bluuebunny/crossref_metadata_2025 huggingface dataset:
Health literacy education at the time of COVID-19: development and piloting of an educational programme for university health professional students in 4 European countries
Authors: Papa Roberta , Sixsmith Jane , Giammarchi Cinzia , Lippke Sonia , McKenna Verna , Di Furia Lucia , Ceravolo Maria Gabriella , De Winter Andrea
Published: September 2023

Background

Health literacy has a strong influence on individual health outcomes and the sustainability of healthcare systems. Healthcare professionals often overestimate patients’ health literacy levels and lack adequate competencies to address limited health literacy effectively. Therefore, promoting understanding through effective health communication between professionals and citizens is becoming increasingly important. Although health literacy has recently gained more attention, health literacy educational programmes targeting future healthcare professionals are still scarce, especially in Europe. This study describes the piloting process of a pan-European health literacy educational programme and shows how the educational material is being used during time of crisis such as the COVID-19 pandemic.

Methods

The educational programme was developed through the definition of an educational philosophy and iterative co-creation processes consisting of stakeholders’ consultations, material development and pilots with students. The evaluation was carried out in Italy through four pilot tests involving 107 students of health-related degrees. An evaluation questionnaire and a pre-post test were developed and used to collect students’ and educators’ feedback (quantitative and qualitative) and assess changes in health literacy awareness, respectively. Three additional pilots were organized in Italy and Germany mostly during the COVID-19 pandemic to evaluate the feasibility of the educational programme through online and hybrid learning, respectively.

Results

The pilots received positive feedback from both students and educators. Students were highly satisfied with the courses, reported their relevance for their future profession and appreciated the interactive teaching methods. The pre-post test showed a significant improvement in health literacy awareness after the training. Educators reported the adequacy and flexibility of the training material, the ease of transferability of the content of the lessons into practice, and the validity of the tested options to integrate the educational programme into the curricula.

Conclusions

Our comprehensive, evidence-based educational programme contributes to addressing the existing challenges in Europe, and its flexibility allows for easy integration in the curricula, through different options, hence supporting a widespread uptake in the European Union and maybe beyond. Health literacy education is a useful tool to improve citizens’ access to healthcare information and services, achieve better health outcomes and support healthcare systems’ sustainability.
Investigation of physical playfulness in physiotherapy students
Authors: Karaali Hayriye Kul , Ozcan Ozlem
Published: September 2023

Background

Physiotherapists show a positive attitude towards playing games in order to be a role model for pediatric patients and to increase the success of therapy. The aim of the present study is to investigate the physical playfulness of physiotherapy students and the relationship of physical playfulness and individual and environmental factors.

Methods

The sociodemographic data, regular physical activity habits of the students were examined as well as their computer game playing status and duration. “Attitudes of 18–22 Age Adults for Playing Games That Contain Physical Activity” scale was used for assessing playfulness.

Results

A total of 268 students participated in the study. Among the game proneness scale subsections, the highest score was obtained in the Social Adjustment while the lowest scores were obtained in the “Desire to Play Game” and “To take pleasure from playing game” subsections. Male students scored higher in “Risk Taking and “To take pleasure from playing game” in comparison with the female students. There was a statistically significant difference between physical activity habits and “Game Compassion”, “Risk Taking”, “Social Adjustment” and “To take pleasure from playing game scores”.

Conclusion

Physiotherapy students were found to be more playful, particularly in terms of social adaptation. Men take more risks in the plays and also play the games more enjoyable. Students with regular physical activity habits were more playful overall. The present study suggests that monitoring physical activity levels, computer games types might be beneficial for evaluating the playfulness.
Are the stars aligned? Healthcare students’ conditions for negotiating tasks and competencies during interprofessional clinical placement
Authors: Törnqvist Tove , Lindh Falk Annika , Jensen Catrine Buck , Iversen Anita , Tingström Pia
Published: September 2023

Background

Healthcare students must learn to collaborate across professional boundaries so they can make use of each other’s knowledge and competencies in a way that benefits the patient. One aspect of interprofessional collaboration implies negotiating what needs to be done and by whom. Research, focused on the conditions under which students perform this negotiation when they are working together during interprofessional clinical placement, needs to be further developed. The study therefore aimed to explore students’ negotiation of tasks and competencies when students are working together as an interprofessional team during clinical placement.

Methods

The study was designed as a focused ethnographic observational study. Two Nordic sites where final-year healthcare students perform clinical interprofessional education were included. Data consists of fieldnotes, together with informal conversations, group, and focus group interviews. In total, 160 h of participating observations and 3 h of interviews are included in the study. The analysis was informed by the theory on communities of practice.

Results

Students relate to intersecting communities of practice when they negotiate what they should do to help a patient and who should do it. When the different communities of practice align, they support students in coming to an agreement. However, these communities of practice sometimes pulled the students in different directions, and negotiations were sometimes interrupted or stranded. On those occasions, observations show how the interprofessional learning practice conflicted with either clinical practice or one of the student’s profession-specific practices. Conditions that had an impact on whether or not communities of practice aligned when students negotiated these situations proved to be ‘having time to negotiate or not’, as well as ‘feeling safe or not’.

