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Background: Although the prescription of physical activity in clinical care has been advocated worldwide, in the Netherlands, "Exercise is Medicine" (E = M) is not yet routinely implemented in clinical care. Methods: A set of implementation strategies was pilot implemented to test its feasibility for use in routine care by clinicians in 2 departments of a university medical center. An extensive learning process evaluation was performed, using structured mixed methods methodology, in accordance with the Reach, Effect, Adoption, Implementation, and Maintenance framework. Results: From 5 implementation strategies employed (education, E = M tool embedded in the electronic medical records, lifestyle coach situated within the department, overviews of referral options, and project support), the presence of adequate project support was a strong facilitator of the implementation of E = M. Also, the presence of the lifestyle coach within the department seemed essential for referral rate. Although clinicians appreciated the E = M tool, barriers hampered its use in practice. Conclusions: Specific implementation strategies, tailored to the setting, are effective in facilitating the implementation of E = M with specific regard to education for clinicians on E = M, deployment of a lifestyle coach within a department, and project coordination. Care providers do see a future for lifestyle coaches who are structurally embedded in the hospital, to whom they can easily refer. [ABSTRACT FROM AUTHOR]

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In VIII: clinical approaches, authors address the following themes: Evaluation, diagnosis and management I-toward a working diagnosis, Evaluation, diagnosis and management II-process steps, Interweaving integrative medicine and family medicine, Halfway-the art of clinical judgment, Seamless integration in family medicine-team-based care, Technology-uncovering stories from noise and Caring for patients with multiple long-term conditions. May readers recognise in these essays the uniqueness of a family medicine approach to care.

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'IX: people and places-diverse populations and locations of care', authors address the following themes: 'LGBTQIA+health in family medicine', 'A family medicine approach to substance use disorders', 'Shameless medicine for people experiencing homelessness', '''Difficult" encounters-finding the person behind the patient', 'Attending to patients with medically unexplained symptoms', 'Making house calls and home visits', 'Family physicians in the procedure room', 'Robust rural family medicine' and 'Full-spectrum family medicine'. May readers appreciate the breadth of family medicine in these essays.

Liquid biopsy has received tremendous attention as a non-invasive approach for detecting and tracking cancer. Here, we discuss the latest work on circulating tumor DNA and circulating tumor cells with respect to clinical applications, including cancer screening, early detection of relapse, real-time monitoring of therapeutic efficacy, and detection of therapeutic targets and resistance mechanisms. [ABSTRACT FROM AUTHOR]

Phloridzin (PL), a natural compound derived from apples, exhibits diverse pharmacological properties including anti-inflammatory, anti-tumor, antioxidant, and anti-aging effects. The present study aimed to evaluate the impact of Phloridzin Carbomer Gel (PL-CG) on skin inflammatory healing in a mouse model of atopic dermatitis (AD). In vitro experiments initially determined the non-toxic concentration range of PL in cells, established a cellular inflammation model by stimulating cells with histamine to ascertain the optimal therapeutic concentration of PL, and subsequently detected decreased mRNA expression levels of relevant inflammatory cytokines, interleukins, through RT-qPCR experiments following PL treatment. For in vivo experiments, an AD mouse model was constructed. Histopathological analysis, along with assessments of epidermal thickness, reduction in scratch counts on the back of mice, and healing rates of inflammatory areas, indicated that PL-CG facilitates epidermal tissue regeneration and wound repair, thereby accelerating skin inflammatory healing. Additionally, PL-CG was subjected to microstructural observation using scanning electron microscopy (SEM), and experiments were conducted to determine its optimal pH value, stability, viscosity, and the influence of different concentrations of carbomer gel on drug release. The study demonstrated that PL-CG possesses anti-inflammatory and antipruritic properties, as well as the ability to promote skin inflammatory healing. Compared to traditional corticosteroids, PL-CG exhibits a higher safety profile and fewer side effects, suggesting broad prospects for its clinical application in the treatment of atopic dermatitis. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and MethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONThis study aimed to assess the prevalence of literature applying LHS and learning organisation (LO) concepts to rehabilitation, gather definitions and core features, and document their application and resultant organisational changes.We searched five electronic databases and included peer-reviewed qualitative, quantitative, and mixed-methods studies, reviews, and grey literature in English. Full texts were screened, resulting in 27 included papers.Most of the included papers discussed the concept of LHS, emphasising key aspects like infrastructure and learning mechanisms. However, only a minority described practical implementation (n = 4) or assessed the effects of applying LHS frameworks within rehabilitation settings (n = 1).This scoping review highlights the limited empirical focus on implementing and operationalising LHS frameworks in rehabilitation services. Based on the available literature, we offer recommendations for rehabilitation services transitioning to a LHS. Our findings emphasise the need for increased dissemination of knowledge and research on the implementation and evaluation of rehabilitation-focused LHS.Learning Health Systems (LHS) and Learning Organisations (LOs) are distinct but similar concepts that align with key rehabilitation principles.LHSs integrate clinical care and research, utilising health data for real-time learning and innovation, while LOs focus on creating supportive cultures and organisational structures to facilitate adaptation.Although LHSs show great promise for improving rehabilitation services, there is limited literature on their implementation and evaluation in rehabilitation contexts.Recommendations for implementing LHSs in rehabilitation based on available literature include assembling multidisciplinary teams, developing robust data infrastructures, fostering effective communication, and assessing outcomes through various measures.Learning Health Systems (LHS) and Learning Organisations (LOs) are distinct but similar concepts that align with key rehabilitation principles.LHSs integrate clinical care and research, utilising health data for real-time learning and innovation, while LOs focus on creating supportive cultures and organisational structures to facilitate adaptation.Although LHSs show great promise for improving rehabilitation services, there is limited literature on their implementation and evaluation in rehabilitation contexts.Recommendations for implementing LHSs in rehabilitation based on available literature include assembling multidisciplinary teams, developing robust data infrastructures, fostering effective communication, and assessing outcomes through various measures. [ABSTRACT FROM AUTHOR]

Synthetic magnetic resonance imaging (SyMRI) is a non-invasive, robust MRI technique that generates multiple contrast-weighted images by acquiring a single MRI sequence within a few minutes, along with quantitative maps, automatic brain segmentation, and volumetry. Since its inception, it has undergone technical advancements and has also been tested for feasibility in various organs and pathological conditions. This scoping review comprehensively pinpoints the critical technical aspects and maps the wide range of clinical applications/benefits of SyMRI.A comprehensive search was conducted across five databases, PubMed, Scopus, Web of Science, Embase, and CINAHL Ultimate, using appropriate keywords related to SyMRI. A total of 99 studies were included after a 2-step screening process. Data related to the technical factors and clinical application was charted.SyMRI provides quantitative maps and segmentation techniques comparable to conventional MRI and has demonstrated feasibility and applications across neuroimaging, musculoskeletal, abdominal and breast pathologies spanning the entire human lifespan, from prenatal development to advanced age. Certain drawbacks related to image quality have been encountered that can be overcome with technical advances, especially AI-based algorithms.SyMRI has immense potential for being incorporated into routine imaging for various pathologies due to its added advantage of providing quantitative measurements for more robust diagnostic and prognostic work-up with faster acquisitions and greater post-processing options. [ABSTRACT FROM AUTHOR]

