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Nanotechnology advancements have resulted in many sensors and devices for biomedical applications. Among the various nanomaterials, gold nanoparticles (AuNPs), due to their size, shape, biocompatibility, and unique plasmonic property, are an excellent candidate for many biomedical applications. AuNPs, known for their easy surface modifications, robust nature, and photothermal activities, find application in drug delivery and cancer treatment studies. In this review, we are highlighting the recent trends in using AuNPs as nanomedicine for cancer immunotherapy. Cancer immunotherapy not only eliminates the primary tumors but also allows for the treatment of metastasis along with the recurrence of the tumor. AuNPs possess tissue-specific delivery functions that depend on the tunability in size and surface functionalization of AuNPs. AuNPs can be used to activate the tumor’s immune defense ability, or they can be used to enhance the anti-tumor immune response. Understanding the interaction of the tumor environment and nanobiomedicine is very important. In the present review, we give an idea of the mode of action of AuNPs and various combinations of therapies for cancer immunotherapy.

Research into pre-service teachers’ (PSTs) ability to develop meaningful interdisciplinary, project-based curricula is lacking; at the same time, many young adolescents fail to see the connections between their schoolwork and the real world. As such, there is a need for new methods to prepare elementary and middle school teachers’ abilities to integrate mathematics and science through authentic content. This article will examine how elementary and middle PSTs collaborated across their mathematics and science methods courses to design project-based learning (PBL) unit plans that integrate social justice and global awareness in a STEM context. The content analysis of 25 distinct PBL unit plans documented the levels at which PSTs could incorporate practical PBL design elements into their projects, integrate robust mathematical content, and identify connections to social justice and global awareness. Through this analysis, we will share the successes and challenges faced in guiding PSTs to create PBL STEM units and present a series of next steps that could be taken to further this cross-curricular endeavor.

Both IDH1 (isocitrate dehydrogenase 1) and IDH2 (isocitrate dehydrogenase 2) mutations play a vital role in the development of gliomas through disruption of normal cellular metabolic processes. Here we describe a case of a patient with an IDH-mutant astrocytoma, in which both IDH1 and IDH2 mutations were detected within the same tumour. The patient remains disease-free, nine and a half years after her initial diagnosis. Interrogation of cancer genomic databases and a systematic review was undertaken, demonstrating the rarity of the co-occurrence of IDH1 and IDH2 mutations in a variety of cancer types, and in glioma specifically. Due to the favourable outcome observed in this patient, the potential effect of concurrent IDH1 and IDH2 mutations on survival was also investigated.

Background and PurposeWhile relative cerebral blood volume (rCBV) may be diagnostic and prognostic for survival in glioblastoma (GBM), changes in rCBV during chemoradiation in the subset of newly diagnosed GBM with subtotal resection and the impact of MGMT promoter methylation status on survival have not been explored. This study aimed to investigate the association between rCBV response, MGMT methylation status, and progression-free (PFS) and overall survival (OS) in newly diagnosed GBM with measurable enhancing lesions.Methods1,153 newly diagnosed IDH wild-type GBM patients were screened and 53 patients (4.6%) had measurable post-surgical tumor (>1mL). rCBV was measured before and after patients underwent chemoradiation. Patients with a decrease in rCBV >10% were considered rCBV Responders, while patients with an increase or a decrease in rCBV

In the original publication of this article [1] the term ‘National Rugby League (NRL)’ was used to refer to professional rugby league competition sport in Australia. The term should have read ‘professional rugby league’ to include the various professional competition nomenclatures over the last fifty years, including but not limited to NRL. In this correction article, the incorrect and correct information are published.

Inflammatory bowel disease (IBD) is a chronic and recurring inflammation of the gastrointestinal tract; however, current pharmaceutical treatments are only moderately effective and have potential long-term toxicity, therefore novel IBD therapies are required. Hen egg white has been shown to be an abundant source of novel immunomodulating proteins and peptides. The anti-inflammatory activity of egg white peptides was examined using a porcine model of dextran sodium sulphate (DSS)-induced colitis. DSS was administered for five days via intra-gastric catheter to induce experimental colitis, followed by five days of treatment with egg white peptides (EWP) or saline.Supplementation with EWP attenuated the DSS-induced clinical symptoms, including weight loss, mucosal and submucosal inflammation, crypt distortion, and colon muscle thickening, and restored gut barrier function by decreasing intestinal permeability and increasing mucin gene expression. Furthermore, treatment with EWP significantly reduced the local expression of pro-inflammatory cytokines TNF-α, IL-6, IL-1β, IFN-γ, IL-8, and IL-17, suggesting that EWP is a promising novel therapeutic for the treatment of IBD.