Conclusions

Final-year healthcare students can negotiate who in the team has the competence suited for a specific task. However, they must adapt their negotiations to different communities of practice being enacted at the same time. Educators need to be attentive to this and make an effort to ensure that students benefit from these intersecting communities of practice, both when they align and when they are in conflict.
Investigating the acceptance and use of massive open online courses (MOOCs) for health informatics education
Authors: Alharbi Ali H
Published: September 2023

Background

This study investigated the acceptance and use of massive open online courses (MOOCs) among health informatics educators and students in Saudi Arabian academic institutions. A theoretical model based on the unified theory of acceptance and use of technology (UTAUT), self-determination theory (SDT), and channel expansion theory (CET) was used to identify factors that affect MOOC adoption in health informatics education.

Methods

A survey research design was employed, and cross-sectional data were collected from health informatics instructors and students in academic institutions in Saudi Arabia. A total of 145 completed responses were used in the final analysis of the data.

Results

The findings indicated that performance and effort expectancy were important factors that could predict the acceptance and use of MOOCs among health informatics instructors and students. Additionally, perceived media richness affected the actual use of health informatics MOOCs among students and instructors in Saudi Arabian academic institutions. The results of this study show that autonomy, relatedness, and competence must be considered in the design of health informatics MOOCs.

Conclusions

A combination of these models can effectively explain the adoption and use of MOOCs in emerging fields such as health informatics.
Exploiting immunostimulatory mechanisms of immunogenic cell death to develop membrane-encapsulated nanoparticles as a potent tumor vaccine
Authors: Liu Qingwen , Hu Yongmao , Zheng Peng , Yang Ying , Fu Yuting , Yang Ying , Duan Biao , Wang Mengzhen , Li Duo , Li Weiran , He Jinrong , Zheng Xiao , Long Qiong , Ma Yanbing
Published: September 2023

Vaccine is one of the most promising strategies for cancer immunotherapy; however, there are no therapeutic cancer vaccine achieving significant clinical efficacy till now. The main limiting factors include the immune suppression and escape mechanisms developed by tumor and not enough capacity of vaccines to induce a vigorous anti-tumor immunity. This study aimed to develop a strategy of membrane-based biomimetic nanovaccine and investigate the immunological outcomes of utilizing the unique immunostimulatory mechanisms derived of immunogenic cell death (ICD) and of fulfilling a simultaneous nanoscale delivery of a highlighted tumor antigen and broad membrane-associated tumor antigens in the vaccine design. TC-1 tumor cells were treated in vitro with a mixture of mitoxantrone and curcumin for ICD induction, and then chitosan (CS)-coated polylactic co-glycolic acid (PLGA) nanoparticles loaded with HPV16 E744-62 peptides were decorated with the prepared ICD tumor cell membrane (IM); further, the IM-decorated nanoparticles along with adenosine triphosphate (ATP) were embedded with sodium alginate (ALG) hydrogel, And then, the immunological features and therapeutic potency were evaluated in vitro and in vivo. The nanovaccine significantly stimulated the migration, antigen uptake, and maturation of DCs in vitro, improved antigen lysosome escape, and promoted the retention at injection site and accumulation in LNs of the tumor antigen in vivo. In a subcutaneously grafted TC-1 tumor model, the therapeutic immunization of nanovaccine elicited a dramatical antitumor immunity. This study provides a strategy for the development of tumor vaccines.

Graphical Abstract
Enhanced therapeutic effect of PEDF-loaded mesenchymal stem cell-derived small extracellular vesicles against oxygen-induced retinopathy through increased stability and penetrability of PEDF
Authors: Fan Ruiyan , Su Lin , Zhang Hui , Jiang Yilin , Yu Zihao , Zhang Xiaomin , Li Xiaorong
Published: September 2023

Background

Several common retinal diseases that cause blindness are characterised by pathological neovascularisation accompanied by inflammation and neurodegeneration, including retinopathy of prematurity (ROP), diabetic retinopathy (DR), age-related macular degeneration (AMD), and retinal vein occlusion (RVO). The current treatment strategies for these diseases have limited benefits. Thus, safer and more effective alternative approaches are required. In this study, we loaded small extracellular vesicles (sEVs) derived from mesenchymal stem cell (MSC) with pigment epithelium-derived factor (PEDF), and tested the therapeutic effect of PEDF-loaded sEVs (PEDF-sEVs) using an oxygen induced retinopathy (OIR) mouse model, aiming to establish a new therapy strategy for the treatment of retinal pathological angiogenesis.

Results

We formulated PEDF-loaded sEVs (PEDF-sEVs) containing high concentrations of PEDF and evaluated their effects through in vivo and in vitro experiments. In OIR mice, PEDF-sEVs showed significantly better effects on retinal avascular areas, inflammation, and neuronal degeneration compared with the anti-vascular endothelial growth factor (VEGF) drug, which may indicate a possible advantage of PEDF-sEVs over anti-VEGF drugs in the treatment of pathological neovascularisation. In vitro, PEDF-sEVs greatly inhibited endothelial cell (EC) proliferation, migration, and tube formation by suppressing the VEGF-induced phosphorylation of extracellular signal-regulated kinase (ERK) and AKT (also known as Protein Kinase B). All experiments and analyses were performed in triplicate. PEDF-sEVs were more effective than PEDF or sEVs alone, both in vitro and in vivo. Furthermore, to determine the distribution of PEDF-sEVs, we used DiD-labelled sEVs and FITC-labelled PEDF to track the sEVs and PEDF, respectively. We found that PEDF-sEVs effectively reduced the degradation of PEDF.

