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Objective: To rate athletes' functional ability and return to sport (RTS) success at the end of their individual, formal, medically prescribed rehabilitation after anterior anterior cruciate ligament (ACL) reconstruction. Methods: In our prospective multicenter cohort study, 88 (42 females) adults aged 18-35 years after acute unilateral ACL rupture and subsequent hamstring grafting were included. All patients were prospectively monitored during their rehabilitation and RTS process until the end of their formal rehabilitation and RTS release. As outcome measures, functional hop and jump tests (front hop, balance hops, and drop jump screening test) and self-report outcomes (Knee Injury and Osteoarthritis Outcome Score, ACL-RTS after injury) were assessed. Literature-based cut-off values were selected to rate each performance as fulfilled or not. Results: At 7.5 months (SD 2.3 months) after surgery, the percentage of participants meeting the functional thresholds ranged from 4% (Knee Injury and Osteoarthritis Outcome Score SPORT) and over 44% (ACL-RTS after injury sum score) to 59% (Knee Injury and Osteoarthritis Outcome Score activities of all daily living) in the self-report and from 29% (Balance side hop) to 69% (normalized knee separation distance) in performance testing. Only 4% fulfilled all the cut-offs, while 45% returned to the same type and level of sport. Participants who successfully returned to their previous sport (type and level) were more likely to be "over-cut-off-performers." Conclusions: The low share of the athletes who fulfilled the functional RTS criteria highlights the importance of continuing the rehabilitation measures after the formal completion to assess the need for and success of, inter alia, secondary-preventive therapies. [ABSTRACT FROM AUTHOR]

Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an inflammatory disease affecting the peripheral nerves and the most frequent autoimmune polyneuropathy. Given the lack of established biomarkers or risk factors for the development of CIDP and patients' treatment response, this research effort seeks to identify potential clinical factors that may influence disease progression and overall treatment efficacy. Methods: In this multicenter, retrospective analysis, we have screened 197 CIDP patients who presented to the University Hospitals in Düsseldorf, Berlin, Cologne, Essen, Magdeburg and Munich between 2018 and 2022. We utilized the respective hospital information system and examined baseline data with clinical examination, medical letters, laboratory results, antibody status, nerve conduction studies, imaging and biopsy findings. Aside from clinical baseline data, we analyzed treatment outcomes using the Standard of Care (SOC) definition, as well as a comparison of an early (within the first 12 months after manifestation) versus late (more than 12 months after manifestation) onset of therapy. Results: In terms of treatment, most patients received intravenous immunoglobulin (56%) or prednisolone (39%) as their first therapy. Patients who started their initial treatment later experienced a worsening disease course, as reflected by a significant deterioration in their Inflammatory Neuropathy Cause and Treatment (INCAT) leg disability score. SOC-refractory patients had worse clinical outcomes than SOC-responders. Associated factors for SOC-refractory status included the presence of fatigue as a symptom and alcohol dependence. Conclusion: Timely diagnosis, prompt initiation of treatment and careful monitoring of treatment response are essential for the prevention of long-term disability in CIDP and suggest a "hit hard and early" treatment paradigm. [ABSTRACT FROM AUTHOR]

Objectives: Intrusive mental imagery is associated with anxiety in bipolar disorder (BD) and presents a novel treatment target. Imagery‐based treatments show promise in targeting anxiety and improving mood instability. This qualitative study explored experiences of receiving up to 12 sessions of a brief structured psychological intervention: Image‐Based Emotion Regulation (IBER), which targets maladaptive mental imagery in the context of BD with an aim to modify the emotional impact of these images. Design: A qualitative study embedded within the Image Based Emotion Regulation (IBER) feasibility randomised controlled trial. Methods: Semi‐structured interviews were conducted with 12 participants in the treatment arm of the trial who received IBER + treatment as usual. Data were analysed using thematic analysis. Results: Despite some initial scepticism about imagery‐focused treatment, all participants expressed broadly positive accounts of treatment experiences. High levels of engagement with imagery modification techniques, beneficial use of techniques post treatment and improvements in anxiety management and agency were described by some. Three sub‐groups were identified: those who reported a powerful transformative impact of treatment; those who embedded some new techniques into their daily lives, and those who felt they had techniques to use when needed. No participants reported overall negative experiences of the IBER treatment. Conclusions: Findings from this study highlight the value for treatment recipients of modifying the underlying meanings associated with maladaptive imagery, and the personalised skills development to manage anxiety within bipolar disorders. Findings can inform treatment refinements and further trial‐based evaluations. [ABSTRACT FROM AUTHOR]

