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This article aims to describe the mapping done by teachers in elementary schools regarding students' backgrounds before they apply differentiated instruction. Mapping students' backgrounds is very important considering the focus of attention from implementing differentiated instruction is alignment with student characteristics, so as to make learning comfortable and enjoyable. There are several methods and aspects used for mapping student backgrounds. The main thing that is expected from the implementation of differentiated instruction is the suitability of what is learned with what is found in students. With these conditions, it is hoped that it will create fun learning that will support an increase in the academic achievement of learning outcomes. There were 44 teachers who participated in this study which was carried out through workshop activities in the community service program. The results of the study revealed that there were things that became problems in mapping students' backgrounds in the implementation of differentiated instruction.

Abstract We aimed to compare the accuracy and reliability of two segmentation tools for magnetic resonance (MR) volumetry (FreeSurfer and Neurophet AQUA) at two magnetic field strengths (1.5T and 3T). We included 101 patients for the 1.5T–3T dataset and 112 for the 3T–3T dataset from three hospitals and five open-source datasets. The mean volume difference and average volume difference percentage with the change in magnetic field strength were compared between the methods. The hippocampus volume was larger with FreeSurfer than the Neurophet AQUA. In most brain regions, the Neurophet AQUA yielded a smaller average volume difference percentage (all 10%). The Neurophet AQUA exhibited more stable connectivity and regularity of the segmented components. Regarding volume, the Neurophet AQUA had effect sizes and ICCs comparable to those of FreeSurfer across the magnetic field strengths. With FreeSurfer, the original volume difference was small, whereas the average volume difference percentage was small with the Neurophet AQUA. Image segmentation took 1 h with FreeSurfer and 5 min with the Neurophet AQUA. When choosing an automatic segmentation method, the differences in image processing time and volume variability due to changes in the magnetic field strength of these methods should be considered.

Yea-Jin Lee,1,2 Namgue Hong,2 Eun Seo Choi,3 Sun-Hyang Choi,2 Eun Young Kim,2 Hyeong Ju Park,4 Jin-Chul Ahn1,2 1Department of Medicine, Dankook University, Cheonan-si, 31116, Republic of Korea; 2Medical Laser Research Center, Graduate School of Medicine, Dankook University, Cheonan-si, 31116, Republic of Korea; 3Department of Physics, Chosun University, Gwangju, 61452, Republic of Korea; 4Bio&Health Photonics Research Center, Korea Photonics Technology Institute, Gwangju, 61007, Republic of KoreaCorrespondence: Hyeong Ju Park; Jin-Chul Ahn, Email phj020603@kopti.re.kr; jcahn@dankook.ac.krPurpose: To evaluate the efficacy and safety of abdominal fat reduction in mini-pigs, utilizing at 1060 nm diode laser with a wavelength of 1060 nm.Patients and Methods: The laser system non-invasively disrupts adipose tissue; its effectiveness and safety were evaluated by ultrasound imaging and histological analysis. Laser irradiation was performed with various powers, and the cooling function was activated to prevent skin surface damage.Results: The dermal tissue temperature increased to at least 43°C during laser exposure, leading to a decrease in abdominal fat thickness after 30 days. Blood tests revealed no significant changes in kidney and liver function but showed increased blood levels of nonessential free acids (NEFAs), likely due to the release of fatty tissue-derived free fatty acids. Histological evaluation demonstrated rapid transformation of adipose tissue into collagen, muscle fibers, and intracellular fibrous tissue.Conclusion: The 1060 nm laser showed promise as a non-invasive and safe tool for reducing abdominal fat.Keywords: diode laser, fat, abdominal, non-invasive, preclinical

Wajd A Alhadi,1,&ast; Ebtihaj Yahya Alshehry,2,&ast; Nouf A Hamood,1,&ast; Lama Dafer Albishri,1,&ast; Ghaida Mohammed Al Hunaif,1,&ast; Roaa M Al Murayyi,1,&ast; Zainah Al-Qahtani,2,&ast; Syed Esam Mahmood3,&ast; 1College of Medicine, King Khalid University, Abha, 61421, Saudi Arabia; 2Neurology Department, Asir Central Hospital, Abha, 61421, Saudi Arabia; 3Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Syed Esam Mahmood, Email smahmood@kku.edu.saBackground: The current annual incidence of cerebral venous thrombosis (CVT) is 3– 4 cases per one million population. CVT manifests itself with varying degrees of clinical presentation that may cause vital or morbid consequences if not treated and managed promptly. Studies have suggested varied levels of CVT public awareness.Aim: To assess the level of knowledge and public perception of CVT across the different socio-economic strata of the Saudi Adult population.Methods: A descriptive cross-sectional study was conducted using a mixed-method approach (an electronic questionnaire and phone interviews) for collecting the data. A validated questionnaire was distributed to consenting study participants and filled out to the best of their ability. The study setting was a nationwide survey conducted in Saudi Arabia and involved a representative portion of the study population.Results: A total of 1912 participants were included in this study. Overall, the majority of study participants (67.2%) had a low knowledge level of CVT on assessment, and only 2.6% had a high knowledge level of CVT. Younger age, female gender, working adults, higher education level, marital status, Saudi nationals, and place of residency were significantly associated with knowledge of CTV (p < 0.001).Conclusion: This study indicates a lower index of knowledge of CVT which offers an opportunity for much improvement in public perception and awareness of CVT in the study population. Our results can be utilized to target the demographics with the lowest knowledge via the most popular ways to gain information.Keywords: cerebral venous thrombosis, knowledge, cross-sectional, Saudi Arabia

En-Yi Lin,1,2 Shao-Xi Hsu,1 Bing-Hua Wu,1 Yu-Chen Deng,1,3 Wei Wuli,1 Yuan-Sheng Li,3 Jui-Hao Lee,3 Shinn-Zong Lin,2,4 Horng-Jyh Harn,2,5 Tzyy-Wen Chiou1 1Department of Life Science and Graduate Institute of Biotechnology, National Dong Hwa University, Hualien, Taiwan; 2Bioinnovation Center, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; 3Everfront Biotech Inc, Taipei, Taiwan; 4Department of Neurosurgery, Hualien Tzu Chi Hospital, Hualien, Taiwan; 5Department of Pathology, Hualien Tzu Chi Hospital, Hualien, TaiwanCorrespondence: Tzyy-Wen Chiou, Department of Life Science, National Dong Hwa University, No. 1, Sec. 2, Da Hsueh Road, Shou-Feng, Hualien, Taiwan, Tel +886-3-890-3638, Email twchiou@gms.ndhu.edu.tw Horng-Jyh Harn, Department of Pathology, Hualien Tzu Chi Hospital, Hualien, Taiwan, Tel +886-3-856-1825, Email arthewduke@gmail.comPurpose: Exosomes are membrane vesicles secreted by various cells and play a crucial role in intercellular communication. They can be excellent delivery vehicles for oligonucleotide drugs, such as microRNAs, due to their high biocompatibility. MicroRNAs have been shown to be more stable when incorporated into exosomes; however, the lack of targeting and immune evasion is still the obstacle to the use of these microRNA-containing nanocarriers in clinical settings. Our goal was to produce functional exosomes loaded with target ligands, immune evasion ligand, and oligonucleotide drug through genetic engineering in order to achieve more precise medical effects.Methods: To address the problem, we designed engineered exosomes with exogenous cholecystokinin (CCK) or somatostatin (SST) as the targeting ligand to direct the exosomes to the brain, as well as transduced CD47 proteins to reduce the elimination or phagocytosis of the targeted exosomes. MicroRNA-29b-2 was the tested oligonucleotide drug for delivery because our previous research showed that this type of microRNA was capable of reducing presenilin 1 (PSEN1) gene expression and decreasing the β-amyloid accumulation for Alzheimer’s disease (AD) in vitro and in vivo.Results: The engineered exosomes, containing miR29b-2 and expressing SST and CD47, were produced by gene-modified dendritic cells and used in the subsequent experiments. In comparison with CD47-CCK exosomes, CD47-SST exosomes showed a more significant increase in delivery efficiency. In addition, CD47-SST exosomes led to a higher delivery level of exosomes to the brains of nude mice when administered intravenously. Moreover, it was found that the miR29b-2-loaded CD47-SST exosomes could effectively reduce PSEN1 in translational levels, which resulted in an inhibition of beta-amyloid oligomers production both in the cell model and in the 3xTg-AD animal model.Conclusion: Our results demonstrated the feasibility of the designed engineered exosomes. The application of this exosomal nanocarrier platform can be extended to the delivery of other oligonucleotide drugs to specific tissues for the treatment of diseases while evading the immune system.Keywords: oligonucleotide drug, functional nanocarriers, hippocampus, SH-SY5Y, 3xTG-AD

