dwelling adults within two years of diagnosis or undergoing diagnosis., Interventions: PrEliMS involves information provision, emotional support, and strategies and techniques based on psychoeducation, Acceptance and Commitment Therapy principles, supportive listening. One version of the intervention was provided by nurse-specialists alone and the other was provided by nurse-specialists plus peer support., Main Measures: The main outcome of interest was the feasibility of proceeding to a definitive trial, exploring recruitment rate, acceptability, completion of outcome measures (perceived stress, mood, self-efficacy, psychological impact, and service use), and signal of efficacy., Results: Of 40 participants randomised (mean age 36.2 years (SD = 14.8); 54% women; 85% with relapsing-remitting MS), 36 and 38 returned 3- and 6-month questionnaires, respectively. Participant interviews suggested the trial was largely feasible, and the intervention acceptable, with some amendments to trial procedures and intervention delivery noted. There were, however, no statistically significant differences between groups at followup for any measures, and effect-size estimates were small., Conclusion: A definitive trial combining nurse-specialist and peer support adjustment to diagnosis intervention is warranted, but more work exploring the delivery and fidelity of the intervention is needed before this is pursued.

Arctium minus (Hill) Bernh., commonly known as "Burdock", is a species within the Arctium genus of the Asteraceae family. Determining the optimum extraction conditions to obtain a concentrated extract with targeted active ingredients guides the most efficient use of natural products. Herein, ultrasound-assisted extraction (UAE) was optimized by using response surface methodology (RSM) to extract bioactive compounds from different organs of A. minus . Furthermore, phytochemical composition of extracts of the A. minus was investigated by using liquid chromatography-high resolution electrospray ionization mass spectrometry (LC-HRESIMS), antioxidant potential by using 2,2-diphenyl-1-picrylhydrazyl (DPPH), diazanium;3-ethyl-2-[(3-ethyl-6-sulfonato-1,3-benzothiazol-2-ylidene)hydrazinylidene]-1,3-benzothiazole-6-sulfonate (ABTS), CUPRAC, and metal chelation assays, and cytotoxic activities by using human breast cancer cell line (MDA-MB-231) and hepatocellular carcinoma cancer cell line (HepG2), and compared against conventional methods; Soxhlet and maceration. The RSM was employed to investigate the influence of ultrasound power, extraction time, and extraction temperature on the antioxidant potential assessed by the DPPH free radical scavenging assay. In UAE of A. minus leaves, flowers, and branches, the conditions resulting in the minimum IC 50 values: 20 °C for 6 min at 50 W for leaves, 20 °C for 3 min at 100 W for flowers, and 20 °C for 3 min at 100 W for branches. Chlorogenic acid was identified as the major phenolic compound in the extracts obtained by UAE, with concentrations of 24,666.96 μg/g in leaves, 1054.92 μg/g in flowers, and 3,501.24 μg/g in branches. Flowers of A. minus had significantly higher levels of arctiin and arctigenin than those of leaves and branches. Extracts from leaves and flowers were more effective against MDA-MB-231 and HepG2 cancer cell lines than arctiin and arctigenin., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

The ability to precisely engineer nanostructures underpins a wide range of applications in areas such as electronics, optics, and biomedical sciences. Here we present a novel approach for the growth of nanoparticle assemblies that leverages the unique properties of superfluid helium. Unlike viscous solvents at or near room temperature, superfluid helium provides an unperturbed and cold environment in which weak van der Waals interactions between molecular templates and metal atoms become significant and can define the spatial arrangement of nanoparticles. To demonstrate this concept, diol and porphyrin-based molecules are employed as templates to grow gold nanoparticle assemblies in superfluid helium droplets. After soft-landing on a solid surface to remove the helium, transmission electron microscopy (TEM) imaging shows the growth of gold nanoparticles at specific binding sites within the molecular templates where the interaction between gold atoms and the molecular template is at its strongest., (© 2024. The Author(s).)

Microrobots are of significant interest due to their smart transport capabilities, especially for precisely targeted delivery in dynamic environments (blood, cell membranes, tumor interstitial matrixes, blood-brain barrier, mucosa, and other body fluids). To perform a more complex micromanipulation in biological applications, it is highly desirable for microrobots to be stimulated with multiple stimuli rather than a single stimulus. Herein, the biodegradable and biocompatible smart micromotors with a Janus architecture consisting of PrecirolATO 5 and polycaprolactone compartments inspired by the anisotropic geometry of tadpoles and sperms are newly designed. These bioinspired micromotors combine the advantageous properties of polypyrrole nanoparticles (NPs), a high near-infrared light-absorbing agent with high photothermal conversion efficiency, and magnetic NPs, which respond to the magnetic field and exhibit multistimulus-responsive behavior. By combining both fields, we achieved an "on/off" propulsion mechanism that can enable us to overcome complex tasks and limitations in liquid environments and overcome the limitations encountered by single actuation applications. Moreover, the magnetic particles offer other functions such as removing organic pollutants via the Fenton reaction. Janus-structured motors provide a broad perspective not only for biosensing, optical detection, and on-chip separation applications but also for environmental water treatment due to the catalytic activities of multistimulus-responsive micromotors.