Long-lasting afterglow luminescence imaging that detects photons slowly being released from chemical defects has emerged, eliminating the need for real-time photoexcitation and enabling autofluorescence-free in vivo imaging with high signal-to-background ratios (SBRs). Organic afterglow nano-systems are notable for their tunability and design versatility. However, challenges such as unsatisfactory afterglow intensity, short emission wavelengths, limited activatable strategies, and shallow tissue penetration depth hinder their widespread biomedical applications and clinical translation. Such contradiction between promising prospects and insufficient properties has spurred researchers' efforts to improve afterglow performance. In this review, we briefly outline the general composition and mechanisms of organic afterglow luminescence, with a focus on design strategies and an in-depth understanding of the structure–property relationship to advance afterglow luminescence imaging. Furthermore, pending issues and future perspectives are discussed. [ABSTRACT FROM AUTHOR]

Atherosclerotic diseases are systemic, and stroke patients often present with both intracranial artery stenosis (ICAS) and coronary artery stenosis (COAS). This study aimed to investigate the prevalence of ICAS and COAS among ischemic stroke patients across different risk strata and to construct a predictive model for assessing atherosclerosis risk. This retrospective study included patients admitted for ischemic stroke at the Affiliated Hospital of Xuzhou Medical University from December 2020 to December 2021. All patients underwent CTA, with significant stenosis defined as exceeding 50% for both cerebral and coronary arteries.Patients were categorized into low-, moderate-, and high-risk groups on the basis of the Framingham risk scale. A total of 5,816 patients were included, with a mean age of 66.54 years. Dual arterial stenosis was found in 2,258 patients (38.8%), single ICAS in 399 (6.8%), and single COAS in 3,159 (54.3%). The moderate- and high-risk groups had significantly lower risks of single ICAS and COAS. Comparing the differences in risk factors between single arterial stenosis and dual arterial stenosis, the key risk factors included hyperlipidemia, smoking, hypertension, and diabetes, with a model accuracy of 73.61% and an AUC values of 0.8562 for dual stenosis. Significant differences in age, sex, and the risk factors were observed among risk groups. The predictive model demonstrated high accuracy, highlighting the importance of personalized medicine in clinical decision-making. [ABSTRACT FROM AUTHOR]

High Mobility Group Box 1 (HMGB1), a multifunctional non-histone protein, and its involvement in various physiological and pathological contexts has garnered significant attention. Given HMGB1's central function in modulating key biological activities, such as inflammatory responses and cellular death, its contribution to the pathogenesis of digestive system diseases has become a focus of growing interest. This review aims to comprehensively explore the mechanisms by which HMGB1 contributes to the progression of inflammatory bowel disease (IBD), liver disorders, and pancreatitis. Furthermore, we explore the prospective clinical applications and outline future research directions for HMGB1 in digestive diseases, providing fresh perspectives that highlight the necessity of ongoing studies to understand its role in these conditions. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the current clinical practice patterns regarding the utilization of "Urolithiasis Guidelines" in Turkey and to identify critical factors influencing their application by urologists. Methods: The study targeted practicing urologists in Turkey, primarily those involved in the management of urolithiasis, to assess their perspectives and experiences regarding the clinical application of established guidelines. A total of 415 urology specialists were invited to participate in a survey-based study conducted via Google Forms. Participation was voluntary, and 65.08% of the invited urologists completed the survey. Results: Among the respondents, 84.7% reported utilizing the available guidelines in their routine clinical practice, with varying frequencies of reference. The primary motivations for guideline use were the prevention of potential complications and the avoidance of legal risks, as indicated by 90.5% of respondents. While 56.9% of participants adhered to the guidelines as a clinically standardized practice, 41.6% reported applying the recommendations on a case-by-case basis. Notably, 41.0% of respondents emphasized the need for locally adapted versions of guideline texts. Additionally, nearly half of the participants reported receiving no formal education or training on the significance, content, and practical application of these guidelines. Furthermore, 12.7% expressed skepticism about the evidence-based foundation of the guidelines, questioning whether the recommendations were derived from rigorously conducted studies. Conclusion: The available urolithiasis guidelines are recognized as valuable resources offering key recommendations for the effective and safe management of urolithiasis. However, findings from this survey highlight significant variability in clinical practice patterns due to local conditions and the individual experience and attitudes of practicing urologists. The application of guideline recommendations is further influenced by perceptions regarding their development, content, and practicality. Insights gathered from this study may contribute to improving the preparation, dissemination, and implementation of urolithiasis guidelines, particularly in adapting them to local clinical settings. [ABSTRACT FROM AUTHOR]

The challenges of recruiting participants for end-of-life (EOL) research are multifaceted. The Last Gift study at the University of California San Diego, an observational study for people with HIV (PWH) with terminal illness, appeals to the altruism of potential participants and community of allied health providers. Involvement of the latter group highlights a potential ethical conundrum of a “dual role”, as primary care providers (PCPs) navigate between clinical responsibilities to their patients, along with opportunities to discuss clinical research. To explore this conundrum and better understand study recruitment dynamics of the Last Gift study, we analyzed screening and enrollment data for a 12-month period (2022–2023). We found that PCPs can play an important role in the recruitment of PWH into EOL research, as having PCPs discuss the study with potential participants yielded more successful enrollments than contact by the study team alone. Our manuscript proposes considerations to mitigate dual role conflicts, including ensuring ethical awareness, prioritizing clinical care and offering strategies to involve PCPs in recruitment without causing unnecessary burden or coercion. These insights aim to guide similar EOL research efforts, emphasizing the need for balanced, ethical recruitment processes in the sensitive context of terminal illness. [ABSTRACT FROM AUTHOR]

Cancer immunotherapy, which leverages the body's immune system to recognize and attack cancer cells, has made significant progress, particularly in the treatment of metastatic tumors. However, challenges such as drug stability and off-target effects still limit its clinical success. To address these issues, metal–organic frameworks (MOFs) have emerged as promising nanocarriers in cancer immunotherapy. MOFs have unique porous structure, excellent drug loading capacity, and tunable surface modification properties. MOFs not only enhance drug delivery efficiency but also allow for precise control of drug release. They reduce off-target effects and significantly improve targeting and therapy efficacy. As research deepens, MOFs' effectiveness as drug carriers has been refined. When combined with immunoadjuvants or anticancer drugs, MOFs further stimulate the immune response. This improves the specificity of immune attacks on tumors. This review provides a comprehensive overview of the applications of MOFs in cancer immunotherapy. It focuses on synthesis, drug loading strategies, and surface modifications. It also analyzes their role in enhancing immunotherapy effectiveness. By integrating current research, we aim to provide insights for the future development of immunoadjuvant-functionalized MOFs, accelerating their clinical application for safer and more effective cancer treatments. [ABSTRACT FROM AUTHOR]

