bluuebunny/crossref_metadata_2025 huggingface dataset:
High-frequency ultrasound-assisted drug delivery of chia, cress, and flax conjugated hematite iron oxide nanoparticle for sono-photodynamic lung cancer treatment in vitro and in vivo
Authors: Abd El-Kaream Samir Ali , Zedan Doha Farhat Mohamed , Mohamed Hagar Mohamed , Soliman Amal Saleh Mohamed , El-Kholey Sohier Mahmoud , Nasra Mohammed Kamal El-Dein
Published: August 2024

Background

Sono-photodynamic therapy (SPDT), which combines photodynamic (PDT) and sonodynamic (SDT) therapies with sensitizers, offers new avenues for cancer treatment. Even though new sensitizers for SPDT have been synthesized with great success, few of them are effectively used. The limited tumor-targeting specificity, inability to transport the sensitizers deeply intratumorally, and the deteriorating tumor microenvironment limit their anti-tumor effectiveness. The current study was carried out aiming at high-frequency ultrasound-assisted drug delivery of chia, cress and flax conjugated hematite iron oxide nanoparticles (CCF–HIONP) for photothermal–photodynamic lung cancer (LCA) treatment in vitro and in vivo as activated cancer treatment up-to-date modality.

Materials and methods

The study was conducted in vitro on human LCA cells (A-549) and the study protocol application groups in vivo on Swiss albino mice treated with benzo[a]pyrene only and were not received any treatment for inducing LCA, and only after LCA induction the study treatment protocol began, treatment was daily with CCF–HIONP as HIFU–SPDT sensitizer with or without exposure to laser (IRL) or high-frequency ultrasound (HIFU–US) or a combination of laser and/or high-frequency ultrasound for 3 min for 2 weeks.

Results

Revealed that HIONP can be employed as effective CCF delivery system that directly targets LCA cells. In addition, CCF–HIONP is a promising HIFU–SPS for HIFU–SPDT and when combined with HIFU–SPDT can be very effective in treatment of LCA–A549 in vitro (cell viability decreased in a dose-dependent basis, the cell cycle progression in G0/G1 was slowed down, and cell death was induced as evidenced by an increase in the population of Pre-G cells, an increase in early and late apoptosis and necrosis, and an increase in autophagic cell death) and benzo[a]pyrene LCA-induce mice in vivo (decreased oxidative stress (MDA), and ameliorated enzymatic and non-enzymatic antioxidants (SOD, GR, GPx, GST, CAT, GSH, and TAC) as well as renal (urea, creatinine) and hepatic (ALT, AST) functions, induced antiproliferative genes (caspase 3,9, p53, Bax, TNFalpha), suppressed antiapoptotic and antiangiogenic genes (Bcl2,VEGF respectively) and effectively reducing the growth of tumors and even leading to cancer cell death. This process could be attributed to photochemical and/or high-frequency sono-chemical activation mechanism HIFU–SPDT.

Conclusions

The results indicate that CCF–HIONP has great promise as an innovative, effective delivery system for selective localized treatment of lung cancer that is activated by HIFU–SPDT.
The COVID-19 pandemic: a threat to higher education? Evidence from a large university in Northern Italy
Authors: Bonaccolto-Töpfer Marina , Castagnetti Carolina
Published: August 2024

Transition to online teaching during the first wave of the COVID-19 pandemic has led to various concerns about educational quality. The study investigates the consequences of this transition on student performance for a prominent university in Northern Italy. Comprehensive administrative data allows us to monitor students’ performance and to have detailed socioeconomic information about them. Using a difference-in-differences design with lecturer fixed effects, we exploit the unique timing of the lockdown that fell together with the start of the summer term in 2020. We find no marked effects on students’ average grades in higher education in the immediate aftermath of the lockdown.
Dietary habits as associated factors with irritable bowel syndrome among medical students: evidence from a cross-sectional study
Authors: Mahyoub Mueataz A. , Abbas Osama , Elhoumed Mohamed , Ghabisha Saif , Refat Moath , Abbas Mustafa , Al-Qurmoti Sarah , Li Yarui , Ren Mudan , He Shuixiang
Published: August 2024

Background

Research on Irritable Bowel Syndrome (IBS) among medical students has increased globally, highlighting a high prevalence in this demographic. However, there is a lack of data specifically regarding the prevalence of IBS among medical students in Yemen. This study aimed to investigate the prevalence and associated factors of IBS among Yemeni medical students.

Methods

We conducted a cross-sectional study involving medical students who completed a validated self-administered questionnaire incorporating socio-demographic information, dietary habits, smoking status, sleep patterns, and the Rome IV criteria for IBS. We used bivariate and multivariate logistic regression models to identify IBS’s associated factors, estimated as odds ratios (ORs) with 95% confidence intervals (CIs) and average marginal effect (AME) on the predicted probability of IBS.

Results

The study included 351 medical students with a mean age of 22.53 ± 2.70 years; 39.60% (139) were females. The prevalence of IBS was 26.21% (92 students), with 67.39% (62) of them classified as IBS-M (mixed). In multivariable analysis, the consumption of carbonated soft drinks remained significantly associated with IBS (OR: 3.35; 95% CI: 1.14–9.88; P = 0.028). In males, coffee consumption had a substantial effect on the predicted probability of IBS (AME: 11.41%; 95% CI: 0.32–22.60). In females, the consumption of carbonated soft drinks had a significant effect on the predicted probability of IBS (AME: 24.91%; 95% CI: 8.34–41.48).