Doreen Anna Mloka,1 Francis Sakita,2 Irene Kida Minja,3 Haruna Dika,4 Edith AM Tarimo,5 Nathanael Sirili,6 Lillian Teddy Mselle,7 Rodrick Richard Kisenge,8 Philip Sasi,9 Livuka Nsemwa,10 Delfina R Msanga,11 Einoti Yohana Matayan,12 Nicholaus Bartholomeo Ngowi,13 Mainen Julius Moshi,14 John Bartlett,15 Sarah B Macfarlane,16 Ephata Kaaya,17 Patricia S O’Sullivan18 1Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 2Department of Emergency Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 3Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 4Department of Anatomy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; 5Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 6Department of Development Studies, Muhimbili University of Health and Allied Sciences, School of Public Health and Social Sciences, Dar es Salaam, Tanzania; 7Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 8Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 9Department of Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 10Department of Nursing and Midwifery, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; 11Department of Pediatrics and Child Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; 12Department of Ophthalmology, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 13Department of Surgery, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 14Department of Biological and Preclinical Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 15Department of Global Health and Medicine, Duke University, Durham, NC, USA; 16Department of Global Health Sciences, University of San Francisco California, San Francisco, CA, USA; 17Department of Pathology, Kilimanjaro Christian Medical University College, Moshi, Tanzania; 18Office of Research and Development in Medical Education, University of San Francisco California, San Francisco, CA, USACorrespondence: Doreen Anna Mloka, Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, 9 United Nations Road, P.O. Box 650013, Dar es Salaam, Tanzania, Tel +255712459528, Email mlokadoreen@gmail.comBackground: Effective implementation of new curricula requires faculty to be knowledgeable about curriculum goals and have the appropriate pedagogical skills to implement the curriculum, even more so if the new curriculum is being deployed at multiple institutions. In this paper, we describe the process of creating a common faculty development program to train cross-institutional faculty developers to support the implementation of national harmonized medicine and nursing curricula.Methods: A five-step approach was used, including a cross-institutional needs assessment survey for faculty development needs, the development of a generic faculty development program, the identification and training of cross-institutional faculty educators, and the implementation of cross-institutional faculty capacity-building workshops.Results: A list of common cross-cutting faculty development needs for teaching and learning was identified from the needs assessment survey and used to develop an accredited, cross-institutional faculty development program for competency-based learning and assessment. A total of 24 cross-institutional faculty developers were identified and trained in 8 core learning and assessment workshops. A total of 18 cross-institutional and 71 institutional workshops were conducted, of which 1292 faculty members and 412 residents were trained, and three cross-institutional educational research projects were implemented.Conclusion: The success attained in this study shows that the use of cross-institutional faculty developers is a viable model and sustainable resource that can be used to support the implementation of harmonized national curricula.Keywords: faculty development across institutions

Chung-Shih Chen,1 Yu-Ming Wang,1– 3 Eng-Yen Huang1– 3 1Department of Radiation Oncology & Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City, 833, Taiwan; 2School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan; 3Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung City, 804, TaiwanCorrespondence: Eng-Yen Huang, School of Medicine, College of Medicine, National Sun Yat-sen University, No. 70, Lienhai Rd, Kaohsiung, 80424, Taiwan, Email huangengyen@gmail.comPurpose: To compare the oncologic outcomes of prophylactic extended-field radiation therapy (EFRT) and whole pelvic radiation therapy (WPRT) in cervical patients at high risk of para-aortic lymph node (PALN) recurrence.Patients and Methods: From July 1999 to May 2022, a total of 115 patients with cervical cancer and high-risk features of PALN recurrence based on tumor markers, positive LNs and extensive parametrial invasion were retrospectively analyzed. All patients had received EFRT or WPRT at a dose of 39.6– 45 Gy and concurrent chemotherapy. In EFRT, coverage was extended to include the para-aortic region below the level of the left renal vein or T12.Results: Twenty-eight and 87 patients underwent EFRT and WPRT, respectively. For patients who survived, the median follow-up time was 60.8 months (range 9.2– 131.6 months) in the EFRT group and 115.9 months (range 16.9– 212.1 months) in the WPRT group. The 5-year overall survival (OS) and pelvic, extrapelvic and PALN recurrence rates were 87.7% vs 60.8% (p=0.019), 10.9% vs 25.3% (p=0.119), 18.1% vs 45.8% (p=0.011), and 0% vs 30.4% (p=0.005), respectively, between the EFRT and WPRT groups. Multivariate analysis revealed that EFRT and 2018 FIGO stage IV disease status were significant predictors of OS and extrapelvic recurrence.Conclusion: Compared to WPRT, EFRT significantly improved OS and reduced extrapelvic and PALN recurrence in patients with cervical cancer with high-risk recurrence features.Keywords: extended-field radiation therapy, cervical cancer, para-aortic recurrence, pelvic chemoradiotherapy

Introduction In 2020, the UK government established a large-scale testing programme to rapidly identify individuals in England who were infected with SARS-CoV-2 and had COVID-19. This comprised part of the UK government’s COVID-19 response strategy, to protect those at risk of severe COVID-19 disease and death and to reduce the burden on the health system. To assess the success of this approach, the UK Health Security Agency (UKHSA) commissioned an independent evaluation of the activities delivered by the National Health System testing programme in England. The primary purpose of this evaluation will be to capture key learnings from the roll-out of testing to different target populations via various testing services between October 2020 and March 2022 and to use these insights to formulate recommendations for future pandemic preparedness strategy. In this protocol, we detail the rationale, approach and study design.Methods and analysis The proposed study involves a stepwise mixed-methods approach, aligned with established methods for the evaluation of complex interventions in health, to retrospectively assess the combined impact of key asymptomatic and symptomatic testing services nationally. The research team will first develop a theory of change, formulated in collaboration with testing service stakeholders, to understand the causal pathways and intended and unintended outcomes of each testing service and explore contextual impacts on each testing service’s intended outcomes. Insights gained will help identify indicators to evaluate how the combined aims of the testing programme were achieved, using a mixed-methods approach.Ethics and dissemination The study protocol was granted ethics approval by the UKHSA Research Ethics and Governance Group (reference NR0347). All relevant ethics guidelines will be followed throughout. Findings arising from this evaluation will be used to inform lessons learnt and recommendations for UKHSA on appropriate pandemic preparedness testing programme designs; findings will also be disseminated in peer-reviewed journals, a publicly available report to be published online and at academic conferences. The final report of findings from the evaluation will be used as part of a portfolio of evidence produced for the independent COVID-19 government inquiry in the UK.Transparency declaration The lead author (the manuscript’s guarantor) affirms that the manuscript is an honest, accurate and transparent account of the study being reported; no important aspects of the study have been omitted, and any discrepancies from the study as planned have been explained.