Bispecific antibodies represent an innovative paradigm in cancer therapy, offering broader therapeutic potential compared to conventional monoclonal antibodies. To increase tumor selectivity while mitigating off-target effects in normal tissues, the concept of prodrug-based bispecific antibodies has emerged. This review delineates the various mechanisms underlying the action of prodrug-based bispecific antibodies, including protease-mediated activation, steric hindrance release via proteolytic processing, activation by soluble factors, conditional assembly, and chain exchange-mediated activation. We also address the critical challenges that must be overcome to optimize the development and clinical application of these sophisticated therapeutic agents. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is one of the most prevalent cancers, characterized by high morbidity and mortality rates. Recently, immunotherapy has emerged as a crucial treatment modality for HCC, following surgery, locoregional therapies, and targeted therapies. This approach harnesses the body's immune system to target and eliminate cancer cells, potentially resulting in durable antitumor responses. However, acquired resistance and the tumor immunosuppressive microenvironment (TIME) significantly hinder its clinical application. Recently, advancements in nanotechnology, coupled with a deeper understanding of cancer biology and nano-biological interactions, have led to the development of various nanoparticles aimed at enhancing therapeutic efficacy through specific targeting of tumor tissues. These nanoparticles increase the accumulation of immunotherapeutic drugs within the tumor microenvironment, thereby transforming the TIME. In this review, we provide a concise overview of the fundamental principles governing the TIME landscape in HCC and discuss the rationale for and applications of nanoparticles in this context. Additionally, we highlight existing challenges and potential opportunities for the clinical translation of cancer nanomedicines. [ABSTRACT FROM AUTHOR]

Question: Can previously reported, largely anecdotal associations between exposure to any of a comprehensive list of putative trigger drugs and the development of pemphigus be reproduced using population level data? Findings: In this series of observational, retrospective, case-control, pharmacovigilance analyses of the FDA Adverse Event Reporting System, the odds of reporting the adverse event pemphigus were significantly elevated among individuals exposed to 11/36 previously reported trigger drugs namely, gold sodium thiomalate, penicillamine, piroxicam, rifampin, hydroxychloroquine, imiquimod, hydrochlorothiazide, irbesartan, lisinopril, nivolumab, and nifedipine. Meaning: Environmental exposures such as drugs are relevant players in the pathogenesis of autoimmune diseases and clinicians who treat patients with autoimmune blistering diseases such as pemphigus should consider performing a detailed medication history leveraging this information regarding deleterious drug-disease interactions at initial evaluation as well as longitudinal monitoring of patients to better inform clinical care decisions. Importance: Pemphigus vulgaris (PV) is a rare, potentially fatal autoimmune disease with pathogenic contributions from both genetic as well as environmental factors, notably drug exposures. Despite anecdotal reports linking multiple drugs to PV, corroborating evidence from large datasets is missing. Objective: To examine the extent to which previously reported associations between a comprehensive list of 36 drugs implicated in PV pathogenesis could be replicated using population-level pharmacovigilance data. Design: Series of observational, retrospective, case-control, pharmacovigilance analyses (one analysis/drug, 36 total). Setting: Population based. Participants: Individuals who submitted a report of a drug-related adverse event to the FDA from Q4 of 2003 to Q2 of 2023. Exposure: Cases were identified by the presence of adverse events described by the MedDRA preferred term "pemphigus" (10034280) and then sorted based on exposure to each of the drugs of interest. Main outcomes and measures: Reporting Odds Ratios (RORs) quantifying the association between a given drug exposure and reports of pemphigus adverse events. Results: The analyses revealed statistically significant associations between reports of pemphigus and exposure to 11/36 previously reported drugs, two of which had particularly high RORs (>200) [gold sodium thiomalate (ROR, 266.0; 95% CI, 202.6-349.3) and hydroxychloroquine (ROR, 282.6; 95% CI, 261.0-306.1)], three had very strong RORs (14-45) [penicillamine (ROR, 30.5; 95% CI, 11.4-81.7), piroxicam (ROR, 14.8; 95% CI, 8.2-26.7), and imiquimod (ROR, 42.3; 95% CI, 26.2-68.3)], and six had modestly strong RORs (2-5) [rifampin (ROR, 2.8; 95% CI, 1.4-5.6), hydrochlorothiazide (ROR, 1.6; 95% CI, 1.2-2.1), irbesartan (ROR, 2.7; 95% CI, 1.6-4.4), lisinopril (ROR, 5.3; 95% CI, 4.5-6.2), nivolumab (ROR, 2.7; 95% CI, 1.8-4.1), and nifedipine (ROR, 3.0; 95% CI, 1.9-5.0)]. Associations for other previously reported drugs (25/36) were not detected. Conclusions and relevance: This study represents a comprehensive evaluation of suspected drug triggers of pemphigus using real-world data. The significant associations reported here provide empirical support for the hypothesis that certain drugs act as triggers for PV. Moreover, all of the drugs found to be associated with PV in this study harbor immunomodulatory capacity, suggesting that the ability to induce such perturbations, directly or indirectly, may be a critical factor connecting drug exposure to pemphigus pathogenesis. However, the absence of signals for other previously reported putative trigger drugs does not preclude their potential role in PV pathogenesis. Our findings reinforce the need for larger, more definitive studies to confirm these associations and to explore the mechanisms by which these drugs may contribute to PV development. Finally, these findings underscore the importance of considering environmental factors in the development and course of PV in genetically susceptible individuals. [ABSTRACT FROM AUTHOR]

Non-small cell lung cancer (NSCLC) is still the disease with the highest incidence rate among malignant tumors, in which NSCLC under N2 stage has obvious survival differences among different patients due to its high heterogeneity. For NSCLC under this stage, the current treatment options are: preoperative neoadjuvant therapy, surgical treatment, postoperative adjuvant chemotherapy, postoperative adjuvant radiotherapy (PORT), Postoperative adjuvant targeted therapy and postoperative adjuvant immunotherapy. Whether postoperative adjuvant radiotherapy is routinely administered to patients with pN2 remains controversial in clinical application. Meanwhile, the booming development of adjuvant targeted therapy and adjuvant immunotherapy also provides newer therapeutic options for the prognosis of postoperative pN2 stage NSCLC, and some new markers will guide the adaptive application of immune drugs in the future. This article analyzes the current stage of therapeutic advances in operable stage N2 non-small cell lung cancer, and discusses in detail in this article the therapeutic controversy of postoperative adjuvant radiotherapy in pN2 stage non-small cell lung cancer, so as to explore a more reasonable treatment mode for future patients with stage N2 non-small cell lung cancer. [ABSTRACT FROM AUTHOR]