Conclusions

Loading PEDF on sEVs effectively enhanced the anti-angiogenic, anti-inflammatory, and neuroprotective effects of PEDF by increasing the stability and penetrability. These results suggest a potential role for PEDF-sEVs in retinal pathological neovascularisation.

Graphical Abstract
LMP2-mRNA lipid nanoparticle sensitizes EBV-related tumors to anti-PD-1 therapy by reversing T cell exhaustion
Authors: Xiang Yu , Tian Miaomiao , Huang Juan , Li Yueyi , Li Guangqi , Li Xue , Jiang Zedong , Song Xiangrong , Ma Xuelei
Published: September 2023

Background

Targeting EBV-proteins with mRNA vaccines is a promising way to treat EBV-related tumors like nasopharyngeal carcinoma (NPC). We assume that it may sensitize tumors to immune checkpoint inhibitors.

Results

We developed an LMP2-mRNA lipid nanoparticle (C2@mLMP2) that can be delivered to tumor-draining lymph nodes. C2@mLMP2 exhibited high transfection efficiency and lysosomal escape ability and induced an increased proportion of CD8 + central memory T cells and CD8 + effective memory T cells in the spleen of the mice model. A strong synergistic anti-tumor effect of C2@mLMP2 in combination with αPD-1 was observed in tumor-bearing mice. The mechanism was identified to be associated with a reverse of CD8 + T cell exhaustion in the tumor microenvironment. The pathological analysis further proved the safety of the vaccine and the combined therapy.

Conclusions

This is the first study proving the synergistic effect of the EBV-mRNA vaccine and PD-1 inhibitors for EBV-related tumors. This study provides theoretical evidence for further clinical trials that may expand the application scenario and efficacy of immunotherapy in NPC.

Graphical Abstract
Characterizing Canadian funded partnered health research projects between 2011 and 2019: a retrospective analysis
Authors: Sibley Kathryn M. , Khan Masood , Touchette Alexie J. , Crockett Leah K. , Driedger S. Michelle , Gainforth Heather L. , Prabhu Devashree , Steliga Dawn , Tefft Olivia , Graham Ian D.
Published: September 2023

Background and Aims

Involving research users in collaborative research approaches may increase the relevance and utility of research findings. Our primary objectives were to (i) identify and describe characteristics of Canadian federally and provincially funded health research projects that included research users and were funded between 2011 and 2019; (ii) explore changes over time; and (iii) compare characteristics between funder required and optional partnerships.

Methods

Retrospective analysis. Inclusion criteria were projects that included research users. We analyzed publicly available project variables, and coded field and type of research using established classification systems. We summarized data with descriptive statistics and compared variables across three funding year blocks and partnership requirement status.

Results

We identified 1153 partnered health research projects, representing 137 fields of research and 37 types of research categories. Most projects included a required partnership (80%) and fell into health and social care services research (66%). Project length and funding amount increased from average of 24.8 months and $266 248 CAD in 2011–2013 to 31.6 months and $438 766 CAD in 2017–2019. There were significantly fewer required partnerships in 2017–2019.

Conclusions

Between 2011 and 2019 Canadian federally and provincially funded partnered health research reflected primarily care services research across many fields. The observed breadth suggests that partnered health research approaches are applicable in many fields of research. Additional work to support partnered research across all types of health research (especially biomedical research) is warranted. The administration of larger grants that are funded for longer time periods may address previously identified concerns among research teams engaging in partnered research but may mean that fewer teams receive funding and risk delaying responding to time-sensitive data needs for users. Our process and findings can be used as a starting point for international comparison.
The effect of patient-led goal setting approach combined with pain neuroscience education or manual therapy in patients with chronic low back pain: protocol for a parallel-group randomized controlled trial
Authors: Soheili Sahar , Letafatkar Amir , Hosseinzadeh Mahdi
Published: September 2023

Background

Low back pain (LBP) is a multifactorial disorder associated with a high range of physical and psychological burden on the society. Patient-led goal-setting approach has shown potential effects for improving chronic LBP. However, there are few studies investigating its benefits when combined with a supplementary intervention. This paper, therefore, presents a protocol for a randomized control trial (RCT) to study the effect of a patient-led goal-setting approach combined with pain neuroscience education (PNE) or manual therapy (MT) among patients with chronic LBP.