Si Mong Yoon,1 Kwang Nam Jin,2 Hyo Jin Lee,3 Hyun Woo Lee,3 Tae Yun Park,3 Eun Young Heo,3 Deog Kyeom Kim,3 Jung-Kyu Lee3 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; 2Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea; 3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of KoreaCorrespondence: Jung-Kyu Lee, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramaero-5-Gil, Dongjak-Gu, Seoul, 07061, Republic of Korea, Tel +82-2-870-2235, Email jk1909@empas.comBackground: Preserved ratio impaired spirometry (PRISm) is a heterogeneous disease entity. Limited data are available regarding its prevalence, clinical course, or prognosis. We aimed to evaluate the longitudinal clinical course of patients with PRISm compared with chronic obstructive pulmonary disease (COPD).Methods: A retrospective study enrolled PRISm and COPD patients who underwent chest computed tomography and longitudinal pulmonary function tests between January 2013 and December 2020. We compared the incidence of acute exacerbations and lung function changes between PRISm and COPD patients.Results: Of the 623 patients, 40 and 583 had PRISm and COPD, respectively. Compared to COPD patients, PRISm patients were younger, more likely to be female and have a history of tuberculosis, and less likely to be smokers. They also had less severe comorbidities, lower forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO). The clinical course was not significantly different between the PRISm and COPD patients in terms of the risk of moderate-to-severe acute exacerbations or proportion of frequent exacerbators. During follow-up, PRISm patients had a significantly slower annual decline of forced expiratory volume in 1 second, FVC, and DLCO than COPD patients.Conclusion: PRISm patients had no significant difference in the risk of acute exacerbations, but a significantly slower decline of lung function during longitudinal follow-up, compared with COPD patients.Plain Language Summary: We evaluated the longitudinal clinical course of patients with preserved ratio impaired spirometry (PRISm) compared to patients with chronic obstructive pulmonary disease (COPD). PRISm and COPD patients showed no significant differences in the risk of moderate-to-severe acute exacerbations or frequent exacerbations, but the former group showed a significantly slower annual decline of lung function during longitudinal follow-up.Keywords: preserved ratio impaired spirometry, chronic obstructive pulmonary disease, exacerbation, lung function

Zhi-Feng Liu,&ast; Yang Zhang,&ast; Jing Liu, Yu-Yan Wang, Mo Chen, Er-Yang Liu, Jun-Ming Guo, Yan-Hua Wang, Zhi-Wen Weng, Chang-Xin Liu, Chang-He Yu, Xi-You Wang Tuina and Pain Management Department, Beijing University of Chinese Medicine Affilliated Dongzhimen Hospital, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chang-He Yu; Xi-You Wang, Email yakno2@163.com; dwxy658@163.comAbstract: Knee osteoarthritis (KOA) stands as a degenerative ailment with a substantial and escalating prevalence. The practice of traditional Chinese non-pharmacological therapy has become a prevalent complementary and adjunctive approach. A mounting body of evidence suggests its efficacy in addressing KOA. Recent investigations have delved into its underlying mechanism, yielding some headway. Consequently, this comprehensive analysis seeks to encapsulate the clinical application and molecular mechanism of traditional Chinese non-pharmacological therapy in KOA treatment. The review reveals that various therapies, such as acupuncture, electroacupuncture, warm needle acupuncture, tuina, and acupotomy, primarily target localized knee components like cartilage, subchondral bone, and synovium. Moreover, their impact extends to the central nervous system and intestinal flora. More perfect experimental design and more comprehensive research remain a promising avenue in the future.Keywords: knee osteoarthritis, traditional Chinese non-pharmacological therapy, mechanism, acupuncture, tuina, acupotomy

Abstract Background Traditionally, in biomedical animal research, laboratory rodents are individually examined in test apparatuses outside of their home cages at selected time points. However, the outcome of such tests can be influenced by various factors and valuable information may be missed when the animals are only monitored for short periods. These issues can be overcome by longitudinally monitoring mice and rats in their home cages. To shed light on the development of home cage monitoring (HCM) and the current state-of-the-art, a systematic review was carried out on 521 publications retrieved through PubMed and Web of Science. Results Both the absolute (~ × 26) and relative (~ × 7) number of HCM-related publications increased from 1974 to 2020. There was a clear bias towards males and individually housed animals, but during the past decade (2011–2020), an increasing number of studies used both sexes and group housing. In most studies, animals were kept for short (up to 4 weeks) time periods in the HCM systems; intermediate time periods (4–12 weeks) increased in frequency in the years between 2011 and 2020. Before the 2000s, HCM techniques were predominantly applied for less than 12 h, while 24-h measurements have been more frequent since the 2000s. The systematic review demonstrated that manual monitoring is decreasing in relation to automatic techniques but still relevant. Until (and including) the 1990s, most techniques were applied manually but have been progressively replaced by automation since the 2000s. Independent of the year of publication, the main behavioral parameters measured were locomotor activity, feeding, and social behaviors; the main physiological parameters were heart rate and electrocardiography. External appearance-related parameters were rarely examined in the home cages. Due to technological progress and application of artificial intelligence, more refined and detailed behavioral parameters have been investigated in the home cage more recently. Conclusions Over the period covered in this study, techniques for HCM of mice and rats have improved considerably. This development is ongoing and further progress as well as validation of HCM systems will extend the applications to allow for continuous, longitudinal, non-invasive monitoring of an increasing range of parameters in group-housed small rodents in their home cages.