The aim of this article is to formulate and study a mathematical model describing hepatitis C virus (HCV) infection dynamics. The model includes two essential modes of infection transmission, namely, virus-to-cell and cell-to-cell. The effect of therapy and adaptive immunity are incorporated in the suggested model. The adaptive immunity is represented by its two categories, namely, the humoral and cellular immune responses. Our article begins by establishing some mathematical results through proving the model's well-posedness in terms of existence, positivity and boundedness of solutions. We present all the steady states of the problem that depend on specific reproduction numbers. It moves then to the theoretical investigation of the local and global stability analysis of the free disease equilibrium and the four disease equilibria. The local and global stability analysis of the HCV mathematical model are established via the Routh-Hurwitz criteria and Lyapunov-LaSalle invariance principle, respectively. Finally, our article presents some numerical simulations to validate the analytical study of the global stability. Numerical simulations have shown the effect of the drug therapies on the system's dynamical behavior. [ABSTRACT FROM AUTHOR]

The objectives of the study were to present the experience of diagnosis, management, and therapy with IL-1 inhibitors in patients with Schnitzler's syndrome (SchS) according to a multicenter Russian cohort. An observational retrospective study for a 10-year period (2012–2022) involved 17 patients with SchS who were admitted to the hospital or were observed on an outpatient basis (eight women and nine men). The diagnosis of all of them corresponded to the Strasbourg diagnostic criteria. The age of patients ranged from 25 to 81 years (Me 53[46; 56]). The age at the time of the onset of the disease ranged from 20 to 72 years (Me 46[39; 54]), the duration of the disease before diagnosis ranged from 1 to 35 years (Me 6.5[3; 6]), in three patients it exceeded 10 years, in the rest it ranged from 1 to 8 years. Infectious and lymphoproliferative diseases, monogenic AIDs (CAPS, TRAPS, and HIDS) were excluded from all patients at the prehospital stage. The referral diagnosis for all of them was Still 's disease in adults. Clinical manifestations of the disease in all patients included fatigue, lethargy, fatigue, rash, and fever. In all patients, skin elements were urticular and were accompanied by itching in 6 (37.5%) patients. Bone pain was observed in 12 (70.6%) patients; arthralgias, in 16 (94.1%); arthritis, in 9 (52.9%); myalgia, in 7 (41.2%); and weight loss, in 4 (23.5%). Lymphadenopathy was detected in 6 (35.3%) patients; enlarged liver, in 6 (35.3%); pericarditis, in 4 (23.5%); angioedema, in 6 (35.3); redness and dryness in the eyes, in 3 (17.6%); sore throat, in 2 (11.8%); abdominal pain, in 1 (5.9%), distal polyneuropathy, in 2 (11.8%); paraesthesia, in 1 (5.9%); and chondritis of the auricles, in 1 (5.9%). Monoclonal gammopathy was detected in all patients with a secretion level of 2.9–15.1 g/L: IgMk (n = 10, 64.7%), less often IgMλ (n = 2), IgGk (n = 2), IgGλ (n = 1), and IgAλ (n = 1). Ben-Jones protein was not detected in any of them. All patients had an increased level of ESR and CRP. Before inclusion in the study, 16 patients received GCs (94.1%) with a temporary effect that disappeared with dose reduction or cancellation. Seven patients received cDMARDs, including methotrexate (5), hydroxychloroquine (2), and cyclophosphamide (1). All patients received NSAIDs and antihistamines, as well as biologics, including the anti-B-cell drug rituximab (1), monoclonal ABs to IgE omalizumab (2, 1 without effect and 1 with partial effect), IL-1i canakinumab (n = 10, 58.8%) subcutaneously once every 8 weeks, and anakinra (n = 4, 23.5%) subcutaneously daily. The duration of taking anakinra, which was prescribed in the test mode, ranged from 1 week to 2.5 months with a further switch to canakinumab in 3 patients. The duration of taking canakinumab at the time of analysis ranged from 7 months to 8 years. Against the background of treatment with IL-1i, 10 out of 11 (90.9%) patients received a complete response in terms of the clinical manifestations of the disease and a decrease in the level of ESR and CRP within a few days. In one patient, a partial response to the administration of anakinra was detected; however, after switching to canakinumab, the effect of treatment was finally lost. One patient received IL-6i for 8 months with an incomplete effect and a positive dynamics after switching to anakinra. Thus, anakinra was initially prescribed to four patients and changed to canakinumab in two of them; canakinumab was started as the first drug in seven patients. Treatment with anakinra was continued in two patients; with canakinumab, in nine patients. In one patient, due to the persistent absence of relapses, the interval between canakinumab injections was increased to 5 months without signs of reactivation; however, subsequently, against the background of stress and relapses of the disease, the intervals were reduced to 4 months. A healthy child was born by the same patient on the background of treatment. The tolerability of therapy was satisfactory in all patients, no SAEs were noted. SchS is a rare multifactorial/non-monogenic AID that should be differentiated from a number of rheumatic diseases and other AIDs. The onset in adulthood, the presence of recurrent urticarial rashes in combination with fever and other manifestations of a systemic inflammatory response are indications for examination for monoclonal secretion. The use of short- or long-acting IL-1i is a highly effective and safe option in the treatment of such patients. [ABSTRACT FROM AUTHOR]