Conclusion

The consumption of carbonated soft drinks is significantly associated with IBS among medical students, with a particularly notable increase in the predicted probability of IBS in females. These findings highlight the necessity for gender-specific dietary recommendations in IBS management. Further research is essential to investigate IBS in the general population to gain a comprehensive understanding of its prevalence and associated factors.
Direct and indirect effects of economic sanctions on health: a systematic narrative literature review
Authors: Yazdi-Feyzabadi Vahid , Zolfagharnasab Atefeh , Naghavi Soheila , Behzadi Anahita , Yousefi Maysam , Bazyar Mohammad
Published: August 2024

Background

Economic sanctions are defined as restrictions imposed by other countries against individuals, groups, or governments of other countries. These sanctions have a detrimental impact on the economies of countries and can also limit access to healthcare services for people as a secondary consequence. This study aims to systematically review the literature to examine the direct and indirect effects of economic sanctions on health through a narrative synthesis.

Methods

This systematic literature review was limited to papers published between January 1990 and July 2023. Relevant documents published in English and Persian were searched for in databases including Cochrane Library, PubMed, Embase, Scopus, Web of Science, SID, Magiran, and Irandoc. The direct and indirect effects of sanctions on health were classified using two frameworks proposed by the World Health Organization (WHO): the Health System Building Blocks and “Social Determinants of Health”.

Results

Out of a total of 18,219 articles, 59 were selected based on inclusion criteria. The effects of sanctions were divided into direct and indirect groups. Direct effects encompassed seven main themes: access to essential medicine, medical products, vaccines and technologies; financing; health workforce; service delivery; research and health information systems; health outcomes; and financial risk protection. Indirect effects also were classified into six main themes: socioeconomic status; food and agricultural products; stress; early life conditions; high-risk behaviors and addiction; and transport. Most studies focused on the access to medicines, food, economic and social status.

Conclusions

Economic sanctions have had profoundly negative impacts on all aspects of the healthcare system. The international community must address these effects on health and take necessary measures to prevent or mitigate them, particularly in ensuring the provision of basic and essential healthcare needs for individuals and communities.
Monson’s sphere in Chinese young adult females with individual normal occlusion: a preliminary study using digital models
Authors: Wang Yajing , Wang Tianqi , Chen Jiangfei , Duan Xiaoni , Liu Dongqiao , Xiao Danna , Zhang Chunxiang
Published: August 2024

Background

This study investigated the characteristics of Monson’s sphere in Chinese young adult females with individual normal occlusion to provide a reference for oral rehabilitation in prosthodontic and orthodontic treatments.

Methods

Points at the dental cusps and incisal edges were selected from 51 digital mandibular dental models of Chinese young adult females (aged 18–22 years) with individual normal occlusion. Monson’s spheres were fitted to the selected points based on the least-squares principle and the radii were calculated. The deviation of each selected point from its relative spherical surface was also calculated. The radii and deviations of these points were examined using conventional descriptive statistics and distributions of the most deviated points inside and outside the spheres were analyzed.

Results

The mean radius of Monson’s sphere in Chinese young adult females was 79.60 ± 14.13 mm. The deviation of each selected point from its relative sphere surface was 0.38 ± 0.30 mm. The maximum deviations inside and outside the sphere were 0.93 ± 0.25 mm and 0.95 ± 0.30 mm, respectively. The most deviated points outside the spheres were mainly distributed at the distolingual cusps of the mandibular second permanent molars (31.37%), while those inside the spheres were mainly distributed at the mesiolingual cusps of the mandibular first permanent molars (45.10%).

Conclusions

The radius of Monson’s sphere in Chinese young adult females was smaller than the classic four-inch value suggested by Monson. Deviation was observed from all selected points to their Monson’s sphere surface, with the most deviated points distributed primarily in the molar region.
Clinical SWIR and CP-OCT imaging of interproximal lesions
Authors: Zhu Yihua , Le Oanh , Xue Joany , Wycoff Spencer , Fried Daniel
Published: August 2024

Background

Enamel is highly transparent at short wavelength infrared imaging (SWIR) wavelengths allowing the detection of dental decay without the need for ionizing radiation. The purpose of this study was to use SWIR imaging methods including cross polarization optical coherence tomography (CP-OCT), occlusal transillumination (SWIR-OT), proximal transillumination (SWIR-PT), and occlusal reflectance (SWIR-R) to image interproximal lesions in vivo and compare the sensitivity with radiography.

Methods

Participants (n = 30) aged 18–80 each with a radiopositive interproximal lesion scheduled for restoration were enrolled in the study. Studies have shown that the opposing proximal surfaces across the contact will likely also have lesions. SWIR images were acquired of the adjoining teeth at each contact with an interproximal lesion scheduled for restoration. Lesion presence and depth were assessed on each side of the contact for radiography and each SWIR imaging method. Lesions on radiographs and in CP-OCT images were identified by a single examiner while lesions in SWIR images were identified by a contrast threshold via semi-automatic image segmentation.

Results

All SWIR imaging methods had significantly higher sensitivity (P < 0.05) than radiographs for the detection of interproximal lesions on the teeth opposite those restored. CP-OCT and SWIR-R imaging methods had significantly higher sensitivity than the other methods. SWIR imaging methods showed significantly higher lesion contrast than radiography.