Methods

A total of 105 patients suffering from chronic LBP will be recruited via flyers displayed in hospitals and universities, and those meeting the study’s criteria will randomly be allocated into a patient-led goal-setting approach with the PNE group, and/or with the MT program group, and/or a control group. The primary outcomes will be the pain intensity and disability. Secondary outcomes include quality of life, depression, anxiety and stress, fear avoidance beliefs, kinesophobia, pain self-efficacy, catastrophic pain, neurophysiology of pain, and central sensitivity. All the outcomes will be recorded at 2 months after receiving the treatment as post-test sessions and after 4 and 12 months as follow-up sessions. The Ethics Committee in Research at Sport Sciences Research Institute of Iran approved the protocol of this trial (IR.SSRC.REC.1400.084). Written, informed consent to participate will be obtained from all participants. All methods will be conducted in accordance with the ethical standards of the Declaration of Helsinki and in accordance with relevant guidelines and regulations. We will disseminate the findings through peer-reviewed publications and conference presentations and send them to the participants.

Discussion

This trial will demonstrate which supplementary intervention can better improve the impact of a patient-led goal-setting approach to treat LBP. If successful, the results will potentially have implications for athletic trainers, physiotherapists, and health care practitioners.

Trial registration

IRCT Iranian Registry of Clinical Trials IRCT20210927052616N1. Registered on November 03, 2021.
Effects of surface topography and subsurface structural irregularities of river embankments on Rayleigh wave propagation
Authors: Miyanaga Shuntaro , Yamanaka Hiroaki
Published: September 2023

A numerical investigation of surface wave propagation in the surface wave exploration of river embankments is implemented using 3D shallow soil models with different subsurface shapes and S-wave velocities. The focus is on the effects of surface and subsurface irregularities on the propagation and dispersion characteristics of Rayleigh waves generated by a surface source and observed at points along the crest of the embankment. Rayleigh wave dispersion curves observed along the embankment crest are found to be contaminated by reflected waves, with the amount of contamination affected more by the position of the velocity boundary at the bottom edge of the embankment than the surface topography. When the velocity boundary is close to the ground surface, especially at the toe of the slope, the effect of reflected waves is sufficiently large to generate biases in the phase velocity estimates.

Graphical Abstract
Cystic lymphangioma of the gall bladder: common disease at uncommon site
Authors: Garg Vasudha , Gupta Pranav
Published: September 2023

Background

Cystic lymphangiomas are benign vascular malformations of lymphatic differentiation. They usually occur in childhood and are commonly seen in the head and neck region. Lymphangioma of the gallbladder is extremely rare, and only a handful of cases have been reported in the literature.

Case presentation

A 56-year-old female presented to the outpatient department for evaluation of right upper quadrant abdominal pain which had been bothering her for the past few months. Abdominal ultrasonography revealed an ill-defined septated cystic lesion surrounding the gallbladder (GB) which was initially thought to be a collection. However, contrast-enhanced computed tomography of abdomen showed a well-marginated fluid density lesion in the gall bladder fossa which was insinuating around the gall bladder and was encasing it. No intralesional enhancement was seen after contrast administration. MRI confirmed the well-defined, multiseptated lesion without any solid component in the gall bladder fossa encasing the GB but without any abnormal communication with the biliary tree. Therefore, a final diagnosis of slow flow lymphatic malformation was formulated. The patient underwent exploratory laparotomy, and the mass was resected en bloc with the GB. Histological evaluation was consistent with lymphatic malformation.

Conclusions

GB lymphangioma is a rare entity and is difficult to diagnose. While the imaging characteristics are essentially similar to lymphangiomas elsewhere in the body, the location is peculiar and should warrant a thorough evaluation by the means of CT and more importantly MRI.
Hepatic involvement in childhood dengue infection
Authors: Alam Rubaiyat , Rukunuzzaman Md. , Nahid Khan Lamia
Published: September 2023

Dengue or breakbone fever is one of the most important causes of febrile illness in children residing in tropical and subtropical regions. This mosquito-borne viral disease is mediated by the bite of the infected Aedes mosquito. Dengue infection has been expanding rapidly throughout the globe in the past few decades. The virus has hepatotoxic effects. However, the pathophysiology of liver involvement in dengue is still not entirely clear. The reported clinical spectrum of dengue hepatitis ranges from mild asymptomatic elevation in transaminaselevels to acute liver failure in children. This review focuses on hepatic manifestation, the pathogenesis of liver injury, and treatment option of the effects of dengue on the liver in the pediatric population.
Optimization of Advanced Molecular Genetic Testing Utilization in Hematopathology: A Goldilocks Approach to Bone Marrow Testing
Authors: AlJabban Ali , Paik Henry , Aster Jon C. , Berliner Nancy , Brouillard Jennifer , Brown Jennifer R. , Burns Kathleen H. , Castillo Jorge J. , Card James , Dal Cin Paola , DeAngelo Daniel J. , Dorfman David M. , Ebert Benjamin L. , Garcia Jacqueline S. , Jacobson Caron A. , Lakhani Hakim , Laubach Jacob P. , Ligon Azra H. , Lindeman Neal I. , Lindsley R. Coleman , Lovitch Scott B. , Luskin Marlise R. , Morgan Elizabeth A. , Nowak Andrew , Petrides Athena , Pinkus Geraldine S. , Pozdnyakova Olga , Steensma David P. , Stone Richard M. , Weinberg Olga K. , Winer Eric S. , Kim Annette S.
Published: September 2023

PURPOSE

This study investigated the effectiveness of algorithmic testing in hematopathology at the Brigham and Women's Hospital and Dana-Farber Cancer Institute (DFCI). The algorithm was predicated on test selection after an initial pathologic evaluation to maximize cost-effective testing, especially for expensive molecular and cytogenetic assays.