Objective: To investigate the application of TCGA molecular typing in endometrial carcinoma, compare the relationship between molecular typing and clinicopathologic features, and provide a new idea for individual treatment of patients. Methods: A total of 146 EC patients who underwent surgical treatment and TCGA molecular typing in Beijing Hospital from December 2019 to March 2023 were collected. The clinicopathologic features, immunohistochemistry, and prognosis of the four TCGA molecular types were analyzed retrospectively. Result: Among the 146 patients with endometrial cancer (EC), 8 patients (5.5%) exhibited the POLE hypermutant type, 29 patients (19.9%) displayed the MSI-H type, 94 patients (64.4%) presented the low copy-number type, and 15 patients (10.3%) manifested the high copy-number type. A comparative analysis of the four TCGA types and age yielded statistically significant results (p = 0.012). Notably, significant associations were observed between menopausal status, the expression of ER, PR, and the four TCGA types. However, no significant difference was observed in CA125 levels before surgery among the four TCGA types (p = 0.587). There were significant differences observed among the four TCGA types and pathological types, pathological grades, FIGO stage, lymph node metastasis, and LVSI. The progression-free survival (PFS) rates of patients with POLE hypermutation, MSI-H type, CNL type, and CNH type were 100%, 100%, 93.62%, and 73.3%, respectively. There was a statistically significant difference between the four groups(p=0.006). POLE mutant and MSI-H type patients have higher PFS, while high copy type patients have the lowest. Conclusions: TCGA molecular typing has feasibility and application value in the clinical application of endometrial cancer, and has a certain predictive effect on the prognosis of EC patients. It has a certain guiding significance for the individual treatment of patients with endometrial cancer. [ABSTRACT FROM AUTHOR]

Background: Intervertebral disc (IVD) degeneration is the main cause of neck pain. Although conventional magnetic resonance imaging can detect morphological changes in intervertebral disc degeneration, it cannot provide accurate and objective evaluations. Magnetic resonance diffusion tensor imaging (DTI) reflects the microstructural changes in tissues by describing the diffusion of water molecules. It was initially applied to the evaluation of lumbar disc degeneration; however, no study has used DTI to evaluate cervical disc degeneration. Objective: To conduct a prospective study to evaluate the efficacy and feasibility of DTI in quantifying cervical disc degeneration by correlating the main parameters of axial DTI of intervertebral discs, namely fractional anisotropy (FA) and mean diffusivity (MD) values, using the Pfirrmann grade. Methods: The cervical discs of 30 symptomatic volunteers with neck pain and 20 asymptomatic volunteers were assessed using a 3.0 T magnetic resonance scanner. We evaluated intervertebral discs from C3/4 to C6/7 in each volunteer. The Pfirrmann grades, FA value, and MD value on the conventional magnetic resonance imaging were evaluated. The Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare the FA and MD values of subjects with different degeneration levels. Results: Statistical analysis showed that the FA value of the nucleus pulposus in patients group was significantly higher than that in the asymptomatic volunteers, and the MD value of the nucleus pulposus was significantly lower than that in the asymptomatic volunteers, and the difference was significant (P < 0.05). In the study group, with an increase in cervical intervertebral disc grade, the FA value of the nucleus pulposus also showed a gradual upward trend, and this difference was significant (P < 0.05). The MD value of the nucleus pulposus showed a gradual downward trend, except between grades I and II, which indicates that the axial FA value can better show the early pathological changes of the cervical intervertebral disc. Conclusions: The FA and MD values of the cervical intervertebral disc can quantitatively evaluate the degree of degeneration of the cervical intervertebral disc; axial DTI imaging technology can provide a good theoretical basis for the imaging diagnosis of cervical intervertebral disc degeneration and has important clinical application value. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this systematic review is to present a comprehensive summary of existing research on the use of 3D printing in spinal surgery. Methods: The researchers conducted a thorough search of four digital databases (PubMed, Web of Science, Scopus, and Embase) to identify relevant studies published between January 1999 and December 2022. The review focused on various aspects, including the types of objects printed, clinical applications, clinical outcomes, time and cost considerations, 3D printing materials, location of 3D printing, and technologies utilized. Out of the 1620 studies initially identified and the 17 added by manual search, 105 met the inclusion criteria for this review, collectively involving 2088 patients whose surgeries involved 3D printed objects. Results: The studies presented a variety of 3D printed devices, such as anatomical models, intraoperative navigational templates, and customized implants. The most widely used type of objects are drill guides (53%) and anatomical models (25%) which can also be used for simulating the surgery. Custom made implants are much less frequently used (16% of papers). These devices significantly improved clinical outcomes, particularly enhancing the accuracy of pedicle screw placement. Most studies (88%) reported reduced operation times, although two noted longer times due to procedural complexities. A variety of 3DP technologies and materials were used, with STL, FDM, and SLS common for models and guides, and titanium for implants via EBM, SLM, and DMLS. Materialise software (Mimics, 3-Matic, Magics) was frequently utilized. While most studies mentioned outsourced production, in-house printing was implied in several cases, indicating a trend towards localized 3D printing in spine surgery. Conclusions: 3D printing in spine surgery, a rapidly growing area of research, is predominantly used for creating drill guides for screw insertion, anatomical models, and innovative implants, enhancing clinical outcomes and reducing operative time. While cost-efficiency remains uncertain due to insufficient data, some 3D printing applications, like pedicle screw drill guides, are already widely accepted and routinely used in hospitals. [ABSTRACT FROM AUTHOR]

College immunization policies vary. To evaluate the landscape of college immunization programs, we distributed a 45-item survey to college health administrators between July and September 2021. Items measured perceptions of institutionally recommended and required vaccines, enforcement strategies, barriers to vaccine uptake, and the impact of the COVID-19 pandemic. Of 566 invitations sent, only 66 college health administrators completed the survey (11.7% response rate). The majority of participating institutions (89%) required at least one vaccine, with measles-mumps-rubella (MMR) being the most commonly required (83%). Geographic region, school type, or size was not significantly correlated with immunization policies but state-level political leanings were. Common barriers to vaccine program implementation identified by respondents included student-based and institutional concerns. The COVID-19 pandemic was described as both exacerbating existing immunization program barriers and providing opportunities to strengthen programs. Future work will evaluate identified themes in a larger study population and monitor change in perceptions over time. [ABSTRACT FROM AUTHOR]