Lekha Rethi,1,2,&ast; Lekshmi Rethi,2,&ast; Chia-Hung Liu,3,&ast; Tin Van Hyun,4,5 Chih-Hwa Chen,1,2,6 Er-Yuan Chuang1,2,7 1Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan; 2International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 11031, Taiwan; 3Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan; 4International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan; 5Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, 700000, Vietnam; 6Department of Orthopedics, Taipei Medical University – Shuang Ho Hospital, New Taipei City, Taiwan; 7Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan&ast;These authors contributed equally to this workCorrespondence: Er-Yuan Chuang, Email eychuang@tmu.edu.twAbstract: Due to their non-toxic function in biological systems, Iron oxide NPs (IO-NPs) are very attractive in biomedical applications. The magnetic properties of IO-NPs enable a variety of biomedical applications. We evaluated the usage of IO-NPs for anticancer effects. This paper lists the applications of IO-NPs in general and the clinical targeting of IO-NPs. The application of IONPs along with photothermal therapy (PTT), photodynamic therapy (PDT), and magnetic hyperthermia therapy (MHT) is highlighted in this review’s explanation for cancer treatment strategies. The review’s study shows that IO-NPs play a beneficial role in biological activity because of their biocompatibility, biodegradability, simplicity of production, and hybrid NPs forms with IO-NPs. In this review, we have briefly discussed cancer therapy and hyperthermia and NPs used in PTT, PDT, and MHT. IO-NPs have a particular effect on cancer therapy when combined with PTT, PDT, and MHT were the key topics of the review and were covered in depth. The IO-NPs formulations may be uniquely specialized in cancer treatments with PTT, PDT, and MHT, according to this review investigation.Keywords: cancer, hyperthermia, iron oxide, magnetic hyperthermia, photodynamic therapy, photothermal therapy, near-infrared

Abstract Sarcopenia is a progressive loss of muscle mass and strength that is associated with increasing the risk of falls, musculoskeletal diseases, and chronic metabolic diseases. However, the animal models adopted to study sarcopenia face limitations since the functional tests conducted on human cannot be directly adapted to animals because the animals do not follow instructions. Moreover, current preclinical research tools for muscle function assessment, such as the rotarod, grip strength, and treadmill, have limitations, including low-intensity simple movements, evaluator subjectivity, and limited power indicators. Hence, in this study, we present a new jumping-power assessment tool in a preclinical rodent model to demonstrate muscle functions. To overcome the light weight and command issues in the rodent model, we developed an electrical stimulation-assisted jump power assessment device. Precisely, the device utilizes a load cell with a 0.1 g resolution and a 50 points/s data acquisition rate to capture the short period of the mouse jump. Additionally, interdigitated electrodes are used to electrically stimulate the mice and make them jump. While our primary focus in this article is the validation of the newly developed jump power assessment device, it is worth noting that this tool has several potential utilities. These include the phenotypic comparison of sarcopenia models, the exploration of muscle function reduction mechanisms, muscle function-related blood biomarkers, and the evaluation of drug intervention effects.

Accurate quantification of amyloid positron emission tomography (PET) is essential for early detection of and intervention in Alzheimer’s disease (AD) but there is still a lack of studies comparing the performance of various automated methods. This study compared the PET-only method and PET-and-MRI-based method with a pre-trained deep learning segmentation model. A large sample of 1180 participants in the Catholic Aging Brain Imaging (CABI) database was analyzed to calculate the regional standardized uptake value ratio (SUVR) using both methods. The logistic regression models were employed to assess the discriminability of amyloid-positive and negative groups through 10-fold cross-validation and area under the receiver operating characteristics (AUROC) metrics. The two methods showed a high correlation in calculating SUVRs but the PET-MRI method, incorporating MRI data for anatomical accuracy, demonstrated superior performance in predicting amyloid-positivity. The parietal, frontal, and cingulate importantly contributed to the prediction. The PET-MRI method with a pre-trained deep learning model approach provides an efficient and precise method for earlier diagnosis and intervention in the AD continuum.

Child maltreatment is a serious problem, worldwide. Children and young people who have experienced maltreatment face multiple physical and mental health challenges which hinder their success at school and these adverse experiences makes them more challenging to teach than their non-maltreated peers. Increasingly, teachers are considered as an important part of the wider the child protection workforce as they are well-placed to intervene and prevent further harm. To fulfil this role effectively, teachers require requisite training beginning in initial teacher education programs. This paper is a protocol for a systematic scoping review that asks: "What is known about preservice/initial teacher education for child protection?" Systematic scoping reviews are worthwhile and necessary in fields where research is diverse and needing of synthesis to identify strengths in the body of evidence and identify gaps to set new research directions. We will draw on Askey and O'Malley's six-stage scoping review methodology to assess the scope, range, and nature of research activity on this topic. We will add an innovative seventh stage involving a commitment to disseminating and applying knowledge generated from the review. The research question has been established, and key terms defined (Stage 1). The search strategy has been devised, and searches have been run (Stage 2). Round 1 screening of titles and abstracts is completed and full text screening is currently in progress (Stage 3). To our knowledge this is the first attempt to systematically map the empirical literature on child protection in pre-service teacher education. When completed, this systematic scoping review will offer a comprehensive, transparent, and replicable way to assess the full scope of empirical research on this important topic of utmost educational relevance.

Ericles Andrei Bellei,1 Miriam Emi Makinodan Shirozaki,1 Ana Lia Pradella Puglia,2,3 André Vicente Esteves de Carvalho,4 Barbara Riquena,2,5 Camilla Carlini Vallilo,2,3 Danilo de Barros,6 Erika Yumi Tamashiro,2 Gabriela Cintra,2 Gleison Vieira Duarte,7 Maria Cecília da Matta Rivitti-Machado,8 Renata Ferreira Magalhães,9 Ricardo Figueiredo do Nascimento,2 Roberto Tunala,5 Roberto da Silva,10 Wagner Guimarães Galvão Cesar,11 Felipe Garutti Thies2 1Department of Data, Digital, and Innovation, Novartis, São Paulo, Brazil; 2Immunology Franchise, Novartis, São Paulo, Brazil; 3Department of Scientific Operations, Novartis, São Paulo, Brazil; 4Dermatology, Hospital Moinhos de Ventos de Porto Alegre, Porto Alegre, Brazil; 5Department of Medical Affairs, Novartis, São Paulo, Brazil; 6Dermatology Service, Hospital Irmandade Santa Casa de Curitiba, Curitiba, Brazil; 7Dermatology, Instituto Bahiano de Imunoterapia (IBIS), Salvador, Brazil; 8Hospital das Clínicas da Faculdade de Medicina, University of São Paulo (USP), São Paulo, Brazil; 9School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil; 10Department of Dermatology, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil; 11Dermatology, Hospital Alemão Oswaldo Cruz, São Paulo, BrazilCorrespondence: Ericles Andrei Bellei, Novartis Biociências S.A, 90 Av Prof Vicente Rao, São Paulo, 04706-900, Brazil, Tel +55 1155327122, Email eric.bellei@novartis.comBackground: Hidradenitis suppurativa (HS) is a chronic skin condition. Its complexity and impact on patients highlight the need for multidisciplinary care that can address the physical, psychological, and social aspects. Centers of excellence can ideally provide the necessary infrastructure, resources, and expertise to effectively treat HS. However, there are still no consolidated models of centers of excellence in HS, and establishing their foundations is an intricate research challenge. Purposely, design and co-creation as innovation techniques are helpful approaches to this type of research.Methods: In this study, we conducted a co-creation with consensus among HS specialists to propose the criteria and requirements to establish outpatient centers of excellence of HS in Brazil. We followed a linear process with mixed methods in 6 stages.Results: The process resulted in 10 categories for establishing outpatient centers, including their respective requirements, rationale, and classification. The categories include onboarding and welcoming; infrastructure and procedures; infusion therapy; flows and referrals; staffing; disease management; metrics during diagnosis; metrics during treatment; awareness and advocacy; research and education.Discussion: The idealized outpatient centers can play a role in the complete multidisciplinary treatment for HS and advancing the science of healthcare services by providing a focus for research, training, and translation of findings into practice.Keywords: hidradenitis suppurativa, centers of excellence, co-design, consensus, health services research, patient-centered care, community-based participatory research, healthcare innovation

