Search

BackgroundTelehealth is an effective means to assist existing health care systems, particularly for the current aging society. However, most extant telehealth systems employ individual data sources by offline data processing, which may not recognize health deterioration in a timely way. ObjectiveOur study objective was two-fold: to design and implement an integrated, personalized telehealth system on a community-based level; and to evaluate the system from the perspective of user acceptance. MethodsThe system was designed to capture and record older adults’ health-related information (eg, daily activities, continuous vital signs, and gait behaviors) through multiple measuring tools. State-of-the-art data mining techniques can be integrated to detect statistically significant changes in daily records, based on which a decision support system could emit warnings to older adults, their family members, and their caregivers for appropriate interventions to prevent further health deterioration. A total of 45 older adults recruited from 3 elderly care centers in Hong Kong were instructed to use the system for 3 months. Exploratory data analysis was conducted to summarize the collected datasets. For system evaluation, we used a customized acceptance questionnaire to examine users’ attitudes, self-efficacy, perceived usefulness, perceived ease of use, and behavioral intention on the system. ResultsA total of 179 follow-up sessions were conducted in the 3 elderly care centers. The results of exploratory data analysis showed some significant differences in the participants’ daily records and vital signs (eg, steps, body temperature, and systolic blood pressure) among the 3 centers. The participants perceived that using the system is a good idea (ie, attitude: mean 5.67, SD 1.06), comfortable (ie, self-efficacy: mean 4.92, SD 1.11), useful to improve their health (ie, perceived usefulness: mean 4.99, SD 0.91), and easy to use (ie, perceived ease of use: mean 4.99, SD 1.00). In general, the participants showed a positive intention to use the first version of our personalized telehealth system in their future health management (ie, behavioral intention: mean 4.45, SD 1.78). ConclusionsThe proposed health monitoring system provides an example design for monitoring older adults’ health status based on multiple data sources, which can help develop reliable and accurate predictive analytics. The results can serve as a guideline for researchers and stakeholders (eg, policymakers, elderly care centers, and health care providers) who provide care for older adults through such a telehealth system.

Objective: This retrospective study aims to compare the efficacy rates in treating hypertrophic scars among four distinct groups of patients who either underwent fractional Erbium: yttrium‐aluminum‐garnet (Er:YAG) laser or microplasma radiofrequency technology as standalone treatments or in combination with compound betamethasone transdermal administration. Method: The study retrospectively examined 208 patients treated at our institution from April 2011 to December 2022 for hypertrophic scars, receiving no less than three treatments (with an interval of 8 weeks between each). The patients were categorized into four groups: the F group (treated with fractional Er:YAG laser), the F + B group (treated with fractional Er:YAG laser combined with compound betamethasone transdermal administration), the P group (treated with microplasma radiofrequency technology), and the P + B group (treated with microplasma radiofrequency technology combined with compound betamethasone transdermal administration). The therapeutic effects were evaluated based on the changes in the Vancouver Scar Scale (VSS) scores before and after treatment in these groups. Results: There was no statistically significant difference in the VSS scores among the four groups before treatment. After undergoing three sessions of the aforementioned four types of treatment, all groups showed a decrease in VSS scores, with average posttreatment VSS scores for the F group scored 5.15 ± 2.084, F + B group scored 3.7 ± 1.781, P group scored 4.41 ± 1.933, and P + B group scored 3.16 ± 1.775, respectively. With an increasing number of treatments, the total effective rate gradually increased in all four groups, and the combination treatment using compound betamethasone transdermal administration proved more effective than the standalone treatment. Conclusion: All four treatments yielded favorable outcomes, with the combined therapy involving compound betamethasone transdermal administration proving more effective than the standalone treatments, meriting further clinical attention. [ABSTRACT FROM AUTHOR]