Objective: To determine HIV pre-exposure prophylaxis (PrEP) availability at student health services (SHS) in New England. Methods: We conducted an electronic survey of medical directors of SHS at New England colleges and universities. We measured the availability and volume of PrEP prescribing, barriers and facilitators to prescribing and provider knowledge. Results: Of 143 institutions surveyed, 39% completed questionnaires; 75% were private and 93% were 4 years. Thirty-six percent of institutions did not offer PrEP. Those offering PrEP started a mean of 2.0 per 1000 students/year. PrEP was available at more schools with higher vs. lower endowments (100 vs. 38%, p = 0.002), 4- vs. 2-year programs (68 vs. 0%, p = 0.042), and private vs. public schools (73 vs. 38%, p = 0.043). Conclusions: PrEP was not available at one in three New England SHS and prescribing rates at institutions that offered PrEP were low. Interventions are needed to improve PrEP access. [ABSTRACT FROM AUTHOR]

Purpose: This study compared the diagnostic performance of standard endoscopic ultrasound (EUS) and submucosal injection of normal saline and epinephrine-enhanced EUS (SINE-EUS) in detecting early colorectal cancer (CRC), emphasizing accuracy, sensitivity, and specificity. Methods: The self-controlled study was conducted with 115 patients diagnosed with early CRC through optical enhancement (OE) magnified endoscopy. Among them, 104 patients underwent sequential diagnostic procedures, starting with standard EUS and followed by SINE-EUS. Pathological findings were used as the reference standard. Statistical analyses assessed the diagnostic metrics and identified factors influencing accuracy. Results: Among 104 patients, 82 were pathologically diagnosed with early CRC (63 cases of Tis/T1a and 19 cases of T1b). Standard EUS showed a sensitivity of 68.3%, specificity of 52.6%, and overall accuracy of 64.6%. In contrast, SINE-EUS significantly improved sensitivity (85.7%), specificity (68.4%), and overall accuracy (81.7%) (P < 0.0167). Risk factors such as ulceration were identified as independent predictors of reduced diagnostic accuracy. Conclusions: SINE-EUS outperforms standard EUS in diagnosing early CRC, particularly in terms of sensitivity and overall accuracy. This technique is reliable for clinical application, although limitations remain in improving specificity for deeper lesions. [ABSTRACT FROM AUTHOR]

Cinnamaldehyde (CA) is an active ingredient extracted from cinnamon and is widely used in the food industry as a natural additive. CA has a variety of biological functions, such as antibacterial, antioxidant, antiviral, and anticancer, as well as its role in regulating gut microbiota, have been well-established. Additionally, CA has shown positive effects on degenerative central nervous system diseases, cognitive impairment, arthritis, and ischemic reperfusion injury, and is widely used in the food industry and clinical medicine. However, its poor water solubility and easy oxidation have largely limited its broad application. To enhance the efficacy of CA delivery, innovative delivery systems have been developed. This review aims to compile the most recent literature on CA extraction methods, biological functions, delivery systems, and toxicology, highlighting the compound's significance. By providing a comprehensive overview of CA, this review intends to serve as a valuable resource for the development and application of CA in both food and medical contexts. [ABSTRACT FROM AUTHOR]

Tumors constantly shed cancer cells that are considered the mediators of metastasis via the blood stream. Analysis of circulating cells and circulating cell-free DNA (cfDNA) in liquid biopsies, mostly taken from peripheral blood, have emerged as powerful biomarkers in oncology, as they enable the detection of genomic aberrations. Similarly, liquid biopsies taken from pregnant women serve as prenatal screening test for an abnormal number of chromosomes in the fetus, e.g., via the analysis of microchimeric fetal cells and cfDNA circulating in maternal blood. Liquid biopsies are minimally invasive and, consequently, associated with reduced risks for the patients. However, different challenges arise in oncology and pregnancy-acquired liquid biopsies with regard to the analyte concentration and biological (background) noise among other factors. In this review, we highlight the unique biological properties of circulating tumor cells (CTC), summarize the various techniques that have been developed for the enrichment, detection and analysis of CTCs as well as for analysis of genetic and epigenetic aberrations in cfDNA and highlight the range of possible clinical applications. Lastly, the potential, but also the challenges of liquid biopsies in oncology as well as their translational value for the analysis of pregnancy-acquired microchimerism are discussed. [ABSTRACT FROM AUTHOR]

While establishing symbiotic relationships with nitrogen-fixing soil bacteria certain legumes produce nodule-specific cysteine rich peptides. These peptides turn the bacteria into terminally differentiated non-replicative bacteroids. Here, we discuss the properties, essentiality, emerging clinical and agricultural applications, and the need to study the detailed mechanism of action of these peptides. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the dilation of lenticulostriate artery (LSA) identified by whole-brain vessel wall imaging (WB-VWI) in differentiating the etiologic subtypes of single subcortical infarction (SSI) and to determine whether the appearance of dilated LSA was associated with 90-day clinical outcomes in parental atherosclerotic disease (PAD)-related SSI. Methods: Patients with acute SSI were prospectively enrolled and categorized into PAD-related SSI and cerebral small-vessel disease (CSVD)-related SSI groups. The imaging features of LSA morphology (branches, length, dilation, and tortuosity), plaques (burden, remodeling index, enhancement degree, and hyperintense plaque), and CSVD (white matter hyperintensity, lacunes, cerebral microbleed, and enlarged perivascular space) were evaluated. The logistic regression was performed to determine the association of dilated LSA with PAD-related SSI and 90-day clinical outcomes. Results: In total, 131 patients (mean age, 52.2 ± 13.2 years; 99 men) were included. The multivariate logistic regression analysis revealed that the presence of dilated LSAs (odds ratio (OR), 7.40; 95% confidence interval (CI): 1.88–29.17; p = 0.004)) was significantly associated with PAD-related SSI. Moreover, after adjusting for confounding factors, the association of poor outcomes with the total length of LSAs (OR, 0.94; 95% CI: 0.90–0.99; p = 0.011), dilated LSAs (OR, 0.001; 95% CI: 0.0001–0.08; p = 0.002), and plaque burden (OR, 1.35; 95% CI: 1.11–1.63; p = 0.002) remained statistically significant. Conclusion: The dilation of LSA visualized on WB-VWI could differentiate various subtypes of SSI within LSA territory and was a prognostic imaging marker for 90-day clinical outcomes for PAD-related SSI. Clinical relevance statement: Evaluation of LSA morphology based on WB-VWI can differentiate the pathogenesis and predict clinical outcomes in SSI, providing crucial insights into the etiologic mechanisms, risk stratification, and tailored therapies for these patients. Key Points: The prognosis of SSIs within lenticulostriate territory depend on the etiology of the disease. LSA dilation on WB-VWI was associated with parental atherosclerosis and better 90-day outcomes. Accurately identifying the etiology of SSIs in lenticulostriate territory assists in treatment decision-making. [ABSTRACT FROM AUTHOR]