Kwok Chuen Wong,1 Edgar Yan Sun,2 Irene Oi Ling Wong,3 Shekhar Madhukar Kumta4 1Orthopaedic Oncology, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong SAR, People’s Republic of China; 2Independent Contractor, Hong Kong SAR, People’s Republic of China; 3School of Public Health, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, People’s Republic of China; 4Northern Health Precinct and Department of Surgery, The University of Melbourne, The Northern Hospital, Melbourne, VIC, AustraliaCorrespondence: Kwok Chuen Wong, Orthopaedic Oncology, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, the Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR, People’s Republic of China, Email skcwong@cuhk.edu.hkIntroduction: In orthopedic oncology, computer navigation and 3D-printed guides facilitate precise osteotomies only after surgical exposure. Before surgeries start, it is challenging to mentally process and superimpose the virtual medical images onto patients’ anatomy for preoperative surgical planning. Mixed Reality (MR) is an immersive technology merging real and virtual worlds, and users can interact with digital objects in real time. Through Head-Mounted Displays, surgeons directly visualize holographic models that overlaid on tumor patients. The technology may facilitate surgical planning before skin incisions.Methods: Nine bone tumor patients were included (July 2021 – Dec 2022). There were six primary bone sarcomas, two benign bone tumors, and one revision pelvic prosthesis. MR applications were created using patients’ preoperative medical images. The surgeon examined each patient clinically using the conventional method of viewing 2D images and MR via HMD, Hololens 2. A Likert-Scale (LS) questionnaire and The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score were used to evaluate and compare the effectiveness of surgical planning and the surgeon’s clinical cognitive workload for the two methods.Results: The qualitative survey of the LS questionnaire suggested that the MR group had superior spatial awareness of tumors and was considered more effective as a preoperative planning tool than the conventional group. For NASA-TLX scores, the overall cognitive workload was lower in MR 3D hologram group than in the 2D Group for preoperative clinical assessment. When using MR technology with HMDs, the surgeon reported no discomfort.Conclusion: MR technology may improve 3D visualization and spatial awareness of bone tumors in patients’ anatomies and may facilitate surgical planning before skin incisions in orthopedic oncology surgery. With less cognitive load and better ergonomics, surgeons can focus on patients and surgical tasks with MR technology. Further studies must investigate whether MR technology improves clinical outcomes.Keywords: mixed reality, holograms, spatial awareness, computer navigation, 3D printing

BackgroundAutism spectrum disorders affect more than 1% of the population, impairing social communication and increasing stereotyped behaviours. A micro-deletion of the 16p11.2 BP4-BP5 chromosomic region has been identified in 1% of patients also displaying intellectual disabilities. In mouse models generated to understand the mechanisms of this deletion, learning and memory deficits were pervasive in most genetic backgrounds, while social communication deficits were only detected in some models.MethodsTo complement previous studies, we itemized the social deficits in the mouse model of 16p11.2 deletion on a hybrid C57BL/6N × C3H.Pde6b+ genetic background. We examined whether behavioural deficits were visible over long-term observation periods lasting several days and nights, to parallel everyday-life assessment of patients. We recorded the individual and social behaviours of mice carrying a heterozygous deletion of the homologous 16p11.2 chromosomic region (hereafter Del/+) and their wild-type littermates from both sexes over two or three consecutive nights during social interactions of familiar mixed-genotype quartets of males and of females, and of same-genotype unfamiliar female pairs.ResultsWe observed that Del/+ mice of both sexes increased significantly their locomotor activity compared to wild-type littermates. In the social domain, Del/+ mice of both sexes displayed widespread deficits, even more so in males than in females in quartets of familiar individuals. In pairs, significant perturbations of the organisation of the social communication and behaviours appeared in Del/+ females.DiscussionAltogether, this suggests that, over long recording periods, the phenotype of the 16p11.2 Del/+ mice was differently affected in the locomotor activity and the social domains and between the two sexes. These findings confirm the importance of testing models in long-term conditions to provide a comprehensive view of their phenotype that will refine the study of cellular and molecular mechanisms and complement pre-clinical targeted therapeutic trials.

White matter hyperintensities (WMHs) are lesions in the white matter of the brain that are associated with cognitive decline and an increased risk of dementia. The manual segmentation of WMHs is highly time-consuming and prone to intra- and inter-variability. Therefore, automatic segmentation approaches are gaining attention as a more efficient and objective means to detect and monitor WMHs. In this study, we propose AQUA, a deep learning model designed for fully automatic segmentation of WMHs from T2-FLAIR scans, which improves upon our previous study for small lesion detection and incorporating a multicenter approach. AQUA implements a two-dimensional U-Net architecture and uses patch-based training. Additionally, the network was modified to include Bottleneck Attention Module on each convolutional block of both the encoder and decoder to enhance performance for small-sized WMH. We evaluated the performance and robustness of AQUA by comparing it with five well-known supervised and unsupervised methods for automatic segmentation of WMHs (LGA, LPA, SLS, UBO, and BIANCA). To accomplish this, we tested these six methods on the MICCAI 2017 WMH Segmentation Challenge dataset, which contains MRI images from 170 elderly participants with WMHs of presumed vascular origin, and assessed their robustness across multiple sites and scanner types. The results showed that AQUA achieved superior performance in terms of spatial (Dice = 0.72) and volumetric (logAVD = 0.10) agreement with the manual segmentation compared to the other methods. While the recall and F1-score were moderate at 0.49 and 0.59, respectively, they improved to 0.75 and 0.82 when excluding small lesions (≤ 6 voxels). Remarkably, despite being trained on a different dataset with different ethnic backgrounds, lesion loads, and scanners, AQUA's results were comparable to the top 10 ranked methods of the MICCAI challenge. The findings suggest that AQUA is effective and practical for automatic segmentation of WMHs from T2-FLAIR scans, which could help identify individuals at risk of cognitive decline and dementia and allow for early intervention and management.

Abstract For multifunctional wearable sensing systems, problems related to wireless and continuous communication and soft, noninvasive, and disposable functionality issues should be solved for precise physiological signal detection. To measure the critical transitions of pressure, temperature, and skin impedance when continuous pressure is applied on skin and tissue, we developed a sensor for decubitus ulcers using conventional analog circuitry for wireless and continuous communication in a disposable, breathable fabric-based multifunctional sensing system capable of conformal contact. By integrating the designed wireless communication module into a multifunctional sensor, we obtained sensing data that were sent sequentially and continuously to a customized mobile phone app. With a small-sized and lightweight module, our sensing system operated over 24 h with a coin-cell battery consuming minimum energy for intermittent sensing and transmission. We conducted a pilot test on healthy subjects to evaluate the adequate wireless operation of the multifunctional sensing system when applied to the body. By solving the aforementioned practical problems, including those related to wireless and continuous communication and soft, noninvasive, and disposable functionality issues, our fabric-based multifunctional decubitus ulcer sensor successfully measured applied pressure, skin temperature, and electrical skin impedance.