Summary: Acute myeloid leukaemia (AML) is a highly heterogeneous disease, exhibiting diverse subtypes according to the characteristics of tumour cells. The immunophenotype is one of the aspects acquired routinely through flow cytometry in the diagnosis of AML. Here, we characterized the antigen expression in paediatric AML cases across both morphological and molecular genetic subgroups. We discovered a subgroup of patients with unfavourable prognosis that can be immunologically characterized, irrespective of morphological FAB results or genetic aberrations. Cox regression analysis unveiled key antigens influencing the prognosis of AML patients. In terms of underlying genotypes, we observed that the antigenic profiles and outcomes of one specific group, primarily composed of CBFA2T3::GLIS2 and FUS::ERG, were analogous to the reported RAM phenotype. Overall, our data highlight the significance of immunophenotype to tailor treatment for paediatric AML. [ABSTRACT FROM AUTHOR]

Achieving hemostasis effectively is essential for surgical success and excellent patient outcomes. However, it is challenging to develop hemostatic adhesives that are fast‐acting, strongly adherent, long‐lasting, and biocompatible for treating hemorrhage. In this study, a sequential crosslinking fibrin glue (SCFG) is developed, of which the first network of the fibrin glue forms in situ within 2 s to act as an initial physical barrier and locks the gelatin methacryloyl precursor for tight construction of the second network to enhance wet adhesion and durability for tissues covered with blood. The sequential crosslinking glue can provide large pressures (≈280 mmHg of burst pressure), makes strong (38 kPa of shear strength) and tough (≈60 J m−2 of interfacial toughness) interfaces with wet tissues, and outperforms commercial hemostatic agents and gelatin methacryloyl. SCFG are demonstrated as an effective and safe sealant to enhance the treatment outcomes of bleeding tissues in rat, rabbit, and pig models. The ultrafast gelation, strong adhesion and durability, excellent compatibility, and easy manufacture of SCFG make it a promising hemostatic adhesive for clinical applications. [ABSTRACT FROM AUTHOR]

Background: Reminiscence therapy (RT) is a commonly used nonpharmaceutical treatment for cognitive impairment. Artifacts or conversations are used in RT to recall individuals' memories and past experiences. Virtual reality (VR) has increasingly been used as an assistive technology during RT. However, the effects of VR-based RT (VR-RT) methods remain unclear, and insights into the related benefits and challenges are urgently needed. Objective: The study aims to systematically review the effects of VR-RTs for older adults with cognitive impairment. Methods: Seven databases (MEDLINE, Academic Search Premier, CINAHL, Web of Science, PubMed, the Cochrane Central Register of Controlled Trials, and ScienceDirect) were searched to identify relevant articles published from inception to August 10, 2023. Peer-reviewed publications that assessed the effect of VR-RTs (ie, using virtual clues to evoke participants' memories or past experiences) on cognitive-related outcomes were included. Two independent researchers conducted the literature search, review, and data extraction processes. A narrative synthesis approach was used to analyze the extracted data. Results: Of the 537 identified articles, 22 were ultimately included in the data analysis. The results revealed that VR-RTs could maintain cognitive status (4/4, 100%) and reduce anxiety (2/2, 100%) in older adults with cognitive impairment. Nevertheless, one study found a cognitive improvement after VR-RTs, whereas cognitive degradation was observed at a 3- to 6-month follow-up measure. Around 88% (7/8) of the included studies indicated that VR-RTs improved memory; however, the evidence regarding the beneficial effects of VR-RTs was limited in improving quality of life (1/4, 25%) and reducing apathy (0/2, 0%) and depression (1/3, 33%). The results indicated that VR-RTs are safe, engaging, acceptable, and satisfying for older adults with cognitive impairment. In VR scenarios, personalized stimulus materials related to the users' youth experiences were more effective for treating cognitive impairment than other stimulus materials. Conclusions: The results of this systematic review demonstrate the potential benefits of VR-RT for older adults with cognitive impairment, especially in improving emotion and memory and maintaining cognitive status. VR-RT is also safe and enjoyable for older adults. However, due to the trial heterogeneity of included studies, we can only provide qualitative results instead of performing meta-analysis to quantify the effect size of VR-RTs. Thus, more randomized controlled trials are required to examine the designs and effects of VR-RTs for groups of older adults with specific needs. [ABSTRACT FROM AUTHOR]