Conclusions

SWIR imaging methods can be used to detect interproximal lesions on posterior teeth with higher diagnostic performance than radiographs. CP-OCT appears well suited as a potential gold standard for the detection of interproximal lesions and assessment of their severity in vivo.
Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era
Authors: van der Ven Fleur–Stefanie L. I. M. , Blok Siebe G. , Azevedo Luciano C. , Bellani Giacomo , Botta Michela , Estenssoro Elisa , Fan Eddy , Ferreira Juliana Carvalho , Laffey John G. , Martin–Loeches Ignacio , Motos Ana , Pham Tai , Peñuelas Oscar , Pesenti Antonio , Pisani Luigi , Neto Ary Serpa , Schultz Marcus J. , Torres Antoni , Tsonas Anissa M. , Paulus Frederique , van Meenen David M. P. ,   for the ERICC–, LUNG SAFE–, PRoVENT–COVID–, EPICCoV–, CIBERESUCICOVID–, SATI–COVID–19–investigators
Published: August 2024

Background

Ventilation management may differ between COVID–19 ARDS (COVID–ARDS) patients and patients with pre–COVID ARDS (CLASSIC–ARDS); it is uncertain whether associations of ventilation management with outcomes for CLASSIC–ARDS also exist in COVID–ARDS.

Methods

Individual patient data analysis of COVID–ARDS and CLASSIC–ARDS patients in six observational studies of ventilation, four in the COVID–19 pandemic and two pre–pandemic. Descriptive statistics were used to compare epidemiology and ventilation characteristics. The primary endpoint were key ventilation parameters; other outcomes included mortality and ventilator–free days and alive (VFD–60) at day 60.

Results

This analysis included 6702 COVID–ARDS patients and 1415 CLASSIC–ARDS patients. COVID–ARDS patients received lower median VT (6.6 [6.0 to 7.4] vs 7.3 [6.4 to 8.5] ml/kg PBW; p < 0.001) and higher median PEEP (12.0 [10.0 to 14.0] vs 8.0 [6.0 to 10.0] cm H2O; p < 0.001), at lower median ΔP (13.0 [10.0 to 15.0] vs 16.0 [IQR 12.0 to 20.0] cm H2O; p < 0.001) and higher median Crs (33.5 [26.6 to 42.1] vs 28.1 [21.6 to 38.4] mL/cm H2O; p < 0.001). Following multivariable adjustment, higher ΔP had an independent association with higher 60–day mortality and less VFD–60 in both groups. Higher PEEP had an association with less VFD–60, but only in COVID–ARDS patients.

Conclusions

Our findings show important differences in key ventilation parameters and associations thereof with outcomes between COVID–ARDS and CLASSIC–ARDS.

Trial registration

Clinicaltrials.gov (identifier NCT05650957), December 14, 2022.
Machine learning-based identification of biomarkers and drugs in immunologically cold and hot pancreatic adenocarcinomas
Authors: Ge Jia , Ge Juan , Tang Gu , Xiong Dejun , Zhu Dongyan , Ding Xiaoling , Zhou Xiaorong , Sang Mengmeng
Published: August 2024

Background

Pancreatic adenocarcinomas (PAADs) often exhibit a “cold” or immunosuppressive tumor milieu, which is associated with resistance to immune checkpoint blockade therapy; however, the underlying mechanisms are incompletely understood. Here, we aimed to improve our understanding of the molecular mechanisms occurring in the tumor microenvironment and to identify biomarkers, therapeutic targets, and potential drugs to improve PAAD treatment.

Methods

Patients were categorized according to immunologically hot or cold PAAD subtypes with distinct disease outcomes. Cox regression and weighted correlation network analysis were performed to construct a novel gene signature, referred to as ‘Downregulated in hot tumors, Prognostic, and Immune-Related Genes’ (DPIRGs), which was used to develop prognostic models for PAAD via machine learning (ML). The role of DPIRGs in PAAD was comprehensively analyzed, and biomarker genes able to distinguish PAAD immune subtypes and predict prognosis were identified by ML. The expression of biomarkers was verified using public single-cell transcriptomic and proteomic resources. Drug candidates for turning cold tumors hot and corresponding target proteins were identified via molecular docking studies.

Results

Using the DPIRG signature as input data, a combination of survival random forest and partial least squares regression Cox was selected from 137 ML combinations to construct an optimized PAAD prognostic model. The effects and molecular mechanisms of DPIRGs were investigated by analysis of genetic/epigenetic alterations, immune infiltration, pathway enrichment, and miRNA regulation. Biomarkers and potential therapeutic targets, including PLEC, TRPV1, and ITGB4, among others, were identified, and the cell type-specific expression of the biomarkers was validated. Drug candidates, including thalidomide, SB-431542, and bleomycin A2, were identified based on their ability to modulate DPIRG expression favorably.

Conclusions

By combining multiple ML algorithms, we developed a novel prognostic model with excellent performance in PAAD cohorts. ML also proved to be powerful for identifying biomarkers and potential targets for improved PAAD patient stratification and immunotherapy.
Emergency robotic surgery: the experience of a single center and review of the literature
Authors: Ceccarelli Graziano , Catena Fausto , Avella Pasquale , Tian Brian WCA , Rondelli Fabio , Guerra Germano , De Rosa Michele , Rocca Aldo
Published: August 2024

Backgrounds

Laparoscopic surgery is widely used in abdominal emergency surgery (AES), and the possibility of extending this approach to the more recent robotic surgery (RS) arouses great interest. The slow diffusion of robotic technology mainly due to high costs and the longer RS operative time when compared to laparoscopy may represent disincentives, especially in AES. This study aims to report our experience in the use of RS in AES assessing its safety and feasibility, with particular focus on intra- and post-operative complications, conversion rate, and surgical learning curve. Our data were also compared to other experiences though an extensive literature review.