The current study pilot tested a popular music media literacy website that was developed based on the final report of the APA Division 46 Task Force on the Sexualization of Popular Music (2018). The study hypothesized that popular music media literacy education would produce significant differences between the baseline assessment and post-literacy assessment for outcomes related to music reflecting real life, viewing the self as similar to music portrayals, music skepticism, level of engagement with music, and self-reported self-esteem. It was also hypothesized that participants would report favorable attitudes regarding the popular music media literacy website being tested. Participants included 52 emerging adult college students who completed the baseline assessment and the post-literacy assessments after reviewing the popular music media literacy website. At baseline, participants reported moderate levels of music as reflecting real life, viewing themselves as similar to music representations and self-reported self-esteem. Participants also reported high levels of music skepticism and engagement with music at baseline. Results indicated that the popular music media literacy website was effective in increasing general music skepticism. The implications for future research and next directions are discussed.

Introduction: Percutaneous tenotomy of the Achilles tendon is a procedure that is part of the Ponseti method for clubfoot correction. The need to apply general anesthesia or sedation for this procedure is controversial. The objective of this study is to compare the acute stress generated in infants by percutaneous Achilles tenotomy under local anesthesia vs. peripheral line placement. Material and methods: This cross-sectional study compares the discomfort experienced by 85 infants undergoing percutaneous Achilles tenotomy with local anesthesia with that experienced by 39 infants undergoing peripheral line placement. The following parameters were determined: the duration of the procedure, crying time, average crying intensity, and maximum crying intensity. Other data recorded included the infant’s age and complications arising during the procedure. Results: The mean ages of these patients were 1.95 and 2.18 months, respectively. The following data were obtained: the mean duration of the procedure for Group A was 8.13 s and for Group B it was 127.43 s; the mean duration of crying for Group A was 84.24 s and for Group B it was 195.82 s; the mean intensity of crying for Group A was 88.99 dB and for Group B it was 100.98 dB; and the maximum crying intensity for Group A was 96.56 dB and for Group B it was 107.76 dB. Conclusions: Percutaneous Achilles tenotomy can be safely performed as an outpatient procedure, under local anesthesia. This method generates less discomfort than peripheral line placement.

Bullying and cyberbullying are global phenomena negatively impacting on children's and young people's (CYP's) mental health and wellbeing and affecting their school social experiences and learning outcomes. Many interventions and prevention approaches have been employed over the decades, most impacting differentially, with some success in certain contexts and situations but not universally, suggesting the need for more contextualised, nuanced approaches at the whole school, community, individual and peer-group levels. The recognition of the importance of student and teacher voice in recent years has heralded interest in co-design practices to deliver more context-relevant interventions and prevention strategies. This article considers how participatory design and co-design practices can form part of the prevention and intervention repertoire for schools, teachers, counsellors and psychologists in their quest to understand and reduce cyberbullying and/or bullying (C/B) behaviours. Two case-study exemplars are provided that reflect the importance of context and student-centred relevancy to inform practice.

Sanjay K Bajpai,1 M Janelle Cambron-Mellott,2 Oliver Will,2 Jiat-Ling Poon,1 Qianqian Wang,1 Beth D Mitchell,1 Eugenia Y Peck,2 Jane Babrowicz,2 Nedina K Raibulet,1 Christopher J Child,1 Kathleen Beusterien2 1Eli Lilly and Company, Indianapolis, IN, USA; 2Cerner Enviza, New York, NY, USACorrespondence: Sanjay K Bajpai, Eli Lilly & Company, 893 S Delaware St, Indianapolis, IN, 46225, USA, Tel +1 317 931 9828, Email sanjay.bajpai@lilly.comBackground: For individuals managing diabetes, the administration of glucagon for severe hypoglycemia can be lifesaving, yet, until recently, there were no easy-to-use devices for these stressful emergencies. New products have emerged to meet this need, including nasal glucagon (NG) and auto-injector glucagon (AI). This study evaluated the psychometric properties of a new measure, the Glucagon Device Attitudes Questionnaire (GDAQ), in assessing attitudes toward NG and AI from the perspectives of persons with diabetes on insulin (PWDs), caregivers, and acquaintances.Methods: Developed based on qualitative research, the GDAQ consists of 38 rating items for each device and 16 direct-elicitation of attitudes of device relative to each other. It was administered to participants via a cross-sectional online survey. Twenty-six rating items were included in principal component analysis and confirmatory factor analysis. Items comprising each factor were averaged to form scales. Additionally, 12 direct elicitation items were averaged to form an overall “Attitudes” scale. Reliability and validity analyses were conducted. Descriptive statistics were provided for the rating items not included in the factor analysis.Results: A total of 405 PWDs, 313 caregivers, and 305 acquaintances participated. Three factors were identified: “Prepared and Protected” (7 items), “Hesitation” (12 items), and “Device Perceptions by Others” (7 items); factor loadings ranged from 0.13 to 0.92, 0.50 to 0.89, and 0.16 to 0.92, respectively. Cronbach’s alpha for the four scales ranged from 0.76 to 0.96. Correlations of the scales with their global item ranged from 0.30 to 0.90. The items outside of the factor analysis showed good distribution in responses and differentiation between the two devices.Discussion: This study supports the validity and reliability of the GDAQ, which successfully conceptualizes attitudes towards devices for administering glucagon among different respondent groups. Use of the GDAQ can help guide the development and testing of new glucagon drug/device combinations.Keywords: diabetes, severe hypoglycemic events, glucagon delivery device, patient attitudes

Olayinka O Shiyanbola,1 Martha Maurer,2 Luke Schwerer,3 Nassim Sarkarati,3 Meng-Jung Wen,1 Ejura Y Salihu,1 Jenna Nordin,3 Phanary Xiong,3 Ugboaku Maryann Egbujor,3 Sharon D Williams4 1Division of Social and Administrative Sciences, University of Wisconsin School of Pharmacy, Madison, WI, USA; 2Sonderegger Research Center, University of Wisconsin School of Pharmacy, Madison, WI, USA; 3University of Wisconsin School of Pharmacy, Madison, WI, USA; 4University of Wisconsin School of Medicine and Public Health, Milwaukee, WI, USACorrespondence: Olayinka O Shiyanbola, Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI, 53705, USA, Email Olayinka.Shiyanbola@wisc.eduIntroduction: Current diabetes self-management programs are often insufficient to improve outcomes for African Americans because of a limited focus on medication adherence and addressing culturally influenced beliefs about diabetes and medicines. This study evaluated the feasibility and acceptability of a novel culturally tailored diabetes self-management intervention that addressed key psychosocial and sociocultural barriers to medication adherence for African Americans.Methods: The intervention consisted of group education and race-congruent peer-based phone support. Three African Americans who were engaged in taking their diabetes medicines (ambassadors), were matched with 8 African Americans who were not engaged in taking medicines (buddies). We conducted a single group, pre/post study design with African Americans with type 2 diabetes. Wilcoxon signed rank tests assessed mean score differences in outcomes at baseline compared with 6-months follow-up. Semi-structured interviews explored buddies’ acceptability of the intervention.Results: Buddies and ambassadors were similar in age and mostly female. Recruitment rates were 80% for buddies and 100% for ambassadors. Retention rate for primary outcomes was 75%. Buddies had a mean completion of 13.4/17 of sessions and phone calls. Ambassadors completed 84% of intervention calls with buddies. Although there were no statistically significant differences in mean A1C and medication adherence, we found a clinically meaningful decrease (− 0.7) in mean A1C at the 6-month follow up compared to baseline. Secondary outcomes showed signal of changes. Themes showed buddies perceived an improvement in provider communication, learned goal setting strategies, and developed motivation, and confidence for self-management. Buddies perceived the program as acceptable and culturally appropriate.Conclusion: This culturally tailored diabetes self-management intervention that addresses diabetes self-management, psychosocial and behavioral barriers to medication adherence, and incorporates race-congruent peer support from African Americans engaged in taking medicines seemed feasible and acceptable. The results provide support for a fully powered randomized trial to test the intervention’s efficacy.Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04857411.Date of Registration: April 23, 2021.Keywords: African Americans, diabetes self-management, peer support, health beliefs, medication adherence