The classical paradigm of liver injury asserts that hepatic stellate cells (HSC) produce, remodel and turnover the abnormal extracellular matrix (ECM) of fibrosis via matrix metalloproteinases (MMPs). In extrahepatic tissues MMP production is regulated by a number of mechanisms including expression of the glycoprotein CD147. Previously, we have shown that CD147 is expressed on hepatocytes but not within the fibrotic septa in cirrhosis [1]. Therefore, we investigated if hepatocytes produce MMPs, regulated by CD147, which are capable of remodelling fibrotic ECM independent of the HSC.Non-diseased, fibrotic and cirrhotic livers were examined for MMP activity and markers of fibrosis in humans and mice. CD147 expression and MMP activity were co-localised by in-situ zymography. The role of CD147 was studied in-vitro with siRNA to CD147 in hepatocytes and in-vivo in mice with CCl4 induced liver injury using ãCD147 antibody intervention.In liver fibrosis in both human and mouse tissue MMP expression and activity (MMP-2, -9, -13 and -14) increased with progressive injury and localised to hepatocytes. Additionally, as expected, MMPs were abundantly expressed by activated HSC. Further, with progressive fibrosis there was expression of CD147, which localised to hepatocytes but not to HSC. Functionally significant in-vitro regulation of hepatocyte MMP production by CD147 was demonstrated using siRNA to CD147 that decreased hepatocyte MMP-2 and -9 expression/activity. Further, in-vivo α-CD147 antibody intervention decreased liver MMP-2, -9, -13, -14, TGF-β and α-SMA expression in CCl4 treated mice compared to controls.We have shown that hepatocytes produce active MMPs and that the glycoprotein CD147 regulates hepatocyte MMP expression. Targeting CD147 regulates hepatocyte MMP production both in-vitro and in-vivo, with the net result being reduced fibrotic matrix turnover in-vivo. Therefore, CD147 regulation of hepatocyte MMP is a novel pathway that could be targeted by future anti-fibrogenic agents.

Background: The use of ultrasound as an adjunct to clinical swallowing evaluation provides quantitative physiological and morphological data. As a low-risk procedure, ultrasound imaging can be performed outside of a medical setting. This is particularly important for patients living in rural areas with restricted access to a hospital. Technical advances have produced pocket-sized ultrasound technology that is more affordable, and therefore within the fiscal reach of most allied health services. Aims: To explore the validity and reliability of pocket-sized ultrasound technology in dysphagia assessment. Methods & Procedures: Data were acquired from 43 patients with dysphagia using the Clarius ultrasound device. Ultrasound and videofluoroscopic measures of hyoid and laryngeal displacement during liquid and puree swallowing were collected concurrently to quantify correlation and agreement between identical measures derived from the two instruments. Reliability of ultrasound was assessed for measures of hyoid and laryngeal displacement, tongue thickness, and size of the submental muscles in eight patients. Reliability was evaluated for the entire process of data acquisition including scanning and online measurement using an iPad in a clinical setting and for offline measurement on a computer screen to explore environmental influences on reliability. Outcomes & Results: Results revealed poor correlation between the measures of interest across instruments. Reliability of the entire process of data acquisition in a clinical setting was insufficient while reliability was more promising for offline measurements. Conclusions & Implications: The clinical use of pocket-sized ultrasound devices, such as the Clarius system, for swallowing evaluation is not indicated at this time. Enhanced validity and reliability of the entire process of data acquisition are needed prior to clinical translation of such technology.