Methods

We retrospectively analysed a single surgeon series of the last 10 years. From January 2014 to December 2023, 36 patients underwent urgent or emergency RS. The robotic devices used were Da Vinci Si (15 cases) and Xi (21 cases).

Results

36 (4.3%) out of 834 robotic procedures were included in our analysis: 20 (56.56%) females. The mean age was 63 years and 30% of patients were ≥ 70 years. 2 (5.55%) procedures were performed at night. No conversions to open were reported in this series. According to the Clavien-Dindo classification, 2 (5.5%) major complications were collected. Intraoperative and 30-day mortality were 0%.

Conclusions

Our study demonstrates that RS may be a useful and reliable approach also to AES and intraoperative laparoscopic complications when performed in selected hemodynamically stable patients in very well-trained robotic centers. The technology may increase the minimally invasive use and conversion rate in emergent settings in a completely robotic or hybrid approach.
Granulosa cell insight: unraveling the potential of menstrual blood-derived stem cells and their exosomes on mitochondrial mechanisms in polycystic ovary syndrome (PCOS)
Authors: Mansoori Mahna , Solhjoo Somayeh , Palmerini Maria Grazia , Nematollahi-Mahani Seyed Noureddin , Ezzatabadipour Massood
Published: August 2024

Background

Polycystic ovary syndrome (PCOS) presents a significant challenge in women’s reproductive health, characterized by disrupted folliculogenesis and ovulatory dysfunction. Central to PCOS pathogenesis are granulosa cells, whose dysfunction contributes to aberrant steroid hormone production and oxidative stress. Mitochondrial dysfunction emerges as a key player, influencing cellular energetics, oxidative stress, and steroidogenesis. This study investigates the therapeutic potential of menstrual blood-derived stem cells (MenSCs) and their exosomes in mitigating mitochondrial dysfunction and oxidative stress in PCOS granulosa cells.

Methods

Using a rat model of PCOS induced by letrozole, granulosa cells were harvested and cultured. MenSCs and their exosomes were employed to assess their effects on mitochondrial biogenesis, oxidative stress, and estrogen production in PCOS granulosa cells.

Results

Results showed diminished mitochondrial biogenesis and increased oxidative stress in PCOS granulosa cells, alongside reduced estrogen production. Treatment with MenSCs and their exosomes demonstrated significant improvements in mitochondrial biogenesis, oxidative stress levels, and estrogen production in PCOS granulosa cells. Further analysis showed MenSCs' superior efficacy over exosomes, attributed to their sustained secretion of bioactive factors. Mechanistically, MenSCs and exosomes activated pathways related to mitochondrial biogenesis and antioxidative defense, highlighting their therapeutic potential for PCOS.

Conclusions

This study offers insights into granulosa cells mitochondria’s role in PCOS pathogenesis and proposes MenSCs and exosomes as a potential strategy for mitigating mitochondrial dysfunction and oxidative stress in PCOS. Further research is needed to understand underlying mechanisms and validate clinical efficacy, presenting promising avenues for addressing PCOS complexity.
Salmonid Rickettsial Septicemia (SRS) disease dynamics and Atlantic salmon immune response to Piscirickettsia salmonis LF-89 and EM-90 co-infection
Authors: Carril Gabriela , Morales-Lange Byron , Løvoll Marie , Inami Makoto , Winther-Larsen Hanne C. , Øverland Margareth , Sørum Henning
Published: August 2024

In Chile, Piscirickettsia salmonis contains two genetically isolated genogroups, LF-89 and EM-90. However, the impact of a potential co-infection with these two variants on Salmonid Rickettsial Septicemia (SRS) in Atlantic salmon (Salmo salar) remains largely unexplored. In our study, we evaluated the effect of P. salmonis LF-89-like and EM-90-like co-infection on post-smolt Atlantic salmon after an intraperitoneal challenge to compare changes in disease dynamics and host immune response. Co-infected fish had a significantly lower survival rate (24.1%) at 21 days post-challenge (dpc), compared with EM-90-like single-infected fish (40.3%). In contrast, all the LF-89-like single-infected fish survived. In addition, co-infected fish presented a higher presence of clinical lesions than any of the single-infected fish. The gene expression of salmon immune-related biomarkers evaluated in the head kidney, spleen, and liver showed that the EM-90-like isolate and the co-infection induced the up-regulation of cytokines (e.g., il-1β, ifnγ, il8, il10), antimicrobial peptides (hepdicin) and pattern recognition receptors (PRRs), such as TLR5s. Furthermore, in serum samples from EM-90-like and co-infected fish, an increase in the total IgM level was observed. Interestingly, specific IgM against P. salmonis showed greater detection of EM-90-like antigens in LF-89-like infected fish serum (cross-reaction). These data provide evidence that P. salmonis LF-89-like and EM-90-like interactions can modulate SRS disease dynamics in Atlantic salmon, causing a synergistic effect that increases the severity of the disease and the mortality rate of the fish. Overall, this study contributes to achieving a better understanding of P. salmonis population dynamics.
A study on the photoisomerization of phenylpropanoids and the differences in their radical scavenging activity using in-situ NMR spectroscopy and on-line radical scavenging activity analysis
Authors: Park Sangah , Kim Hojin , Bang Miyeon , Um Byung-Hun , Cha Jin Wook
Published: August 2024