Hyo Jin Lee,1 Kwang Nam Jin,2 Hyun Woo Lee,1 Jung-Kyu Lee,1 Tae Yeon Park,1 Eun Young Heo,1 Deog Kyeom Kim1,3 1Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea; 2Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea; 3Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South KoreaCorrespondence: Deog Kyeom Kim, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea, Tel +82-2-870-2130, Fax +82-2-831-0714, Email kimdkmd@snu.ac.krPurpose: Few studies have reported the association between the radiographic characteristics and the development of pneumonia in patients with chronic obstructive pulmonary disease (COPD) treated with inhaled corticosteroids (ICSs). Our study aimed to assess the effect of radiographic phenotypes on the risk of pneumonia in patients treated with ICSs.Patients and Methods: This study retrospectively analysed all patients with COPD treated with ICSs in a subset of the Korea Chronic Obstructive Pulmonary Disorders Subgroup Study registry between January 2017 and December 2019. The association between radiographic phenotypes including the presence and severity of emphysema, airway wall thickening, or bronchiectasis on chest computed tomography were determined visually/qualitatively and the risk of pneumonia was analyzed using the Cox regression model.Results: Among the 90 patients with COPD treated with ICSs, 41 experienced pneumonia more than once during the median follow-up of 29 (interquartile range, 8– 35) months. In univariate Cox regression analysis, older age, longer use of ICSs, use of fluticasone propionate or metered dose inhaler, and severe exacerbation events increased the risk of pneumonia. In multivariate analysis, the presence of emphysema (adjusted hazard ratio [aHR]=3.73, P=0.033), severity measured using the visual sum score (mild-to-moderate, aHR=8.58, P=0.016; severe, aHR=3.58, P=0.042), Goddard sum score (mild-to-moderate, aHR=3.31, P=0.058; severe, aHR=5.38, P=0.014), and the upper lobe distribution of emphysema (aHR=3.76, P=0.032) were associated with a higher risk of pneumonia. Subtypes of centrilobular and panlobular emphysema had a higher risk of pneumonia compared with paraseptal emphysema (aHR=3.98, P=0.033; HR=3.91, P=0.041 vs HR=2.74, P=0.304). The presence of bronchiectasis (aHR=2.41, P=0.02) and emphysema/bronchiectasis overlap phenotype (aHR=2.19, P=0.053) on chest CT was a risk factor for pneumonia in this population. However, severity of bronchiectasis and the presence or severity of bronchial wall thickening according to the visual sum score were not associated with the risk of pneumonia.Conclusion: Among patients with COPD treated with ICSs, radiographic phenotypes including the presence of emphysema, bronchiectasis or emphysema/bronchiectasis overlap phenotype, severity with emphysema, subtypes of centrilobular or panlobular emphysema, and upper lobe distribution of emphysema may help predict the risk of pneumonia.Keywords: chronic obstructive pulmonary disease, inhaled corticosteroid, pneumonia, chest computed tomography, CT

Purpose This study investigated functional outcomes in lower urinary tract symptoms (LUTS), the incidence of incidental prostate cancer (PCa), and changes in prostate-specific antigen (PSA) levels after holmium laser enucleation of the prostate (HoLEP) in patients with elevated PSA and benign prostatic hyperplasia (BPH). Methods A retrospective review of a prospectively designed protocol for patients who underwent HoLEP at our institution from January 2010 to May 2020 was conducted. Patients were classified into low-PSA (0.05). At 6 months postoperatively, both groups showed significant improvements in the maximum flow rate, postvoid residual volume, and all domains of the International Prostate Symptom Score (P

Muhammad Saqib,1 Phong A Tran,2 Batur Ercan,3– 5 E Yegan Erdem1,6 1Department of Mechanical Engineering, Bilkent University, Ankara, Turkey; 2Queensland University of Technology (QUT), Brisbane, QLD, 4000, Australia; 3Department of Metallurgical and Materials Engineering, Middle East Technical University, Ankara, Turkey; 4Biomedical Engineering Program, Middle East Technical University, Ankara, Turkey; 5BIOMATEN, Center of Excellence in Biomaterials and Tissue Engineering, Middle East Technical University, Ankara, 06800, Turkey; 6National Nanotechnology Research Center (UNAM), Ankara, TurkeyCorrespondence: E Yegan Erdem, Bilkent University, Mechanical Engineering, EA 122, Bilkent, Ankara, 06800, Turkey, Tel +90 312 290 3068, Email yeganerdem@bilkent.edu.trAbstract: Janus particles have been at the center of attention over the years due to their asymmetric nature that makes them superior in many ways to conventional monophase particles. Several techniques have been reported for the synthesis of Janus particles; however, microfluidic-based techniques are by far the most popular due to their versatility, rapid prototyping, low reagent consumption and superior control over reaction conditions. In this review, we will go through microfluidic-based Janus particle synthesis techniques and highlight how recent advances have led to complex functionalities being imparted to the Janus particles.Keywords: anisotropy, droplet-based, asymmetric, nanoparticles, multi-functionality