MATERIALS AND METHODS

Standard ordering protocols (SOPs) for 17 disease categories were developed and encoded in a decision support application. Six months of retrospective data from application beta testing was obtained and compared with actual testing practices during that timeframe. In addition, 2 years of prospective data were also obtained from patients at one community satellite site.

RESULTS

A total of 460 retrospective cases (before introduction of algorithmic testing) and 109 prospective cases (following introduction) were analyzed. In the retrospective data, 61.7% of tests (509 of 825) were concordant with the SOPs while 38.3% (316 of 825) were overordered and 30.8% (227 of 736) of SOP-recommended tests were omitted. In the prospective data, 98.8% of testing was concordant (244 of 247 total tests) with only 1.2% overordered tests (3 of 247) and 7.6% omitted tests (20 of 264 SOP-recommended tests; overall P < .001). The cost of overordered tests before implementing SOP indicates a potential annualized saving of $1,347,520 in US dollars (USD) in overordered testing at Brigham and Women's Hospital/DFCI. Only two of 316 overordered tests (0.6%) returned any additional information, both for extremely rare clinical circumstances.

CONCLUSION

Implementation of SOPs dramatically improved test ordering practices, with a just right number of ancillary tests that minimizes cost and has no significant impact on acquiring key informative test results.
Non-equilibrium memory effects: Granular fluids and beyond
Authors: Patrón A. , Sánchez-Rey B. , Plata C. A. , Prados A.
Published: September 2023

In this perspective paper, we look into memory effects in out-of-equilibrium systems. To be concrete, we exemplify memory effects with the paradigmatic case of granular fluids, although extensions to other contexts such as molecular fluids with non-linear drag are also considered. The focus is put on two archetypal memory effects: the Kovacs and Mpemba effects. In brief, the first is related to imperfectly reaching a steady state —either equilibrium or non-equilibrium—, whereas the second is related to reaching a steady state faster despite starting further. Connections to optimal control theory thus naturally emerge and are briefly discussed.
Thyroid Cancer Polygenic Risk Score Improves Classification of Thyroid Nodules as Benign or Malignant
Authors: Pozdeyev Nikita , Dighe Manjiri , Barrio Martin , Raeburn Christopher , Smith Harry , Fisher Matthew , Chavan Sameer , Rafaels Nicholas , Shortt Jonathan A , Lin Meng , Leu Michael G , Clark Toshimasa , Marshall Carrie , Haugen Bryan R , Subramanian Devika , Crooks Kristy , Gignoux Christopher , Cohen Trevor
Published: September 2023

Context

Thyroid nodule ultrasound-based risk stratification schemas rely on the presence of high-risk sonographic features. However, some malignant thyroid nodules have benign appearance on thyroid ultrasound. New methods for thyroid nodule risk assessment are needed.

Objective

We investigated polygenic risk score (PRS) accounting for inherited thyroid cancer risk combined with ultrasound-based analysis for improved thyroid nodule risk assessment.

Methods

The convolutional neural network classifier was trained on thyroid ultrasound still images and cine clips from 621 thyroid nodules. Phenome-wide association study (PheWAS) and PRS PheWAS were used to optimize PRS for distinguishing benign and malignant nodules. PRS was evaluated in 73 346 participants in the Colorado Center for Personalized Medicine Biobank.

Results

When the deep learning model output was combined with thyroid cancer PRS and genetic ancestry estimates, the area under the receiver operating characteristic curve (AUROC) of the benign vs malignant thyroid nodule classifier increased from 0.83 to 0.89 (DeLong, P value = .007). The combined deep learning and genetic classifier achieved a clinically relevant sensitivity of 0.95, 95% CI [0.88-0.99], specificity of 0.63 [0.55-0.70], and positive and negative predictive values of 0.47 [0.41-0.58] and 0.97 [0.92-0.99], respectively. AUROC improvement was consistent in European ancestry-stratified analysis (0.83 and 0.87 for deep learning and deep learning combined with PRS classifiers, respectively). Elevated PRS was associated with a greater risk of thyroid cancer structural disease recurrence (ordinal logistic regression, P value = .002).

Conclusion

Augmenting ultrasound-based risk assessment with PRS improves diagnostic accuracy.
Comparison of the effects of contrast-enhanced ultrasound and conventional ultrasound-guided radiofrequency ablation on benign thyroid nodules
Authors: Xu Shouxing , He Huiling , Jiang Meijuan
Published: September 2023

Objective: To compare the effect of contrast-enhanced ultrasound (CEUS) and conventional ultrasound-guided radiofrequency ablation (RFA) on benign thyroid nodules (BTNs).