Phenylpropanoids are naturally occurring secondary metabolites that exhibit various biological activities such as ultra-violet (UV) light protection and reactive-oxygen species (ROS) scavenging. In this study, we utilized a light-emitting diode (LED) based in-situ UV irradiation nuclear magnetic resonance (NMR) technique to monitor the photoisomerization reactions of these phenylpropanoids under UV irradiation in real-time. Through this approach, we measured the photochemical reaction rates and photostationary state (PSS) ratios of these molecules and observed distinct reaction rate and PSS ratio information depending on the variation of substituent groups in each phenylpropanoid molecule. We also evaluated the radical scavenging activity (RSA) for each photochemical product through diphenyl-1-picrylhydrazyl radical (DPPH) assay and 2,2’-azino-bis(3-ethylbenzenthiazoline-6-sulphonic acid) (ABTS) assay. We found that the photoisomerization product of caffeic acid can increase both DPPH and ABTS radical scavenging activities, and confirmed the enhanced ABTS radical scavenging ability of caffeic acid cis-isomer based on the online high-pressure liquid chromatography (HPLC)-ABTS analysis and the PSS ratio information of each isomer.
The levels of serum lipoprotein(a) on clinical outcomes in Chinese hospitalized patients with cardiovascular diseases
Authors: Min Tingting , Yue Yilin , Fan Xin , Yang Deguang , Su Shaohui , Wan Huaibin
Published: August 2024

Objective

Serum lipoprotein(a) [Lp(a)] is a risk factor of cardiovascular diseases. However, the relationship between the serum Lp(a) and clinical outcomes has been seldom studied in Chinese hospitalized patients with cardiovascular diseases.

Methods

We retrospectively collected the clinical data of hospitalized patients with cardiovascular diseases in the Cardiovascular Department of Dongguan People’s Hospital from 2016 to 2021 through the electronic case system. Patients were divided into 4 groups based on Lp(a) quartiles: Quartile1 (≤ 80.00 mg/L), Quartile 2 (80.01 ~ 160.90 mg/L), Quartile 3 (160.91 ~ 336.41 mg/L), Quartile 4 (> 336.41 mg/L). Cox proportional hazard regression models were constructed to examine the relationship between Lp(a) and cardiovascular events.

Results

A total of 8382 patients were included in this study. After an average follow-up of 619 (320 to 1061) days, 1361 (16.2%) patients developed major adverse cardiovascular events, and 125 (1.5%) all-cause death were collected. The incidence of MACEs was 7.65, 8.24, 9.73 and 10.75 per 100 person-years in each Lp(a) quartile, respectively; the all-cause mortality was 0.48, 0.69, 0.64 and 1.18 per 100 person-years in each Lp(a) quartile, respectively. The multivariate Cox regression analysis suggested that high Lp(a) level was an independent risk factor for MACEs (HR: 1.189, [95% CI: 1.045 to 1.353], P = 0.030) and all-cause death (HR: 1.573, [95% CI: 1.009 to 2.452], P = 0.046).

Conclusion

In addition to traditional lipid indicators, higher Lp(a) exhibited higher risks of adverse cardiovascular events and death, indicated worse prognosis. Lp(a) may be a new target for the prevention of atherosclerotic diseases.
Informed consent form for platelet rich plasma injections: evidence-based and legally guide for orthopaedic surgeons
Authors: Jeyaraman Madhan , Pai Satvik N. , Filippo Migliorini , Jeyaraman Naveen , Venkatasalam Ravichandran , Nallakumarasamy Arulkumar , Khanna Manish , Patro Bishnu Prasad , Sharma Shilpa , Rangarajan Ravi Velamor
Published: August 2024

Regarding medico-legal malpractice suits, lawyers and insurers focus on informed consent documentation. Unfortunately, there is no standard protocol for obtaining informed consent for platelet-rich plasma (PRP) injections. The objective of the present study was to create a pre-designed, evidence-based informed consent form specifically for PRP injections. The current evidence on the medico-legal implications of PRP injections was accessed, as well as informed consent in general and specifically informed consent in PRP injections. Additionally, we interviewed orthopaedic surgeons and patients who had undergone PRP injections in the past year using a semi-structured approach. A legally valid and evidence-based informed consent form for PRP injections ensures rights, encouraging open communication and transparency between the patient and surgeon. Moreover, if a lawsuit arose, informed consent would be a critical document in surgeons' defence and would withstand scrutiny from lawyers and the judiciary. An evidence-based informed consent form for PRP injections was elaborated and reviewed by a legal expert to ensure adherence to legal proprieties. The final form of the informed consent for PRP injection was administered for one year and validated at our institution.
Structural dynamics and sustainability in the agricultural sector: the case of the European Union
Authors: Peng Bo , Melnikiene Rasa , Balezentis Tomas , Agnusdei Giulio Paolo
Published: August 2024

This paper seeks to draw a research agenda for unveiling the underlying bottlenecks and possibilities for improving the agricultural total factor productivity in the European Union (EU). To this aim, the paper first surveys the key challenges for the modern agricultural economy. Then, the case of the EU is discussed by looking at the convergence in the partial productivity indicators (including the GHG emission) and growth efficiency that relate to the gap in the total factor productivity growth. The results suggest that the EU member states exhibited growth inefficiency (i.e., a gap in the total factor productivity growth) of 5–9% on average during 2004–2021. The paper also discusses the possibilities to utilize the production theory for assessing the pathways towards improvements in the productivity and sustainability of the EU agriculture.
Knowledge and attitude of university nursing students towards forensic nursing and their influencing factors: a mixed-methods study
Authors: Abou Hashish Ebtsam Aly
Published: August 2024

Background

Forensic nursing, which merges healthcare and legal expertise to address trauma and violence, is vital yet often underrepresented in nursing education. Many nursing students lack knowledge in this field, underscoring the need for enhanced education to improve patient care and legal outcomes. This study aimed to assess university nursing students’ knowledge and attitudes towards forensic nursing, as well as identify factors influencing their knowledge. A mixed-methods design was conducted at a Saudi nursing college with a convenience sample of 250 students. The data were collected using a structured questionnaire comprising two parts. The quantitative part included demographic and academic characteristics, knowledge and opinions on forensic nursing, knowledge of forensic evidence, and attitudes towards forensic nursing. The qualitative part consisted of four open-ended questions about factors affecting forensic knowledge. Data analysis involved inferential statistics and content analysis.