Purpose: Ultrasound imaging offers a noninvasive adjunct to clinical swallowing assessment. Published reliability of sophisticated ultrasound systems is promising; however, no data exist for reliability using more affordable, pocket-sized devices. This study explored intrarater, interrater, and test-retest reliability of swallowing measures acquired with pocket-sized ultrasound technology. Method: Five participants collected measures of swallowing from 20 healthy individuals using the Clarius ultrasound. Hyoid excursion and thyrohyoid approximation were derived during saliva, liquid, and puree swallowing. The cross-sectional area of the floor of mouth muscles and tongue thickness were obtained at rest. Measures were collected at two occasions minimum 11 days apart. Reliability was assessed for the entire process of data acquisition including scanning and online measurement, and for offline measurement of saved images. Results: For most measures, reliability was poor (ICC [intraclass correlation coefficient] < 0.50) to moderate (ICC = 0.50-0.75) for the entire process of data acquisition and poor to good (ICC > 0.75) when measuring saved images. Conclusion: Further work is needed to elucidate whether our study findings apply to the Clarius system only or the data suggest a general limitation of pocket-sized ultrasound technology.

Background: The Test of Masticating and Swallowing Solids (TOMASS) is an international standardized swallowing assessment tool. However, its psychometric characteristics have not been analysed in patients with dysphagia. Aims: To analyse TOMASS's (1) inter- and intra-rater reliability in a clinical population of patients with dysphagia, (2) known-group validity, (3) concurrent validity and (4) correlation with meal duration. Methods & Procedures: Two age- and gender-matched groups of 39 participants each were recruited: A group of patients with dysphagia and a control group with no history of dysphagia. The TOMASS was carried out in both populations, video-recorded and scored offline by two speech and language therapists (SLT 1 and SLT 2) (inter-rater reliability) and twice by the same SLT (intra-rater reliability). In the clinical group, the TOMASS was carried out three times: (1) to verify understanding of the required tasks, (2) performed concurrently during fibreoptic endoscopic evaluation of swallowing (FEES) to assess validity and (3) during clinical assessment to assess reliability. TOMASS under endoscopic control was recorded and the number of white-out events was counted to compare with the number of observed swallows per cracker during standard TOMASS as a measure of concurrent validity. As additional measures of TOMASS validity, oral dental status, classified as 'functional' or 'partially functional', and duration of a standard meal were assessed by an SLT (SLT 1 or SLT 2), and then correlated with TOMASS. Outcome & Results: TOMASS's inter- and intra-rater reliability were high (intraclass correlation coefficient (ICC) > 0.95) in both the clinical and the control groups. The number of masticatory cycles (p = 0.020), swallows (p = 0.013) and total time (p = 0.003) of TOMASS were significantly lower in the control group than in the clinical group. Patients with 'partially functional' oral dental status showed a significantly higher number of masticatory cycles per cracker and a longer duration of ingestion than patients with a 'functional' one. Concurrent validity suggested a substantial agreement between TOMASS and FEES in defining the number of swallows per cracker. The mean difference of the two measures was -0.02 (95% confidence interval (CI) = -1.7 to 1.2). Meal duration significantly correlated with the 'number of swallows per cracker' (r = 0.49; p = 0.002) and 'total time' (r = 0.41; p = 0.011). Conclusions & Implications: Preliminary psychometric analysis of TOMASS in a clinical sample of outpatients with dysphagia suggests that it is a reliable and valid (specifically related to the number of swallows per cracker) tool. TOMASS's application in clinical practice to quantitatively measure solid bolus ingestion is recommended.

Purpose: Cough reflex testing (CRT) is an adjunct to the clinical swallowing evaluation (CSE), providing information on patients' risk of silent aspiration. CRT has been shown to influence diet recommendations, but in previous work, the many varied patient characteristics are not controlled. Therefore, the specific role of CRT results in these decisions remains unclear as this relationship has not been directly assessed. Method: An online survey was sent to speech language therapists working in dysphagia. Two patient cases were presented that differed only by the presence of risk factors for the development of aspiration pneumonia. For each patient case, there were three assessment scenarios: CSE information only, CSE information with a "pass" CRT result, and CSE information with a "fail" CRT result. Clinicians outlined their patient management plans for each of the six scenarios. Results: Ninety-seven data sets were used in the final analysis. A "fail" result was found to lead to the most restrictive patient management. Decisions made when provided with only CSE information were very similar to decisions made for a CSE with a "pass" result. Aspiration pneumonia risk factors were shown to influence decision making, with the low-risk patient more likely to be recommended a less restrictive diet. Conclusions: When information was available regarding silent aspiration risk, clinicians factored the results into their decision making. However, in the absence of a CRT result, airway sensation was assumed to be intact in the absence of information. This finding warrants further investigation given the impact this assumption may have on a patient's pulmonary health. [ABSTRACT FROM AUTHOR]