Methods: In this retrospective observational study, the data of 72 patients with BTNs who received RFA treatment in The Fourth Affiliated Hospital of Zhejiang University School of Medicine from January 2020 to December 2021 were retrospectively reviewed and selected. The records showed that 34 patients received RFA under the guidance of conventional ultrasound (conventional ultrasound group) and 38 patients received RFA under the guidance of CEUS (CEUS group). The effect of treatment, complications and recurrence of the two groups were compared and analyzed.

Results: There was a smaller volume of thyroid nodules in the two groups immediately post-operation. The incidence of complications was lower in the CEUS group (5.26%) compared to the conventional ultrasound group (23.53%) (P<0.05). The recurrence rate at 6-months (0.00% vs 11.76%) and 12- months (2.63% vs 20.59%) post-operation was lower in the CEUS group compared to the conventional ultrasound group (P<0.05).

Conclusions: Compared with conventional ultrasound, CEUS-guided RFA is effective in treating BTNs, with smaller postoperative nodule volume, reduced occurrence of surgical complications, and reduced recurrence rate of thyroid nodules.

doi: https://doi.org/10.12669/pjms.39.6.8250

How to cite this: Xu S, He H, Jiang M. Comparison of the effects of contrast-enhanced ultrasound and conventional ultrasound-guided radiofrequency ablation on benign thyroid nodules. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.8250

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Anti-cytokine storm activity of fraxin and quercetin, alone and in combination, and their possible molecular mechanisms via TLR4 and PPAR-γ signaling pathways in lipopolysaccharide-induced RAW 264.7 cell line
Authors: S. Shaker Nada , B. Sahib Hayder , A. Hussein Zeena , J. Tahseen Nibras
Published: September 2023

Background: Cytokine storm syndrome (CSS) is a leading cause of morbidity and mortality in patients with late-stage coronavirus disease 2019 (COVID-19), causing multiple organ failure and death. According to prior research, fraxin, and quercetin have anti-inflammatory, antioxidant, antimicrobial, and antiviral properties. Therefore, this study aimed to investigate the anti-cytokine storm activity of fraxin and quercetin, their combination, and the molecular mechanism behind this activity in Lipopolysaccharide (LPS)-induced RAW 264.7 cells.

Methods: LPS-induced macrophage cells were treated with fraxin, quercetin, or their combinations at various doses for cytotoxicity, anti-cytokine assays, and gene expression analyses. An enzyme-linked immunosorbent assay was used to quantify the levels of proinflammatory cytokines, interleukin 1 beta (IL1β), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α), and RT-PCR was used to measure the gene expression of PPAR-γ and Toll-like receptor 4 (TLR-4) concerning GAPDH as a reference gene.

Results: The results revealed a slight decrease in cell viability only when higher concentrations were applied to the cells. Fraxin, quercetin, and their combination reduced the generation of proinflammatory cytokines. The combination (fraxin + quercetin (FQ)) reduced the levels of IL-1β, IL-6, and TNF-α by 56.2%, 58.5%, and 70.6% respectively, compared to the LPS-only control; pretreatment of cells with farxin, quercetin, and their combination resulted in significant inhibition of TLR-4 gene expression by 89%, 82%, and 93% respectively, compared to the control (P˂ 0.05); FQ upregulated PPAR-γ expression up to 60-fold compared to the control, while fraxin and quercetin increased PPAR-γ by 17.6 and 8.6-folds, respectively.

Conclusions: Based on these findings, fraxin, quercetin and their combination might be considered anti-cytokine storm agents, which could lay the groundwork for future research into other combinations of fraxin and quercetin, as well as the pathways involved in the molecular mechanisms underlying the synergistic anti-cytokine-storm-activity.
Development and Initial Implementation of a Clinical Monitoring Strategy in a Non-regulated Trial: a research note from the ReStOre II Trial
Authors: O'Neill Linda , Murphy Fiona , Reidy Derval , Poisson Camille , Hussey Juliette , Guinan Emer
Published: September 2023

Background: Data and Safety Monitoring is integral to quality assurance of clinical trials. Although monitoring is a core legal component of regulated clinical trials, non-regulated trials are not mandated to incorporate monitoring. Consequently, the monitoring process has been underutilised and underreported in this setting. This research report outlines the development and plans for implementing a bespoke Clinical Monitoring Strategy within the ‘Rehabilitation Strategies Following Oesophagogastric and Hepatopancreaticobiliary Cancer (ReStOre II) Trial’, a non-regulated trial comparing a 12-week multidisciplinary programme of rehabilitation to standard care in a cohort of 120 cancer survivors.

Methods: This research note provides a detailed overview of the ReStOre II Clinical Monitoring Strategy and describes the development of the strategy pre and post awarding of the grant. The strategy consists of the establishment and implementation of a comprehensive trial governance structure, inclusive of a Trial Management Group, Trial Steering Committee Meeting, and Independent Data Monitoring Committee. In addition, external trial monitoring by the Clinical Research Facility at St James’s Hospital. Three monitoring visits will be conducted during the trial; i) site initiation visit, ii) interim monitoring visit, and iii) close our visit.

Results: The Clinical Monitoring Strategy has been finalised and is currently being implemented within the ReStOre II Trial. Two site initiation visits and one interim monitoring visit have been completed to date.