Comprehensive Summary: Hemostatic hydrogels are widely applied for wound management of damaged tissues, traumatic wounds, and surgical incisions. Some hydrogels composed of bioactive components, including fibrin and thrombin, showed great promise in the clinic due to their good pro‐coagulation effect. With the expanding knowledge of cascade reaction of blood coagulation and emerging bioactive substances, massive bioactive hydrogels consisting of peptides, hemocoagulase, polyphosphate (polyP), etc., have been developed as effective hemostatic materials. Based on the coagulation process and mechanism, we summarize the role of reported bioactive hydrogels in hemostasis in this review. We conclude the key points in the coagulation process, including activation of coagulation factors, fibrinogen polymerization, etc., then discuss how to design bioactive hydrogels to accelerate coagulation targeted to these points. Finally, we conclude the progress and propose a perspective of bioactive hydrogels with a pro‐coagulation effect for hemostasis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Diabetes is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Juvenile myelomonocytic leukaemia (JMML) is an aggressive paediatric leukaemia characterized by mutations in five canonical RAS pathway genes, including the NF1 gene. JMML is driven by germline NF1 gene mutations, with additional somatic aberrations resulting in the NF1 biallelic inactivation, leading to disease progression. Germline mutations in the NF1 gene alone primarily cause benign neurofibromatosis type 1 (NF1) tumours rather than malignant JMML, yet the underlying mechanism remains unclear. Here, we demonstrate that with reduced NF1 gene dose, immune cells are promoted in anti‐tumour immune response. Comparing the biological properties of JMML and NF1 patients, we found that not only JMML but also NF1 patients driven by NF1 mutations could increase monocytes generation. But monocytes cannot further malignant development in NF1 patients. Utilizing haematopoietic and macrophage differentiation from iPSCs, we revealed that NF1 mutations or knockout (KO) recapitulated the classical haematopoietic pathological features of JMML with reduced NF1 gene dose. NF1 mutations or KO promoted the proliferation and immune function of NK cells and iMacs derived from iPSCs. Moreover, NF1‐mutated iNKs had a high capacity to kill NF1‐KO iMacs. NF1‐mutated or KO iNKs administration delayed leukaemia progression in a xenograft animal model. Our findings demonstrate that germline NF1 mutations alone cannot directly drive JMML development and suggest a potential cell immunotherapy for JMML patients. [ABSTRACT FROM AUTHOR]

Tumor microenvironment (TME)-induced nanocatalytic therapy is a trending strategy for tumor-targeting therapy, but the low catalytic efficiency remains to limit its therapeutic effect. The single-atom catalysts (SACs) appear as a novel type of nanozymes that possesses incredible catalytic activity. Here, we developed PEGylated manganese/iron-based SACs (Mn/Fe PSACs) by coordinating single-atom Mn/Fe to nitrogen atoms in hollow zeolitic imidazolate frameworks (ZIFs). Mn/Fe PSACs catalyze cellular hydrogen peroxide (H2O2) converting to hydroxyl radical (•OH) through a Fenton-like reaction; it also enhances the decomposition of H2O2 to O2 that continuously converts to cytotoxic superoxide ion (•O2−) via oxidase-like activity. Mn/Fe PSACs can reduce the depletion of reactive oxygen species (ROS) by consuming glutathione (GSH). Here, we demonstrated the Mn/Fe PSACs-mediated synergistic antitumor efficacy among in vitro and in vivo experiments. This study proposes new promising single-atom nanozymes with highly efficient biocatalytic sites and synergistic therapeutic effects, which will give birth to abundant inspirations in ROS-related biological applications in broad biomedical fields. [ABSTRACT FROM AUTHOR]