Background: Bromhidrosis, characterized by foul‐smelling sweat, is a prevalent condition that significantly affects patients' social and psychological well‐being. Methods: This review presents novel treatment approaches and discusses the pros and cons of various treatment options for axillary bromhidrosis. Results: Extensive research has explored numerous treatment modalities for bromhidrosis. This article systematically reviews both surgical and nonsurgical interventions utilized in clinical practice. Conclusion: By synthesizing available evidence, this review aims to offer evidence‐based recommendations for effectively managing bromhidrosis, considering factors such as treatment efficacy, safety profiles, patient preferences, and clinical outcomes. [ABSTRACT FROM AUTHOR]

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Mental health researchers have focused on promoting culturally sensitive clinical care (Herman et al., 2007; Whaley & Davis, 2007), emphasizing the need to understand how biases may impact client well-being. Clients report that their therapists commit racial microaggressions—subtle, sometimes unintentional, racial slights—during treatment (Owen et al., 2014). Yet, existing studies often rely on retrospective evaluations of clients and cannot establish the causal impact of varying ambiguity of microaggressions on clients. This study uses an experimental analogue design to examine offensiveness, emotional reactions, and evaluations of the interaction across three distinct levels of microaggression statements: subtle, moderate, and overt. We recruited 158 adult African American participants and randomly assigned them to watch a brief counseling vignette. We found significant differences between the control and three microaggression statements on all outcome variables. We did not find significant differences between the microaggression conditions. This study, in conjunction with previous correlational research, highlights the detrimental impact of microaggressions within psychotherapy, regardless of racially explicit content. Public Significance Statement: African Americans tend to exhibit consistently negative reactions in response to therapist racial microaggressions, regardless of how racially explicit they are. These experimental findings can inform the culturally sensitive training of therapists. [ABSTRACT FROM AUTHOR]

Pancreatic cancer (PC) is characterized by its notably poor prognosis and high mortality rate, underscoring the critical need for advancements in its diagnosis and therapy. Gold nanoparticles (AuNPs), with their distinctive physicochemical characteristics, demonstrate significant application potential in cancer therapy. For example, upon exposure to lasers of certain wavelengths, they facilitate localized heating, rendering them extremely effective in photothermal therapy. Additionally, their extensive surface area enables the conjugation of therapeutic agents or targeting molecules, increasing the accuracy of drug delivery systems. Moreover, AuNPs can serve as radiosensitizers, enhancing the efficacy of radiotherapy by boosting the radiation absorption in tumor cells. Here, we systematically reviewed the application and future directions of AuNPs in the diagnosis and treatment of PC. Although AuNPs have advantages in improving diagnostic and therapeutic efficacy, as well as minimizing damage to normal tissues, concerns about their potential toxicity and safety need to be comprehensively evaluated. [ABSTRACT FROM AUTHOR]