Conclusion: This research note provides a template for implementation of a Clinical Monitoring Strategy in a non-regulated clinical trial.

Registration: ReStOre II Trial: https://clinicaltrials.gov/ct2/show/NCT03958019
Syphilis - a disease that still occurs
Authors: Ben Rhaiem Rami , Kępka Przemysław , Kuziemkowska Daria , Kuźma Jan , Łącka-Majcher Anna , Łokczewska-Bojar Aleksandra , Tarsa Grzegorz , Skotalczyk Magdalena , Sawińska Zuzanna , Sudelska Katarzyna
Published: September 2023

Introduction: Syphilis is a systemic disease caused by Treponema pallidum. Humans are the only hosts, and the incubation period lasts from 9-90 days. Currently it can be divided into congenital or acquired. This division is due to the moment in which the infection occurred. Congenital Syphilis- when the infection happens during the prenatal period, whereas acquired, when the infection took place in the period after birth. In early acquired syphilis the I and II stages can be distinguished as well as early latent syphilis. As defined, early latent syphilis includes an acquired infection up to 1 or 2 years back, depending on the guidelines. Late syphilis however includes: late latent syphilis, tertiary syphilis, late cardiovascular syphilis, late neurosyphilis. Congenital syphilis has also been divided into early (which includes the first 2 years) as well as late, which is characterised by signs of congenital syphilis, the so-called stigmata of congenital syphilis constituting the untreated infection during the fetal stage or the infancy stage.  Aim of the Study: The aim of our study is to divert the attention to one of the sexually transmitted diseases, which despite the downward trend at the end of the 20th century, rebounded at the beginning of the 21st century, especially among men who have sexual contact with other men. We paid attention to the symptoms accompanying this disease, also in the context of congenital syphilis, as well as the different methods of pharmacological treatment according to European guidelines.  Materials and methods: Reviewed literature available at scientific articles , Google Scholar using keywords: “syphilis – epidemiology”, “syphilis treatment”, “symptoms of syphilis”, as well as European guidelines regarding the treatment of syphilis.
Food Allergies - Trends and Challenges in Treatment and Diagnosis
Authors: Sawińska Zuzanna , Sudelska Katarzyna , Tarsa Grzegorz , Kępka Przemysław , Łokczewska-Bojar Aleksandra , Skotalczyk Magdalena , Kuziemkowska Daria , Kużma Jan , Ben Rhaiem Rami , Łącka-Majcher Anna
Published: September 2023

Introduction:

Food allergies are becoming an increasingly significant challenge for medicine, public health and patients' quality of life. Over the past few decades, there has been an observed increase in the number of cases of food allergies. This has led to heightened interest among scientists, doctors and specialists in various aspects related to the diagnosis and treatment of this condition. With the increasing precision of food allergy diagnosis, it is necessary to adjust the therapy to the individual needs of patients.

Aim of the study:

The aim of our study is to summarize the trends and challenges in treatment and diagnosis of food allergies. We focused on current diagnostic methods and treatment options, as well as

new promising therapeutic approaches.

State of knowledge:

In molecular or component-resolved diagnostic tests (CRD), specific IgE antibodies are measured for individual food allergenic molecules. This presents an opportunity to improve specificity for selected foods. Studies have shown that the Basophil Activation Test (BAT) exhibits higher specificity than skin prick tests (SPT) and s-IgE tests, while maintaining its sensitivity. BAT relies on flow cytometry, where the expression of activation markers on the surface of basophils stimulated by an antigen is measured.

Due to the existing limitations of certain tests, Oral Food Challenge (OFC) is still considered the gold standard for diagnosing IgE-mediated food allergies.Summary:Research shows that the foundation of diagnosis is the patient's medical history, including a properly collected interview, which should then guide the doctor towards appropriate tests.

An elimination diet based on the clinical interview should be implemented until significant relief of allergy symptoms is achieved.
Optimal Joint Assortment for an Omni-Channel Retailer
Authors: Sapra Amar , Kumar Subodha
Published: September 2023

With the growing popularity of e-commerce, nearly every prominent retailer is aiming to turn omni-channel. One crucial decision in this pursuit is the identification of the joint assortment. In this study, we contribute by examining joint assortment and product prices for a retailer that sells products through both brick-and-mortar and online channels. Our analysis indicates that the optimal assortment should be thought of as a portfolio of two types of products: customized and omni-channel. Customized products are priced in such a way that they are targeted toward customers who prefer to shop from the channel the products are sold through. In contrast, omni-channel products are priced attractively so that all customers consider buying them. The relative mix of these products depends on how flexible customers are in shopping from the channel they do not prefer and the number of customers who prefer each channel. Additionally, we investigate whether the conventional wisdom of selling niche products through the online channel is always optimal. We find that this suggestion may be sub-optimal when the online channel has greater cost of including a product in the assortment and fewer preferring customers compared with the brick-and-mortar channel.
Rethinking recovery: rehabilitation and intra-abdominal pressure management to reduce the risk of parastomal hernia
Authors: Mills Julie
Published: September 2023