Extracellular vesicles (EVs) represent a diverse class of nanoscale membrane vesicles actively released by cells. These EVs can be further subdivided into categories like exosomes and microvesicles, based on their origins, sizes, and physical attributes. Significantly, disease-derived EVs have been detected in virtually all types of body fluids, providing a comprehensive molecular profile of their cellular origins. As a result, EVs are emerging as a valuable addition to liquid biopsy techniques. In this collective statement, the authors share their current perspectives on EV-related research and product development, with a shared commitment to translating this newfound knowledge into clinical applications for cancer and other diseases, particularly as disease biomarkers. The consensus within this document revolves around the overarching recognition of the merits, unresolved questions, and existing challenges surrounding EVs. This consensus manuscript is a collaborative effort led by the Committee of Exosomes, Society of Tumor Markers, Chinese anti-Cancer Association, aimed at expediting the cultivation of robust scientific and clinically applicable breakthroughs and propelling the field forward with greater swiftness and efficacy. [ABSTRACT FROM AUTHOR]

Frailty and multimorbidity are common in older adults, but the prevalence and interaction of these conditions in surgical patients remain unclear. This study describes the clinical characteristics of a heterogeneous cohort of older UK surgical patients. We conducted a prospective observational cohort study during 5 days in March 2022, aiming to recruit all UK patients aged 60 yr and older undergoing surgery, excluding minor procedures (e.g. cataract surgery). Data were collected on patient characteristics, clinical care, frailty, and multimorbidity measures. A total of 7134 patients from 214 NHS hospitals were recruited, with a mean (sd) age of 72.8 (8.1) yr. Of all operations, 69% (95% confidence interval [CI] 67.9–70.1%) were elective, and 34% (95% CI 32.7–34.8%) were day cases. Of the patients, 19% (95% CI 18.3–20.1%) were living with frailty (Clinical Frailty Score ≥5), and 63.1% (95% CI 62.0–64.3%) were living with multimorbidity (count of ≥2 comorbidities). Those living with frailty, multimorbidity, or both were typically older, were from lower socioeconomic backgrounds, and experienced greater polypharmacy and reduced independence. Patients living with frailty were less likely to undergo elective and day-case surgeries. Four out of five (78.8% [1079/1369]) of those who were living with frailty were also living with multimorbidity; 27.1% (1079/3978) of those who were living with multimorbidity were also living with frailty. In the UK, one in five older patients undergoing surgery is living with frailty, and almost two-thirds of older patients are living with multimorbidity. These data highlight the importance of frailty screening. In addition, they can serve to guide resource allocation and provide comparative estimates for future research. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the outcomes of three-dimensional (3D) Printing-Assisted Osteotomy in treating varus knee deformity from old tibial plateau fractures. Methods: The study retrospectively analyzed patients with varus deformity induced by old-tibial plateau fractures between January 2019 and June 2023. All patients utilized 3D printed models for surgical planning. The Lysholm Knee Score (LKS), Visual Analog Scale (VAS) and Knee Society Score (KSS) were measured for functional outcomes. Medial Proximal Tibial Angle (MPTA), Joint Line Convergence Angle (JLCA), Mechanical Axis (%MA), Medial Tibial Plateau Depression (MTPD), and Femorotibial Angle (FTA) were measured for radiological outcomes. Results: 15 patients (12 males and 3 females) were included in this study and followed up for 21.9 ± 8.6 (range, 12 to 28) months. Healing of the osteotomy sites were achieved in all patients at 15.8 ± 1.5 (range, 13 to 18) weeks. The knee varus deformities were significantly corrected as reflected by %MA (2.13 ± 13.1°(range, -20 to 22) versus 57.06 ± 9.8°(range, 41 to 70), p < 0.01), FTA (186.7 ± 3.2°(range, 181 to 193) versus 172.3 ± 2.1°(range, 169 to 175), p < 0.01), JLCA (5.8 ± 1.7°(range, 3 to 8) versus 1.3 ± 0.8°(range, 0 to 3), p < 0.01), and MPTA (5.6 ± 1.2°(range, 3 to 8) versus 1.2 ± 1.1°(range, -1 to 3), p < 0.01). Postoperative knee function showed dramatic improvements as reflected by VAS (4.6 ± 1.6 (range, 1 to 7) versus 0.7 ± 0.9 (range, 0 to 2), p < 0.01), KSS (50.1 ± 16.5 (range, 27 to 88) versus 88.5 ± 5.2 (range, 80 to 95), p < 0.01), and LKS (49.5 ± 10.2 (range, 37 to 69) versus 89.2 ± 2.5 (range, 87 to 94), p < 0.01). Conclusions: 3D printing technology provides a valuable tool for understanding deformities and optimizing osteotomy strategies, thereby improving surgical efficacy and treatment outcomes. Its clinical application is highly recommended. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is now recognized to be a multifactorial disorder caused by several endotypes that differ between individuals and patient populations. In order to understand the current clinical implications of OSA endotypes, this review aims to examine the current state of play in endotype measurements, endotype modification and their impact on clinical outcomes/prognosis. In summary, the field has developed multiple techniques to measure the endotypes over the last few decades. There is now good proof-of-concept evidence that a priori knowledge of an individual's OSA endotype traits may be useful in helping to guide treatment decisions. However, in order to truly deliver a personalized medicine approach to the treatment of OSA, we need to address critical gaps in: understanding OSA endotype treatment thresholds, and the impact of OSA modification on patient centred outcomes and hard clinical endpoints. Such efforts will benefit from a united, collaborative approach that involve partnerships between academics and consumers (i.e. patients, healthcare providers, industry). • OSA is a disorder caused by several endotypes that differ between individuals. • Multiple techniques now exist to measure these endotypes. • They can be used to help choose a treatment for OSA as well as guide adjunct therapies. • Such efforts are helping make personalized sleep medicine for OSA a clinical reality. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical significance of induced sputum in asthma through a retrospective analysis of induced sputum in patients with asthma. Data sources: The data and references cited in this article were obtained from PubMed, Sci-Hub, and Web of Science. Study selection: Observational studies with reliable data were selected. Conclusions: The cytological count, -omics, and pathogen detection of induced sputum are helpful for the clinical diagnosis of asthma and in guiding medication choices. [ABSTRACT FROM AUTHOR]

IgA nephropathy and IgA vasculitis with nephritis, albeit rare, represent two relatively frequent glomerular conditions in childhood. Compared to adults, pediatric IgA nephropathy has a more acute presentation, most frequently with synpharyngitic macrohematuria and histologically with more intense inflammation and less intense chronic damage. Management of these conditions is controversial and supported by little high-quality evidence. The paucity of evidence is due to the disease heterogeneity, its inter-ethnic variability, and the difficulty of extrapolating data from adult studies due to the peculiarities of the condition in children. IgA vasculitis with nephritis is a kidney manifestation of a systemic disorder, typical of the pediatric age, in which both the diagnosis of kidney involvement and its management are poorly defined, and an interdisciplinary approach is crucial. Both conditions can have a profound and long-lasting impact on kidney function and the global health of affected children. The International Pediatric Nephrology Association has therefore convened a diverse international group of experts from different disciplines to provide guidance on the recommended management of these conditions in children and to establish common definitions and define priorities for future high-quality, evidence-based collaborative studies for the benefit of children. [ABSTRACT FROM AUTHOR]