Context: The genus Glaucium Mill., one of the important Papaveraceae family plants, is rich in isoquinoline alkaloids and distributed worldwide., Objective: Isolation and identification of bioactive alkaloids from Glaucium grandiflorum Boiss. & Huet. subsp. refractum (Nabelek) Mory var. torquatum (Cullen) Mory and G. corniculatum (L.) Rudolph var. corniculatum (Aslan 2012) , and investigation of their antioxidant and anticholinesterase activities., Materials and Methods: The aerial parts of each plant were dried, powdered, and percolated with methanol, then each extract was fractionated between 50% aqueous acetic acid and petroleum. Their aqueous acidic layer was adjusted to pH 7-8 with NH 4 OH and extracted with chloroform, the extract was subjected to CC separation and isolation. Structures of the isolated alkaloids were elucidated by 1D and 2D-NMR and mass spectral analyses. The alkaloid extracts and their pure alkaloids were tested for anti-cholinesterase (AChE and BuChE) and antioxidant (ABTS, CUPRAC, β-carotene linoleic acid tests) activities in vitro ., Results: Methanol extracts of Glaucium grandiflorum subsp. refractum var. torquatum and G. corniculatum var. corniculatum afforded a novel compound glauciumoline and seven known isoquinoline alkaloids three of which have an aporphine-type and the other five have a protopine-type skeleton. Among them, trans -protopinium ( 7 ) and cis -protopinium ( 8 ) were isolated from a Glaucium species for the first time. Tertiary amine extracts (TAEs) of both plants showed very strong acetylcholinesterase inhibitory activity. The TAE of the plants also showed strong antioxidant activity while the isolated alkaloids showed no meaningful activity in the anticholinesterase and antioxidant tests., Discussion and Conclusions: Glaucium species are considered promising therapeutic agents in the treatment of Alzheimer's disease.

Background: Coronavirus disease 19 (COVID-19) has affected many aspects of the lives of medical professionals. Postgraduate training has also been affected and mitigation plans are still ongoing., Objective: To understand the perspectives of trainees in obstetrics and gynaecology (ObGyn) during the pandemic., Materials and Methods: A cross-sectional exploratory survey conducted electronically from 20th of April 2020 to 1st July 2020., Main Outcome Measures: The original questionnaire comprised of 40 questions and a free-text option. The free-text questions covered five main domains: effect of the pandemic on training, worries about training, acquisition of skills during the pandemic, training period and extensions and responsibilities outside training during the pandemic. The responses to these questions in the survey were analysed using pragmatic thematic analysis., Results: Trainees felt there was lack of training as well as training opportunities. Some took the pandemic as an opportunity to gain new skills. Trainees were also worried about time in training and uncertainty about extensions. Lastly, many had concerns pertaining to patient care, an inability to contribute to departmental organisation, and dissatisfaction with the implemented policies., Conclusion: The difficulties in Obstetrics and gynaecology training due to the pandemic need to be mitigated. When planning for reshaping the training programmes to accommodate for the discrepancies caused, trainers need to consider the perspectives of trainees and actively involve them in the decision making, designing and executing future plans., What Is New?: Efforts are currently underway to address the training time lost during the pandemic in Europe. Recognising the paramount importance of providing exceptional care for women and children across the continent, it becomes imperative to consider the valuable perspectives and insights offered by those who represent the future generation of specialists in the field.

Glioblastoma is one of the most devastating neoplasms of the central nervous system. This study focused on the development of serum extracellular vesicle (EV)-based glioblastoma tumor marker panels that can be used in a clinic to diagnose glioblastomas and to monitor tumor burden, progression, and regression in response to treatment. RNA sequencing studies were performed using RNA isolated from serum EVs from both patients ( n = 85) and control donors ( n = 31). RNA sequencing results for preoperative glioblastoma EVs compared to control EVs revealed 569 differentially expressed genes (DEGs, 2XFC, FDR < 0.05). By using these DEGs, we developed serum-EV-based biomarker panels for the following glioblastomas: wild-type IDH1 (96% sensitivity/80% specificity), MGMT promoter methylation (91% sensitivity/73% specificity), p53 gene mutation (100% sensitivity/89% specificity), and TERT promoter mutation (89% sensitivity/100% specificity). This is the first study showing that serum-EV-based biomarker panels can be used to diagnose glioblastomas with a high sensitivity and specificity.