Julie Mills, RN, Global Ostomy Nurse Engagement Manager, Convatec, writes that parastomal hernia is a common and consequential complication of stoma surgery, but the risk can be reduced with a structured rehabilitation programme based on appropriate core abdominal exercises, supported by the full multidisciplinary team
Parastomal hernia: an overview
Authors: Denti Francesco Carlo , Brambilla Davide , De Luca Giovanni , Malvone Alessandro Pasquale , Maglio Andrea , Oliveri Matteo , Scaduto Vitalba , Rosati Riccardo , Tamburini Andrea Marco , Villa Giulia
Published: September 2023

Parastomal hernia (PH) is one of the most frequent ostomy complications, and the reported incidence in the literature is highly variable. As highlighted by the Association of Stoma Care Nurses UK, this complication develops mainly in children and older men over 70, but many predisposing factors are related to the individual patient and surgery. There is no standardised system for assessing PH. The main assessment techniques include objective examination, ultrasound scan and computed tomography. Prevention is based on various interventions by surgeons and stoma care nurses (SCNs). The SCN's primary interventions include accurate patient evaluation, pre-operative ostomy siting, education about body weight management and advice on appropriate exercises. The treatment of PH can be conservative or surgical, and the choice is based on the patient's clinical condition. Ostomy can significantly impact on a patient's quality of life (QoL), and the presence of PH can further aggravate the situation. This overview of PH considers the incidence, aetiology, prevention, treatment and impact on QoL.
Prevention of pressure injuries using a non-motorised decompression air mattress: a non-interventional study
Authors: Meaume Sylvie , Marty Marc
Published: September 2023

Objective:

Prevention of pressure injuries (PI) is a public health issue. Among the preventive measures, the use of support surfaces adapted to the risk of PI occurrence is recommended. This study aimed to report the incidence of PIs in patients at medium-to-high risk of occurrence of PIs and using a new non-motorised automated decompression air mattress combined with other recommended PI prevention measures.

Method:

An observational, national, multicentre, prospective, non-comparative study, with a follow-up period of 35 days was conducted. Patients at medium-to-high risk of PIs and without PIs at baseline were included if they were lying on a specific non-powered automated decompression air mattress. The primary outcome was the percentage of patients who developed at least one category 2 or more severe PI of the sacrum, backbone or heel between day 0 and day 35.

Results:

In total, 81 patients were included from four participating centres. There was one report of a patient with a PI that fitted within the definition of the primary outcome, meaning an incidence of 1.2% (95% confidence interval (CI) 0–6.7%). More than 80% of patients rated the overall comfort and the stability of the non-motorised automated decompression air mattress as satisfactory or very satisfactory. In more than 80% of cases, the healthcare teams found the use of the mattress to be easy or very easy.

Conclusion:

This study has shown that in combination with other preventive measures, the use of a specific non-motorised air mattress with automated decompression is associated with a low incidence of PIs in patients with medium-to-high risk of occurrence of PIs.
Evaluation of in-shoe plantar pressure and shear during walking for diabetic foot ulcer prevention
Authors: Tang Jinghua , Bader Dan L , Parker Daniel J , Forghany Saeed , Nester Christopher J , Moser David , Jiang Liudi
Published: September 2023

Objective:

To investigate reliability and changes of in-shoe plantar pressure and shear during walking at three cadences with two insole designs. This was a precursor to the investigation of plantar loading in people with diabetes for potential foot ulcer prevention.

Method:

A sensorised insole system, capable of measuring plantar pressure and shear at the heel, fifth metatarsal head (5MH), first metatarsal head (1MH) and hallux, was tested with ten healthy participants during level walking. Reliability was evaluated, using intra-class correlation coefficient (ICC), while varying the cadences and insole types. Percentage changes in pressure and shear relative to values obtained at self-selected cadence with a flat insole design were investigated.

Results:

Mean±standard deviation of maximum pressure, medial–lateral and anterior–posterior shear of up to 380±24kPa, 46±2kPa and –71±4kPa, respectively, were measured. The ICC in ranges of 0.762–0.973, 0.758–0.987 and 0.800–0.980 were obtained for pressure, anterior–posterior and medial–lateral shear, respectively. Opposite anterior–posterior shear directions between 5MH and 1MH (stretching), and between 1MH and hallux (pinching) were observed for some participants. Increasing cadence increased pressure and anterior–posterior shear (by up to +77%) but reduced medial–lateral shear at the heel and hallux (by up to –34%). Slower cadence increased anterior–posterior shear (+114%) but decreased medial–lateral shear (–46%) at the hallux. The use of a flexible contoured insole resulted in pressure reduction at the heel and 5MH but an increase in anterior–posterior shear at the heel (+69%) and hallux (+75%).

Conclusion:

The insole system demonstrated good reliability and is comparable to reported pressure-only systems. Pressure measurements were sensitive to changes in cadence and insole designs in ways that were consistent with the literature. However, our plantar shear showed localised shear changes with cadences and insoles for the first time, as well as stretching and pinching effects on plantar tissue. This opens new possibilities to investigate plantar tissue viability, loading characteristics and orthotic designs aimed towards foot ulcer prevention.