Alzheimer's disease is the most common form, accounting for 60–70% of 55 million dementia cases. Even though the precise pathophysiology of AD is not completely understood, clinical trials focused on antibodies targeting aggregated forms of β amyloid (Aβ) have demonstrated that reducing amyloid plaques can arrest cognitive decline in patients in the early stages of AD. In this study, we provide an overview of current research and innovations for controlled release from nano-biomaterial-assisted chimeric antigen receptor macrophage (CAR-M) therapeutic strategies targeted at AD. Nano-bio materials, such as iron-oxide nanoparticles (IONPs), can be made selectively (Hp-Hb/mannose) to bind and take up Aβ plaques like CAR-M cells. By using nano-bio materials, both the delivery and stability of CAR-M cells in brain tissue can be improved to overcome the barriers of the BBB and enhance therapeutic effects. By enhancing the targeting capabilities and stability of CAR-M cells, mRNA-loaded nano-biomaterials can significantly improve the efficacy of immunotherapy for plaque reduction in AD. This novel strategy holds promise for translating preclinical successes into clinical applications, potentially revolutionising the management of AD. [ABSTRACT FROM AUTHOR]

Because symptoms of cardiopulmonary disease often occur with exertion, cardiopulmonary exercise testing (CPET) has a unique role in the assessment of patient symptoms, disease severity, prognosis, and response to therapy. In addition to the evaluation of cardiovascular and pulmonary physiology, CPET provides an assessment of the interaction of the cardiovascular and pulmonary systems with the musculoskeletal, nervous, and hematological systems. In this article, we review key CPET variables, protocols, and clinical indications. [ABSTRACT FROM AUTHOR]

The aim of this study was to report the clinical experience of repairing mandibular defects with a deep circumflex iliac artery perforator flap with iliac crest (DCIAPF) and to analyse the relevant anatomical data to guide clinical application. Forty patients with mandibular defects, who underwent reconstruction with a DCIAPF after oncological resection were included in the study. During the operation, anatomical features relevant to the structure of the DCIAPF were measured, including the position of the perforator, mobility of the skin paddle, length of the vascular pedicle, and adipose tissue thickness of the skin paddle. Three types of DCIAPF perforator were identified: type I, with a dominant perforator, which was observed in 17 patients (42.5%); type II, with a dominant perforator that divides into multiple tiny branches, in 20 patients (50%); type III, with no visible dominant perforator, in three patients (7.5%). In summary, the DCIAPF provides adequate bone tissue and satisfactory soft tissue. [ABSTRACT FROM AUTHOR]

Cholangiocarcinoma (CCA) is known for its high aggressiveness and dismal prognosis, whose effectiveness of systemic therapy remains limited. As a multi-target drug, lenvatinib has exhibited promising effects in many solid tumors. However, the therapeutic role of lenvatinib in CCA is rarely investigated. Here, the in vitro assays including EdU, colony formation, transwell, wound healing, and apoptosis analyses demonstrated that lenvatinib significantly inhibited the proliferation, migration, and invasion, while simultaneously inducing apoptosis of CCA cells. Mechanistically, lenvatinib downregulated the expression of FGF19 and inactivated the PI3K/AKT signaling pathway. Depletion of FGF19 enhanced the anti-tumor effects of lenvatinib, which was attributed to the inhibition of p-PI3K and p-AKT expression in CCA cells. In contrast, overexpression of FGF19 activated the PI3K/AKT signaling pathway, thereby impairing the inhibitory effects of lenvatinib against CCA. In addition, the AKT inhibitor, MK-2206, reinforced the lenvatinib-induced CCA inhibition. Notably, the in vivo experiment confirmed that the subcutaneous tumorigenicity of CCA cells in nude mice was weakened by lenvatinib. Lenvatinib markedly downregulated the expression of FGF19, p-AKT, Ki-67, vimentin, and VEGF in the xenograft tumor tissues. Collectively, these findings demonstrated that lenvatinib inhibits CCA progression by targeting the FGF19/PI3K/AKT signaling pathway. The present study provides novel experimental evidence for the potential clinical application of lenvatinib in CCA, which also highlights the promising role of targeting FGF19 in combined therapeutic approaches for CCA. [ABSTRACT FROM AUTHOR]

Photobiomodulation (PBM) has been demonstrated as a non‐invasive and painless technique with great potential to accelerate orthodontic tooth movement (OTM). However, there is a great inconsistency among PBM protocols and reported outcomes, probably due to the poor translatability of preclinical knowledge into early clinical practice. Hence, this review aims to fill this gap by establishing the state‐of‐the‐art on both preclinical and clinical applications of PBM, and by comprehensively discussing the most suitable stimulation protocols described in the literature. This review was conducted according to PRISMA guidelines. A bibliographic search was carried out in the PubMed, Scopus and Cochrane databases using a combination of keywords. Only studies written in English were eligible and no time limit was applied. A total of 69 studies were selected for this review. The revised literature describes that PBM can effectively reduce orthodontic treatment time and produce analgesic and anti‐inflammatory effects. We found that PBM of 640 ± 25, 830 ± 20 and 960 ± 20 nm, delivered at a minimum energy density per irradiation point of 5 J/cm2 daily or every other day sessions is robustly associated with increased tooth movement rate. Pain relief seems to be achieved with lower irradiation doses compared to those required for OTM acceleration. For the first time, the bioeffects induced by PBM for the acceleration of OTM are comprehensively discussed from a translational point of view. Collectively, the evidence from preclinical and clinical trials supports the use of PBM as a coadjuvant in orthodontics for enhancing tooth movement and managing treatment‐associated discomfort. Overall, the revised studies indicate that optimal PBM parameters to stimulate tissue remodelling are wavelengths of 830 ± 20 nm and energy densities of 5–70 J/cm2 applied daily or every other day can maximize the OTM rate, while lower doses (up to 16 J/cm2 per session) delivered in non‐consecutive days seem to be optimal for inducing analgesic effects. Future research should focus on optimizing laser parameters and treatment protocols customized for tooth and movement type. By fine‐tuning laser parameters, clinicians can potentially reduce treatment times, improve patient comfort and achieve more predictable outcomes, making orthodontic care more efficient and patient‐friendly, thus consolidating PBM usage in orthodontics. [ABSTRACT FROM AUTHOR]