It is challenging to stop bleeding effectively in patients treated with heparin which leads to enhanced risk of uncontrolled bleeding during operation. Herein, we report an easy-to-use and heparin-tolerant hemostatic agent based on a thrombin-like cysteine enzyme (papain), which catalyzes the hydrolysis of fibrinogen and cross-linking of fibrin clots. A papain-based hemostat with increased procoagulant activity is developed through immobilizing papain on the cellulose carrier, which displays short clotting time in both normal and heparinized plasmas. The excellent hemostatic performance of the papain-based hemostat is further confirmed with reduced hemostatic time and limited blood loss in a mouse tail amputation model, rabbit auricular artery injury model and rat liver injury model, in which a natural coagulation system fails to function on account of heparin. This bio-hemostat has great potential to reverse the effect of heparin and stop topical hemorrhage rapidly in surgical procedures. [ABSTRACT FROM AUTHOR]

Aims: To explore the influence of nine healthy lifestyle factors on the risk of type 2 diabetes mellitus in adults in Guizhou, China. Methods: Data were obtained from a large population‐based prospective cohort study in Guizhou Province, China. A total of 7,319 participants aged ≥18 years without diabetes at baseline were included in this study and were followed up from 2016 to 2020. A healthy lifestyle score was calculated based on the number of healthy lifestyle factors. Results: During an average of 7.1 person‐years of follow‐up, 764 participants were diagnosed with type 2 diabetes mellitus. Compared with those of participants who scored 0–3 for a healthy lifestyle, the hazard ratios (95% confidence intervals) of those who scored 4, 5, 6, and ≥7 were 0.676 (0.523–0.874), 0.599 (0.464–0.773), 0.512 (0.390–0.673), and 0.393 (0.282–0.550), respectively, showing a gradual downward trend (P for trend <0.01). More importantly, they had lower fasting and 2 h post‐load plasma glucose levels and fewer changes in plasma glucose levels during follow‐up. If ≥7 healthy lifestyle factors were maintained, 33.8% of incident diabetes cases could have been prevented. Never smoking was the strongest protective factor against type 2 diabetes mellitus. Conclusions: A healthy lifestyle can effectively decrease plasma glucose levels and reduce the incidence of type 2 diabetes mellitus in adults in Guizhou, China. In addition, not smoking may be an effective way to prevent type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Recently, there has been a lot of interest in monitoring and identifying changes in dynamic networks, which has led to the development of a variety of monitoring methods. New methods are often designed for a specialized use‐case and rarely compared to competing methods in a systematic fashion. In light of this, the use of simulation is proposed to compare the performance of network monitoring methods over a variety of dynamic network changes. Using the family of simulated dynamic networks, the performance of several state‐of‐the‐art social network monitoring methods from the literature are compared. Their performance over a variety of types of change is compared; both increases in communication levels as well as changes in community structure are considered. It is shown that there does not exist one method that is uniformly superior to the others; the best method depends on the context and the type of change one wishes to detect. As such, it is concluded that a variety of methods are needed for network monitoring and that it is important to understand in which scenarios a given method is appropriate. [ABSTRACT FROM AUTHOR]

Oral health has been previously reported to be related with cardiovascular diseases (CVD). This study aimed to evaluate whether oral hygiene could reduce the risk of incident hypertension and type 2 diabetes mellitus (T2DM) in a population‐based cohort. A total of 9280 people aged 18 years or above in Guizhou province were recruited from November 20th, 2010 to December 19th, 2012. Sociodemographic characteristics, lifestyles, anthropometric measurements, oral health status and care were collected by trained interviewers. The occurrences of hypertension and T2DM were ascertained until 2020. Cox proportional hazard models were used to evaluate the associations between oral hygiene and the occurrence of hypertension and T2DM, respectively. Compared with almost no tooth brushing, tooth brushing at least twice a day was associated with a 45% reduction (HR:.55; 95% CI:.42–.73) in hypertension events and reduced diabetes risk by 35% (HR:.65; 95% CI:.45–.94). For hypertension, those associations tended to be more pronounced in participants with Han ethic, or living in urban area, while those aged less than 60 or without baseline hypertension were more likely to have T2DM when they brush teeth less than twice a day. Frequent tooth brushing was associated with reduced risks of incident hypertension and T2DM. Tooth brushing at least twice a day may prevent future hypertension and T2DM events. [ABSTRACT FROM AUTHOR]