Results

The study revealed that 80.4% of nursing students lacked prior knowledge of forensic nursing, and only 59.76% had some awareness of forensic evidence. A strong positive relationship was found between attitudes towards forensic nursing and knowledge of forensic evidence (r = 0.817, p < 0.001), indicating that positive attitudes could predict 66.8% of the variance in forensic evidence knowledge. Key barriers included lack of support from upper management, insufficient resources, and concerns about faculty qualifications. Students recommended integrating forensic nursing into the curriculum, offering specialized programs, and promoting research and social media awareness campaigns.

Conclusions

These findings underscore significant gaps in knowledge and misconceptions about forensic nursing among participants, emphasizing the critical need for education and awareness in this field. The study highlights the potential implications for integrating forensic nursing concepts into undergraduate curricula, enhancing faculty training, and utilizing diverse teaching modalities. Addressing these gaps will not only improve future nurses’ competency in forensic nursing, but also contribute to better patient care.
Financial inclusion and Financial Performance: The interplay role of capital adequacy requirements in Egyptian Banks
Authors: Obiedallah Yousra R. , Abdelaziz Asmaa H.
Published: August 2024

Purpose

Financial inclusion aims to provide affordable financial services, including banking, loans, equity, and insurance products, to underserved populations. This study aims to examine the moderating effect of a bank’s capital adequacy ratio (CAR) on the nexus between financial inclusion (FI) and a bank’s financial performance (FP) in the Egyptian setting.

Design/methodology/approach

The study uses two empirical linear mixed models (LMM) to test the moderation effect of a bank’s CAR on the association between FI and FP. The study sample comprises 360 bank quarter-observations of 10 listed banks in the Egyptian Stock Exchange (EGX) from 2013 to 2021.

Findings

The findings show that the bank’s CAR strengthens the association between FI dimensions, namely, deposit growth, loan growth, and the number of employees, and the bank’s FP with contradicted directions.

Research limitations/implications

This study provides policymakers insights into the crucial role of complying with banking regulation, namely, the capital adequacy ratio (CAR) and expanding financial inclusion practices to enhance and improve the bank’s FP. Thus, encouraging more strategies and facilities toward financial inclusion.

Originality/value

Due to the scarcity of financial inclusion literature in emerging economies, this paper extends FI literature by highlighting the moderation impact of a bank’s CAR on the relationship between FI dimensions and FP in the Egyptian banking sector. Consequently, this study clarifies this beneficial relationship, which may have significant implications for restoring the challenges faced by the Egyptian economy following the critical events it went through, which, in turn, impacted the country’s poor and vulnerable.
Exploring the Therapeutic Potential of Nicotinamide Mononucleotide: A Review of Safety and Efficacy with Emphasis on Diabetes
Authors: Gugulski Hubert , Kozicz Michał Andrzej , Rudawski Szymon , Wójcik Łukasz , Zięba Magdalena , Jastrzębska Ilona , Bado Michał , Nowoświat Patrycja , Cuper Paulina , Bilecki Krzysztof
Published: August 2024

Introduction: Nicotinamide mononucleotide (NMN) is a supplement that can boost nicotinamide adenine dinucleotide (NAD+) levels in the body, which is crucial for maintaining energy balance and stress response. Declining NAD+ levels with age contribute to aging and related diseases, making NMN supplementation a potential solution. Despite its potential benefits, NMN’s safety and efficacy need further investigation.
Aim of the Study: This study aimed to analyze recent research on NMN supplementation regarding its safety and efficacy in improving human health, especially in patients with diabetes and prediabetes, and to suggest potential research directions for this compound.
Methods and Materials: Extensive research was conducted using PubMed and Google Scholar, focusing on literature from the past 5 years, primarily on randomized controlled trials. The databases were searched using the term “nicotinamide mononucleotide” to gather articles, and references from selected articles were included.
Conclusion: A beneficial direction for NMN research is an in-depth analysis of its effects on skeletal muscles in both healthy individuals and those with diabetes. Studies on larger groups, with higher doses, and over longer periods are crucial to determine the optimal supplementation protocol and assess individual variability in NMN’s metabolic effects.
Ulcerative colitis - ustekinumab as a new biologic therapy, review 2024
Authors: Felińska Zuzanna , Silldorff Julia , Fura Tomasz , Dudek Marcin , Zaucha Radosław , Iszczuk Oliwia , Anczyk Stanisław , Gajkiewicz Magdalena , Zając Małgorzata
Published: August 2024