Background: Adolescents and young adults (AYA) living with HIV face several challenges to engaging in HIV care, which can impact adherence to antiretroviral therapy (ART). Point-of-care (POC) diagnostics that detect tenofovir in urine may be a useful tool to support ART adherence, but perspectives from AYA in South Africa have not been explored. Methods: We conducted in-depth interviews (IDIs) among young people (age 18–24) newly diagnosed with HIV in Cape Town, and a focus group discussion (FGD) with HIV care providers to understand their perspectives regarding the use of POC urine tenofovir testing to support ART adherence. Transcripts were analyzed using Dedoose, with an iterative thematic approach. Results: Transcripts from 8 IDI participants and 8 FGD participants were included in the analysis. Major themes identified during analysis related to beliefs about POC urine adherence testing and recommendations for future clinical implementation. Most IDI participants indicated they would want to use the tests if clinically available, and both IDI and FGD participants believed the tests would be helpful to clinicians. Participants believed the tests could motivate people to take their ART regularly, either by reassuring them ART was present in their bodies, or to avoid the negative consequences of being found to be non-adherent. Drawbacks of POC adherence testing identified by respondents included not wanting to be caught skipping ART doses, concerns about privacy, how the test results would be explained, and adding to the amount of testing required for HIV clinical care. Conclusions: AYA living with HIV in South Africa had favorable views toward POC tenofovir adherence testing and felt utilizing these tests in HIV clinical care would motivate people to remain adherent to ART. [ABSTRACT FROM AUTHOR]

Emotion malleability beliefs (EMB) have been shown to be a potential predictor of cognitive reappraisal use. However, the nature of the relationship between EMB and cognitive reappraisal use remains unclear. The present study manipulated EMB with an online intervention and measured participants’ EMB and cognitive reappraisal before the intervention as well as at three follow-ups. Eighty-six late adolescents who scored in the bottom 50% on EMB in a previous investigation were randomly assigned to the intervention group (increasing EMB) and the control group. The intervention significantly increased EMB, and this effect remained one week and one month after the intervention. More importantly, the results showed that the lag paths from a previous measure of EMB on later cognitive reappraisal were positive and significant. The cross-lagged paths from cognitive reappraisal to EMB were not significant. The intervention to increase EMB showed significant indirect effects on cognitive reappraisal via EMB. The findings not only support that the intervention of EMB had a sustained effect but also evidenced that EMB had a causal effect on cognitive reappraisal. This suggests a promising way to enhance cognitive reappraisal for application in the treatment of clinical emotion disorders. [ABSTRACT FROM AUTHOR]

Background: Patients with prior abdominal surgeries are at higher risk of intra-peritoneal adhesions near the trocar entry site, increasing the likelihood of organ injury during laparoscopic cholecystectomy (LC). This study evaluates a novel technique where the epigastric trocar is inserted first, after creating pneumoperitoneum, to allow safe dissection of adhesions under direct vision before placing the umbilical trocar. Methods: This prospective study included 244 patients with symptomatic uncomplicated gallstone disease and a history of previous abdominal surgeries extending to the umbilicus. Patients were randomly assigned to two groups: Group I (n = 98) underwent traditional umbilical trocar-first LC using the Hasson technique, while Group II (n = 146) received LC using the epigastric trocar-first approach. Operative time, complications, and conversion rates were analyzed. Results: There was no significant difference in the demographics between both groups. The epigastric trocar-first approach significantly reduced total operative time (41.6 ± 7.7 min vs. 46.8 ± 8.8 min, p = 0.031) and small bowel injury rates (p = 0.006). Otherwise, intraoperative complications were comparable. Conversion to open surgery was lower in Group II (2.1% vs. 8.2%, p = 0.012). Postoperative pain at 6 h was significantly lower in Group II (p = 0.001). Conclusions: The epigastric trocar-first approach, offers a safer alternative for patients with prior abdominal surgeries when undergoing LC. This approach is safe; minimizes bowel injury risk, reduces conversion rates, and enhances patient recovery. This approach may also be beneficial in other laparoscopic procedures requiring safe entry in patients with prior abdominal surgeries. Further studies are recommended to validate its broader clinical application. [ABSTRACT FROM AUTHOR]

Recent advances in oncology research have highlighted the promising synergy between low-dose radiation therapy (LDRT) and immunotherapies, with growing evidence highlighting the unique benefits of the combination. LDRT has emerged as a potent tool for stimulating the immune system, triggering systemic antitumor effects by remodeling the tumor microenvironment. Notably, LDRT demonstrates remarkable efficacy even in challenging metastatic sites such as the liver (uveal) and brain (cutaneous), particularly in advanced melanoma stages. The increasing interest in utilizing LDRT for secondary metastatic sites of uveal, mucosal, or cutaneous melanomas underscores its potential efficacy in combination with various immunotherapies. This comprehensive review traverses the journey from laboratory research to clinical applications, elucidating LDRT's immunomodulatory role on the tumor immune microenvironment (TIME) and systemic immune responses. We meticulously examine the preclinical evidence and ongoing clinical trials, throwing light on the promising prospects of LDRT as a complementary therapy in melanoma treatment. Furthermore, we explore the challenges associated with LDRT's integration into combination therapies, addressing crucial factors such as optimal dosage, fractionation, treatment frequency, and synergy with other pharmacological agents. Considering its low toxicity profile, LDRT presents a compelling case for application across multiple lesions, augmenting the antitumor immune response in poly-metastatic disease scenarios. The convergence of LDRT with other disciplines holds immense potential for developing novel radiotherapy-combined modalities, paving the way for more effective and personalized treatment strategies in melanoma and beyond. Moreover, the dose-related toxicities of immunotherapies may be reduced by synergistic amplification of antitumor efficacy with LDRT. [ABSTRACT FROM AUTHOR]

Inhibition of the protein neddylation pathway has emerged as an attractive anticancer strategy in pre-clinical studies. MLN4924, as a small molecule inhibitor of neddylation, has been found to effectively inhibit the growth of a variety of cancer cells. However, its clinical application still faces some major challenges in terms of poor water solubility, biological stability, poor targeting, and rapid clearance from the body. Herein, we developed a biomimetic nanovesicle platform (named P-PAM/MLN) by ultrasonically storing the MLN4924-loaded polyamidoamine (PAMAM) dendrimer inside platelet membrane vesicles (PMVs) for tumor therapy. Benefiting from PMV-based camouflage, P-PAM/MLN exhibited enhanced tumor affinity, avoiding the off-target toxicity of MLN4924. Moreover, P-PAM/MLN could selectively release MLN4924 in response to the acidic microenvironment of lysosomal compartments via the "proton sponge" effect. Consequently, the biomimetic nanovesicles could remarkably inhibit tumor progression with negligible toxicity. In terms of significance, the nanovesicles provide a precisely targeted delivery platform for delivering small molecule drugs to the tumor tissue as well as an effective reference for the combined application of nanocarriers and clinical drugs. [ABSTRACT FROM AUTHOR]