Background: Emodin and aloe-emodin are two anthraquinones having positive effects in wound healing. However, their mechanism of action of wound healing is not fully understood. The MAP kinase family, which plays an active role in wound healing, is a well-characterized large family of serine/threonine kinases and regulates processes such as proliferation, oncogenesis, differentiation, and inflammation in the cell. The aim of this study is to comparatively elucidate the mechanisms of action of emodin and aloe-emodin, which are potential agents in wound healing., Methods: The mechanism of the effects of emodin and aloe-emodin on cell viability and cell migration was examined using the human skin fibroblast (CCD-1079Sk) cell line. The gene expression levels of the MAP kinases (JNK, P38, ERK) in the skin fibroblast cells along with a molecular docking study analyzing their interaction potential were evaluated. Furthermore, the molecules' effects on the lifespan of Caenorhabditis elegans were studied., Results: Emodin and aloe-emodin inhibited the ATP content of the cells in a concentration dependent manner and accelerated cell migration at the lower concentrations while inhibiting cell migration in the higher concentration treatment groups. The expressions of JNK and P38 were upregulated at the low concentrations and downregulated at the higher concentrations. The molecular docking studies of the molecules gave high docking scores indicating their interaction potential with JNK and P38. C. elegans lifespan under heat stress was observed longer after 75 µM emodin and was significantly reduced after 150 µM aloe-emodin treatment., Conclusion: Aloe-emodin was found to be more potent on cell viability, cell migration, gene expression levels of the MAP kinases in healthy fibroblastic skin cells, and on the lifespan of C. elegans. This study reveals the functional effects and the biological factors that interact in the wound healing process of emodin and aloe-emodin, and give a possible treatment alternative to shorten the duration of wound care., (© 2023. The Author(s).)

Background: Diagnosing multiple sclerosis (MS) can be a lengthy process, which can negatively affect psychological well-being, condition management, and future engagement with health services. Therefore, providing timely and appropriate emotional support may improve adjustment and health outcomes., Purpose: To develop a patient care pathway for providing emotional support around the point of diagnosing MS, and to explore potential barriers and facilitators to delivery and implementation., Methods: Focus groups were conducted with 26 stakeholders, including 16 people living with MS, 5 carers/family members and 5 professionals working with people living with MS (3 MS nurses, 1 psychiatrist, and 1 charity staff member). Discussions were audio-recorded, transcribed verbatim and analyzed using framework analysis., Results: Participants suggested that a patient care pathway should include comprehensive information provision as a part of emotional support at diagnosis, and follow-up sessions with a healthcare professional. Barriers including increasing staff workloads and financial costs to health services were acknowledged, thus participants suggested including peer support workers to deliver additional emotional support. All participants agreed that elements of a care pathway and embedded interventions should be individually tailored, yet provided within a standardized system to ensure accessibility., Conclusions: A patient care pathway was developed with stakeholders, which included an embedded MS Nurse support intervention supplemented with peer support sessions. Participants suggested that the pathway should be delivered within a standardized system to ensure equity of service provision across the country., Patient or Public Contribution: This research was conceptualized and designed collaboratively with Nottingham Multiple Sclerosis Patient and Public Involvement and Engagement (PPIE) group members. One member is a co-author and was actively involved in every key stage of the research process, including co-design of the pathway and research protocol, data collection (including presenting to participants and moderating group discussions), analysis and write-up. Authors consulted with PPIE members at two meetings (9 and 11 PPIE attendees per meeting) where they gave feedback on the research design, findings and the resulting pathway. People living with MS and carers of people with MS were included in the focus groups as participants., (© 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Purpose: This meta-synthesis aimed to synthesise qualitative evidence on experiences of people with Multiple Sclerosis (MS) in receiving a diagnosis, to derive a conceptual understanding of adjustment to MS diagnosis., Methods: Five electronic databases were systematically searched to identify qualitative studies that explored views and experiences around MS diagnosis. Papers were quality-appraised using a standardised checklist. Data synthesis was guided by principles of meta-ethnography, a well-established interpretive method for synthesising qualitative evidence., Results: Thirty-seven papers were selected (with 874 people with MS). Synthesis demonstrated that around the point of MS diagnosis people experienced considerable emotional upheaval (e.g., shock, denial, anger, fear) and difficulties (e.g., lengthy diagnosis process) that limited their ability to make sense of their diagnosis, leading to adjustment difficulties. However, support resources (e.g., support from clinicians) and adaptive coping strategies (e.g., acceptance) facilitated the adjustment process. Additionally, several unmet emotional and informational support needs (e.g., need for personalised information and tailored emotional support) were identified that, if addressed, could improve adjustment to diagnosis., Conclusions: Our synthesis highlights the need for providing person-centred support and advice at the time of diagnosis and presents a conceptual map of adjustment for designing interventions to improve adjustment following MS diagnosis.Implications for RehabilitationThe period surrounding Multiple Sclerosis diagnosis can be stressful and psychologically demanding.Challenges and disruptions at diagnosis can threaten sense of self, resulting in negative emotions.Adaptive coping skills and support resources could contribute to better adjustment following diagnosis.Support interventions should be tailored to the needs of newly diagnosed people.