Background: The Test of Masticating and Swallowing Solids (TOMASS) has been developed to provide clinicians with objective data regarding the efficiency of oral phase function and solid bolus ingestion. Aims: To determine if the TOMASS will detect changes in the oral phase of swallowing imposed by topical anaesthesia, thus providing validation of its clinical utility. Methods & Procedures: Per the standard protocol, 10 healthy participants ate one-quarter of an Arnotts Salada[superscript TM] biscuit. The number of bites per cracker, number of masticatory cycles, number of swallows and total time taken were recorded at baseline, following application of topical oral anaesthetic; this was additionally compared with a post-anaesthetic condition. Median and interquartile range (IQR) were calculated. Wilcoxon signed-rank tests were conducted to evaluate trial effect, and Friedman's tests were used to detect differences in the number of bites, number of swallows, number of chews and time taken to eat the crackers. Outcomes & Results: Results indicated that the number of both bites and swallows did not significantly change across conditions (?[superscript 2](2) = 0.105, p = 0.949, ?[superscript 2](2) = 1.357, p = 0.507); however, the number of chews for the anaesthetic condition was significantly higher when compared with the baseline (p = 0.02) and post-anaesthesia conditions (p = 0.02). Further, the durations of ingestion in the anaesthetic condition were significantly longer than the baseline (p = 0.01) and post-anaesthesia (p = 0.01) conditions. Across all measures, there were no differences between baseline and post-anaesthesia conditions. Conclusions & Implications: Although further exploration is required, these early data suggest the TOMASS is a sensitive measure in the evaluation of the oral-phase preparation of solid textures.

Background: Clinical swallowing assessment is largely limited to qualitative assessment of behavioural observations. There are limited quantitative data that can be compared with a healthy population for identification of impairment. The Test of Masticating and Swallowing Solids (TOMASS) was developed as a quantitative assessment of solid bolus ingestion. Aims: This research programme investigated test development indices and established normative data for the TOMASS to support translation to clinical dysphagia assessment. Methods & Procedures: A total of 228 healthy adults (ages 20-80+ years) stratified by age and sex participated in one or more of four consecutive studies evaluating test-retest and interrater reliability and validity to instrumental assessment. For each study the test required participants to ingest a commercially available cracker with instructions to "eat this as quickly as is comfortably possible". Further averaged measures were derived including the number of masticatory cycles and swallows per bite, and time per bite, masticatory cycle and swallow. Initial analyses identified significant differences on salient measures between two commercially available crackers that are nearly identical in shape, size and ingredients, suggesting the need for separate normative samples for specific regional products. Additional analyses on a single cracker identified that the TOMASS was sensitive at detecting changes in performance based on age and sex. Test-retest reliability across days and interrater reliability between clinicians was high, as was validation of observational measures to instrumental correlates of the same behaviours. Therefore, normative data are provided for the TOMASS from a minimum of 80 healthy controls, stratified by age and sex, for each of seven commercially available crackers from broad regions worldwide. Outcomes & Results: Analyses on a single cracker identified Arnott's Salada, and that TOMASS measures were sensitive for detecting changes in performance based on age and sex. Interrater and test-retest reliability across days were high, as was validation of observational measures to instrumental correlates of the same behaviours. Significant differences were identified between two commercially available crackers, nearly identical in shape, size and ingredients, thus normative samples for specific regional products were required. Normative data were then acquired for the TOMASS from a minimum of 80 healthy controls, stratified by age and sex, for each of seven commercially available crackers from broad regions worldwide. Conclusions & Implications: The TOMASS is presented as a valid, reliable and broadly normed clinical assessment of solid bolus ingestion. Clinical application may help identify dysphagic patients at bedside and provide a non-invasive, but sensitive, measure of functional change in swallowing.