Endra Yustin Ellistasari,1 Harijono Kariosentono,2 Bambang Purwanto,3 Brian Wasita,4 Risya Cilmiaty Arief Riswiyant,5 Eti Poncorini Pamungkasari,6 Soetrisno Soetrisno7 1Doctoral Program of Medical Sciences Department, Sebelas Maret University, Surakarta, Indonesia; 2Dermatology and Venereology Department, Sebelas Maret University, Surakarta, Indonesia; 3Internal Medicine Department, Sebelas Maret University, Surakarta, Indonesia; 4Anatomical Pathology Department, Sebelas Maret University, Surakarta, Indonesia; 5Dentistry Department, Sebelas Maret University, Surakarta, Indonesia; 6Public Health Department, Sebelas Maret University, Surakarta, Indonesia; 7Obstetric and Gynecology Department, Sebelas Maret University, Surakarta, IndonesiaCorrespondence: Endra Yustin Ellistasari, Dermatology and Venereology Department, Dr Moewardi General Hospital/Faculty of Medicine Sebelas Maret University, Jl Kol Sutarto 132 Jebres, Surakarta, Central Java, Indonesia, Tel +62 271634634, Email endra_yustin@yahoo.comPurpose: This is an in-vitro experimental study to analyze the effect of Exo-HUVEC on endothelial cell (CD31), cell proliferation, matrix metalloproteinase 1 (MMP-1) and collagen type 1 on irradiated fibroblast with UVB as photo-aging model.Patients and Methods: Fibroblast cultures were divided into 5 groups, namely without UVB exposure, UVB exposure 600mJ/cm2 for 80 seconds as photo-aging model, and UVB exposure +Exo-HUVEC exposure 0.1%, 0.5% and 1%. The endothelial cell was stained with a CD31 marker, MMP-1 were examined with ELISA, cell proliferation is detected using an MTT assay; meanwhile, collagen type 1 deposition and endothelial cell were measured using flowcytometry.Results: This study found positive endothelial cell marker CD31. Significant difference was found in cell proliferation, MMP-1 and collagen type 1 level between the control group with UVB irradiation and the treatment group with Exo-HUVEC (p < 0.05).Conclusion: Exo-HUVEC significantly increases cell proliferation and collagen type 1 level, while decrease MMP-1 levels on irradiated fibroblast; therefore, Exo-HUVEC ameliorate the photo-aging of skin fibroblast.Graphical Abstract: Keywords: photo-aging, Exo-HUVEC, endothelial cell, cell proliferation, MMP-1, collagen type 1

Eshetu Yisihak Ukumo,1 Feleke Gebremeskel Woldehawariat,2 Samuel Abebe Dessalegn,1 Desta Markos Minamo,2 Gebresilasea Gendisha Ukke1 1Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 2School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Eshetu Yisihak Ukumo, Tel +251926266071, Email eshetuyisihak@gmail.comPurpose: This study aimed to determine the knowledge of human papillomavirus vaccination (PHV) and associated factors among primary school girls in Arba Minch town, South Ethiopia, in 2020. Hence, the levels of knowledge towards the HPV vaccination of girls were assessed and recommended to the concerned bodies. Clinically, this study could increase the acceptance of HPV vaccination after the intervention of the concerned bodies to improve adolescents’ knowledge levels. As a result, it could decrease the incidence of cervical cancer. Socially, this study may increase the research involvement of adolescents, communities, and stakeholder groups.Patients and Methods: A school-based cross-sectional study involving 537 female students was conducted on January 24, 2020. The study participants were selected by a simple random sampling technique. A pre-tested questionnaire was used to collect the data. The logistic regression model was used to identify the statistically significant variables for knowledge of the human papillomavirus vaccination.Results: The overall knowledge level of the participants in this study was 71.7%. Their main source of information is social media (41.74%), followed by medical staff (29.69%). Age ≥ 15 years old, AOR =3.74, 95% CI (2.20_6.37), P-value < 0.001, grade level of 7 and 8, AOR =3.98, 95% CI (2.40_6.58), P-value < 0.001, mother’s educational status of secondary and more than secondary, and father’s educational status of more than secondary, AOR=13.60, 95% CI (5.69_32.53) P-value < 0.001, 22.27, 95% CI (8.23_60.30), P-value< 0.001, 2.18, 95% CI (1.09_4.35), P-value 0.03, respectively, and access to HPV vaccination information (AOR = 8.65, 95% CI (3.92_19.07), P-value 0.001) were associated with overall knowledge.Conclusion: Nearly three-fourths of the study participants were knowledgeable about human papillomavirus vaccination. Knowledge about the human papillomavirus vaccination shows a positive association with age, education level, parents’ educational status, and access to information sources.Keywords: cervical cancer, human papillomavirus

Su Jung Lee,1 Hyun-Ju Seo,2 IL Han Choo,3 Seong Min Kim,4 Jeong Min Park,5 Eun-Young Yang,4 Yu Mi Choi6 1College of Nursing, Inje University, Gimhae, South Korea; 2College of Nursing, Chungnam National University, Daejeon, South Korea; 3Department of Neuropsychiatry, Chosun University and Chosun University Hospital, Gwangju, South Korea; 4Department of Nursing, Donggang University, Gwangju, South Korea; 5Department of Nursing, Nambu University, Gwangju, South Korea; 6College of Nursing, Graduate School of Chungnam National University, Daejeon, South KoreaCorrespondence: Hyun-Ju Seo, College of Nursing, Chungnam National University, Daejeon, 35015, South Korea, Tel +82-42-580-8320, Fax +82-42-580-8309, Email shj5th@korea.ac.krObjective: Accumulating evidence of the effects of dementia caregiving on individuals, society, and health has generated intervention studies to reduce the stress among family caregivers of people with dementia. This study aims to evaluate the effectiveness of a family support program, community-based dementia caregiver intervention (CDCI), among family caregivers of people with dementia compared with a control group (no intervention).Patients and Methods: This study is a quasi-experimental, non-randomized controlled trial conducted in six dementia relief centers of a community healthcare center in Korea. Family caregivers of 83 patients with dementia were recruited; of these 78 were included in the final study, with 40 in the intervention group and 38 in the control group. Analysis of covariance (ANCOVA) was used to compare the mean difference in the scores of the total short-form Zarit Burden Interview (SZBI), personal strain, role strain, depression, and attitude between the groups.Results: Compared with controls, in the intervention group, the adjusted mean score of personal strain (F = 4.353, t = 0.041) and attitude toward dementia (F = 10.284, t = 0.002) differed significantly after the intervention, with a small to moderate effect. There was no significant difference in the total SZBI, role strain, or depression mean score.Conclusion: The findings suggest that CDCI may be an effective intervention strategy to reduce personal strain and enhance the attitudes of family caregivers of people with dementia.Keywords: community-based intervention, caregiver burden, dementia, family support program, family caregiver

Autism is characterized by atypical social communication and stereotyped behaviors. Mutations in the gene encoding the synaptic scaffolding protein SHANK3 are detected in 1–2% of patients with autism and intellectual disability, but the mechanisms underpinning the symptoms remain largely unknown. Here, we characterized the behavior of Shank3Δ11/Δ11 mice from 3 to 12 months of age. We observed decreased locomotor activity, increased stereotyped self-grooming and modification of socio-sexual interaction compared to wild-type littermates. We then used RNAseq on four brain regions of the same animals to identify differentially expressed genes (DEGs). DEGs were identified mainly in the striatum and were associated with synaptic transmission (e.g., Grm2, Dlgap1), G-protein-signaling pathways (e.g., Gnal, Prkcg1, and Camk2g), as well as excitation/inhibition balance (e.g., Gad2). Downregulated and upregulated genes were enriched in the gene clusters of medium-sized spiny neurons expressing the dopamine 1 (D1-MSN) and the dopamine 2 receptor (D2-MSN), respectively. Several DEGs (Cnr1, Gnal, Gad2, and Drd4) were reported as striosome markers. By studying the distribution of the glutamate decarboxylase GAD65, encoded by Gad2, we showed that the striosome compartment of Shank3Δ11/Δ11 mice was enlarged and displayed much higher expression of GAD65 compared to wild-type mice. Altogether, these results indicate altered gene expression in the striatum of Shank3-deficient mice and strongly suggest, for the first time, that the excessive self-grooming of these mice is related to an imbalance in the striatal striosome and matrix compartments.