Aim. Primary central nervous system lymphoma (PCNSL) is an aggressive, destructive, and rapidly progressive malignant brain tumor. Although aggressive therapies were studied trying to increase the median survival of PCNSL, the high relapse rate of PCNSL is still a big problem for the oncology medicine. A retrospective study was made to evaluate the efficacy and safety of pemetrexed in the treatment of patients with recurrent PCNSL. Methods. Twenty-three confirmed recurrent PCNSL patients were selected during April 2012 and August 2016. Dexamethasone, B12, and folic acid were used to produce the toxicity related to pemetrexed. The patients were intravenously given pemetrexed (900 mg/m2) every three weeks for 6 weeks. Results. After the treatment, 7 patients were in complete remission, 6 patients in partial remission, 4 patients in stable condition, and 6 patients in progression. There were 56.5% and 73.9% in the overall response rate and the disease control rate, respectively. The median overall survival (OS) was 6.6 months (95% CI, 4.6–8.6). Conclusion. This study has been the first time to evaluate the safety and effectiveness of pemetrexed on elderly recurrent PCNSL patients. Results demonstrate that using high-dose pemetrexed might be a feasible and effective treatment for recurrent PCNSL in the elderly, and clinical trials should be conducted to further confirm it. [ABSTRACT FROM AUTHOR]

Macrophage is a very promising cell type for cancer immunotherapy, yet it is difficult to obtain enough functional macrophages for clinical cell therapy. Herein, we descibe a reliable method to produce functional macrophages through the differentiation of human induced pluripotent stem cells (hiPSCs). By optimizing the size control of embryoid bodies (EBs), we accelerated the differentiation process of macrophages and increased the production of macrophages without attenuating macrophage functions. Our final yield of macrophages was close to 50-fold of starting iPSCs. The macrophages showed phagocytic capacity in vitro and a xenograft tumor model. M0 macrophages could be further polarized into M1 and M2 subtypes, and M1 cells exhibited typical proinflammatory characteristics. Moreover, we found that hematopoietic differentiation originated from the outside of EB and matured inward gradually. Taken together, our protocol provides an effective method for the generation of macrophages comparable to blood-derived macrophages, which provides potential value for cell therapy and gene editing studies. [ABSTRACT FROM AUTHOR]

Aluminum silicate materials were widely used for temporary hemostasis of external wounds. Although they are commonly deemed to be nontoxic, side effects were proved to have some potential risks. In addition to obvious thermal effect and distal thrombosis, other chemical analysis should be performed to validate whether there is active components in the blood circulation system even when there is no obvious distal thrombosis. On the other hand, blood electrolytes disturbance is a safety concern, and this issue has been ignored in previous studies. In this study, a systematic and stringent safety evaluation of aluminium silicate hemostatic agents was performed to provide useful information for their future clinical applications. In this study, a low-heat producing Zeolite Granular Dressing (Z-Granular, Zeo-Innov Medical Technology Co., Ltd, Hangzhou, China) was used as hemostatic agents for safety evaluation in a rabbit femoral artery hemorrhage model. In addition to the time to achieve definite hemostasis and heat producing properties, blood electrolytes concentrations of the rabbits pre- and post-application were measured. Although the in vitro electrolyte concentration tests indicated the significant change of Ca2+ and K+ after the zeolite-accelerated hemostasis, in vivo rabbit model suggested that no obvious blood electrolyte disordered occurred. X-ray photography confirmed that there is no zeolite residual granule remained in the wound sites after the debridement. Element analysis proved that the possibility of these inorganic materials entering the blood circulation is very low. The histological results revealed that no pathological changes resulting from Z-Granular were found. Thus, Zeolite Granular Dressing would be an effective and safe hemostatic agent for emergency arterial bleeding. Furthermore, packing zeolite granules within nonwoven-fabric bags would solve the problem of debridement without compromising their hemostatic efficiency. This is a systematic and stringent safety evaluation of aluminium silicate hemostatic agents and provides useful information for their future clinic applications. [ABSTRACT FROM AUTHOR]