Biologic agents have significantly transformed the therapeutic approach to ulcerative colitis. Anti-tumor necrosis factor (TNF) agents were the pioneering biologic drugs introduced to induce and maintain remission in this inflammatory bowel disease. Recently, ustekinumab, another biologic option, has been approved for the treatment of moderate-to-severe ulcerative colitis. Ustekinumab demonstrates a favorable clinical efficacy and safety profile for the treatment of moderately to severely active ulcerative colitis. As the first biologic agent to target the IL-12/IL-23 pathways, ustekinumab represents a viable therapeutic option, particularly following the failure of other biologics such as anti-tumor necrosis factor-α (TNF-α) antagonists and anti-α4ß7 integrin antagonists
Challenges and risks of using GLP-1 antagonists in treating type 2 diabetes and obesity
Authors: Głuszczyk Agnieszka , Plizga Jakub , Makłowicz Aleksandra , Kopczyńska Ewelina , Szpulak Angelika , Frańczuk Agata , Grzelka Michalina , Głoskowska Julia , Kuleta Katarzyna , Karkos Patrycja
Published: August 2024

Introduction: Ozempic (semaglutide) is a long-acting GLP-1 receptor agonist widely used to treat type II diabetes and obesity. Its mechanism of action includes stimulation of insulin secretion, inhibition of glucagon secretion, and delaying gastric emptying, which leads to lower blood glucose levels and body weight reduction. Despite its therapeutic benefits, the use of Ozempic may cause side effects that affect patients' quality of life and their ability to continue treatment. This article aims to comprehensively analyze side effects associated with using Ozempic to provide a detailed understanding of their development mechanisms and their impact on patient's daily functioning.Material and Methods of Research: The literature was collected through searches in the PubMed and Google Scholar databases and references from the initially retrieved articles. Results: The literature review indicates various potential side effects of liraglutide, including gastrointestinal upset, pancreatitis, and the 'Ozempic face' phenomenon. This phenomenon, characterized by a skeletal facial appearance with deepened wrinkles, may result from the drug's impact on body composition and fat distribution, leading to a loss of subcutaneous fat in the face and a more pronounced appearance of underlying facial structures.Conclusion: Clinical studies highlight the need for continuous patient monitoring by healthcare providers to ensure the safe and effective use of Ozempic. Further education on a healthy lifestyle, diet, and physical activity is necessary to maintain the effects of drug therapy and prevent weight gain after treatment. Additional research on the long-term safety of GLP-1 is also crucial. Physicians should be aware of the potential risks and side effects associated with the use of Ozempic and should educate their patients to enable them to make informed decisions about their treatment.
Application of hypnosis, yoga and relaxation techniques in the treatment of Post-traumatic Stress Disorder – literature review
Authors: Rybak Julia , Pawłowski Piotr , Sadłowski Bartosz , Bieganek Paula , Łukaszewicz Stanisław , Kordialik Jakub , Koćwin Julia , Sarnacka Sandra , Tokarski Michał , Tokarska Angelika
Published: August 2024

Introduction and Purpose:Post-traumatic stress disorder (PTSD) presents a complex clinical picture, making treatment challenging. Current pharmacological approaches predominantly target the serotonin system, yet treatment efficacy remains variable. Growing interest in non-pharmacological approaches arises from challenges in identifying effective drug treatments. Dysregulation of the autonomic system and respitarory irregularities highlight the potential of relaxation methods in managing PTSD symptoms. Our study aims to assess the efficacy of unconventional methods such as hypnosis and relaxation techniques as complementary or alternative treatments for PTSD.
The State of Knowledge:Numerous studies demonstrate significant reductions in negative PTSD symptoms, particularly re-experiencing, avoidance, and excessive anxiety, through relaxation techniques, meditation, and mindfulness interventions. Promising results are seen in both adult and pediatric populations affected by trauma.. Hypnosis-assisted therapy shows potential in alleviating anxiety, dissociation, and sleep disturbances. Breathing yoga and mindfulness-based therapy also show promise in reducing PTSD symptoms, although further research is needed.
Conclusion:Our review underscores the potential of non-pharmacological interventions, like hypnosis, yoga, mindfulness, and relaxation techniques, in alleviating PTSD symptoms. Despite study limitations, these approaches offer valuable adjunctive therapies. Future research should focus on validating their efficacy through well-designed trials. Integrating these techniques into treatment plans could enhance overall well-being for individuals with PTSD, bearing in mind the importance of individualized care.
Diagnosis, clinical symptoms and treatment of Hakim-Adams syndrome
Authors: Kozikowska Marta , Pociecha Agnieszka , Kmak Bożena
Published: August 2024

Introduction and purpose
Normal pressure hydrocephalus (NPH) is a chronic and progressive neurological disorder that affects the accumulation of cerebrospinal fluid (CSF) in the brain's ventricles. The disease is not limited by age, but it is more prevalent in older adults. The accumulation of excess CSF in the brain's ventricles is caused by the obstruction of normal CSF flow, leading to an enlargement of the ventricles and pressure on brain structures. NPH manifests as cognitive disorders, gait disorders, and urinary incontinence. NPH is considered a potentially reversible cause of dementia. This study aims to discuss the etiology, symptoms, differential diagnosis, and treatment methods associated with normotensive hydrocephalus.
 
Materials and methods
A comprehensive literature review was conducted through an extensive bibliographic search, with a primary focus on original research articles obtained from reputable databases such as PubMed, BioMed Central, Polish Medical Platform, and Google Scholar. The search was specifically targeted towards articles pertaining to Normal Pressure Hydrocephalus (NPH).
 
Conclusions
Normotensive hydrocephalus (NPH) is a complex neurological condition that is characterized by an imbalance between the production and absorption of cerebrospinal fluid (CSF). NPH is classified into idiopathic and secondary types, which helps to determine the possible underlying causes and mechanisms that contribute to the development of the condition. The clinical manifestations of NPH are highly variable, and the diagnostic process can be complicated due to the need to differentiate it from other neurodegenerative disorders. Underdiagnosis or misdiagnosis is common, leading to a decrease in patients' quality of life and, in many cases, disability.
The prevalence of NPH is increasing, highlighting the need for further research and the development of novel therapeutic approaches to improve patient outcomes.
Sleep Cycles and Health: Role of Sleep Stages, Circadian Rhythms, and Lifestyle Factors on Optimizing Physical Performance and Mental Well-Being – a literature review
Authors: Rutkowska Marta , Bieńko Mateusz , Król Tomasz , Toborek Michalina , Marchaj Magdalena , Korta Karolina , Putra Anna , Niedziela Natalia , Margas Mikołaj , Bednarz Karolina
Published: August 2024

Introduction:
Sleep is a crucial physiological process impacting cognitive function, emotional resilience, and physical health. It is fundamental to overall well-being and understanding its nuances is imperative for unraveling the secrets of restorative sleep.
Purpose:
This review explores sleep cycles, synthesizing research on physiology, variability, and Non-Rapid Eye Movement (NREM) / Rapid Eye Movement (REM) dynamics to understand optimal rest. It assesses how disruptions, from lifestyle or sleep disorders, affect overall health.
State of Knowledge:
Sleep behaviors vary among individuals, influenced by factors like age, environment, health and lifestyle. Aging leads to changes in sleep patterns, impacting sleep quality. Sleep disorders, such as epilepsy and apnea, significantly alter sleep architecture, illustrating the close link between health and sleep. Lifestyle factors, including diet, physical activity and drug use, affect sleep quality, emphasizing the need for promoting healthy habits.
Conclusion :
The comprehensive exploration of sleep architecture, individual variability in sleep patterns, circadian rhythms, age-related changes, impact of drugs and sleep disorders, sleep hygiene, and associations with mental health underscores the intricate relationship between sleep and overall well-being. Sleep disorders pose an increased risk for mental health disorders, such as anxiety, stress, depression and ADHD. Conversely, mental health issues can significantly affect sleep quality and patterns. Developing strategies to promote healthy sleep hygiene and lifestyle habits is crucial in improving sleep quality, ultimately contributing to enhanced mental health, physical performance and well-being.
Chronic Fatigue Syndrome: Insights and Treatment Perspectives – a literature review
Authors: Ślesicka Iga , Przestrzelska Magda , Zozula Natalia , Tomczewska Zuzanna , Rykucka Aleksandra , Wąs Marcin , Latała Aleksandra , Kiełbasa Justyna , Kowalczyk Agata , Bil Katarzyna
Published: August 2024

Introduction: Chronic Fatigue Syndrome (CFS) is an exhausting continuous medical condition. In most cases it affects patients after a flu-like infection. CFS correlates with alterations in the nervous and immune systems, metabolism, and hormone secretion. Diagnostic process is very challenging due to the absence of a definitive diagnostic test and wide symptomatology. It negatively impacts people's both mental and physical health.
Aim of the study: The aim of this literature review is to comprehensively examine current research findings and literature on Chronic Fatigue Syndrome (CFS), understand its etiology, how it affects the body, why it's challenging to diagnose, the various treatments available, new ideas and viewpoints in the field.Describing the State of Knowledge: Despite extensive investigation, the exact etiology of CFS remains unknown. In literature CFS is also often described as Myalgic Encephalomyelitis. In the WHO's most recent classification, the ICD-11, both Chronic Fatigue Syndrome and Myalgic Encephalomyelitis are classified as “other disorders of the nervous system” which indicates the significance of the issue.
Conclusions: This literature review underlines the importance of a comprehensive and collaborative approach in addressing the complexities of CFS and improving outcomes for individuals living with this debilitating condition.
Optic neuritis – general overview with particular emphasis on differential diagnosis
Authors: Nowak Aleksandra , Janus Anita , Kaptur Agata , Dziedziński Dawid , Kwaśniewska Oliwia , Łoś Dawid
Published: August 2024

Introduction and purpose
 
Optic neuritis (ON), especially retrobulbar, is a common inflammatory neuropathy of the optic nerve occurring typically in young adults. This neuro-ophthalmological condition is involved in the clinical picture of multiple diseases and may be frequently a heralding symptom of them [1,2,3,4,5,7,13]. 
The main aim of this review is to provide clinicians with thorough information on the possible etiologies of ON, its differentiation and management.
 
Review Methods
 
For this report, we conducted a research of the available, most recent literature in Pubmed and medical books using the keywords (below). As a result, we included over 30 articles and chapters as a benchmark of our analysis.
 
A brief description of the State of Knowledge
 
Optic neuritis is a frequent manifestation of many diseases, with a particular focus on demyelinating processes [1,2,3,4,5,7,13]. Its incidence in central Europe is about 5 per 100 000 people per year [26].  Although the symptoms may be very severe including even abrupt vision loss or intense pain on ocular movement, the prognosis regarding future visual acuity is generally good [1,2,9]. In contrast, the spectrum of diseases underlying optic neuritis is much more diverse [9,10,13,25].

Summary
 
Although a definite diagnosis is not always possible when looking for the cause of ON, it is crucial to know the possible etiologies and to differentiate them as much as we can by means of commonly used tools. In this way, a correct diagnosis will lead to earlier, more personalized treatment and a better overall prognosis [1,5,9,10,11,15,25].