Simple Summary: The microenvironment of hepatocellular carcinoma is a really complex milieu, containing a wide variety of cells with specific tasks, belonging to both the mesenchimal and immunitary systems, the extracellular matrix, growth factors, proinflammatory cytokines, and translocated bacterial products. This intricate environment represents a source of potential targets in order to establish a wide and multitask therapeutic strategy for hepatocellular carcinoma. Hepatocellular carcinoma is a malignant tumor that originates from hepatocytes in an inflammatory substrate due to different degrees of liver fibrosis up to cirrhosis. In recent years, there has been growing interest in the role played by the complex interrelationship between hepatocellular carcinoma and its microenvironment, capable of influencing tumourigenesis, neoplastic growth, and its progression or even inhibition. The microenvironment is made up of an intricate network of mesenchymal cells, immune system cells, extracellular matrix, and growth factors, as well as proinflammatory cytokines and translocated bacterial products coming from the intestinal microenvironment via the enterohepatic circulation. The aim of this paper is to review the role of the HCC microenvironment and describe the possible implications in the choice of the most appropriate therapeutic scheme in the prediction of tumor response or resistance to currently applied treatments and in the possible development of future therapeutic perspectives, in order to circumvent resistance and break down the tumor's defensive fort. [ABSTRACT FROM AUTHOR]

This research paper explores the theories of Albert Ellis and Jeffrey Young in Cognitive Behavioral Therapy (CBT), a therapeutic approach aimed at modifying behavior and building resilience against psychological pressures and negative thoughts. The paper discusses the key principles and techniques used in CBT, including rational thinking, challenging irrational beliefs, and modifying maladaptive schemas. It also highlights the importance of the therapeutic relationship in both theories. While CBT has been effective in improving mental health, it has faced criticisms for its focus on cognitive aspects over emotional and affective aspects. Overall, CBT has proven to be effective in addressing psychological problems and improving well-being. [Extracted from the article]

Hypothalamic-pituitary-thyroid axis seems to play an important role in the pathogenesis of depression in hypothyroid patients. Studies have shown that hypothyroidism can induce mood changes and major depressive disorders, but what governs the reason for this linkage and the most suitable therapy to manage this condition is not very clear. We aim to investigate the various existing therapies administered for depression due to hypothyroidism and the potential scope of yoga therapy to treat these conditions effectively. A systematic literature search of five databases, namely, EBSCO, SCOPUS, PROQUEST, PubMed, and Elsevier using the keywords in the area of "hypothyroidism, depression, and therapies" was carried out till the period 2023 following the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines to select the relevant English-language peer-reviewed articles for the study. The objective of this study was to present the work done so far in the field of treating depression in hypothyroidism through therapy techniques. The paper reviews 18 specific empirical studies on various available therapies administered for depression in hypothyroidism and based on the extant literature covers four broad themes: (1) hormone therapy, (2) antidepressant pharmacotherapy, (3) cognitive psychotherapy, and (4) yoga therapy. This review provides a clear need for more yoga therapy studies, as only two yoga studies were found for treating depression in hypothyroidism that have shown significant outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer (BC) is a global health concern, hindered by the limited effectiveness and adverse effects of current treatments. To address this, we propose a method for identifying membrane proteins in tumors, offering potential targets for BC therapy and diagnosis by analyzing gene expressions in breast tumor and healthy tissues using bioinformatics tools, like TCGA, UALCAN, TNM Plot, and LinkedOmics. Four transcripts (LRRC15, EFNA3, TSPAN13, and CA12) were identified with heightened expressions in BC tissue. These transcripts showed high accuracy in identifying tumor samples and were consistently elevated across all BC molecular subtypes. Tissue microarray (TMA) analysis confirmed an increased expression in tumor tissues compared to adjacent breast tissue. The study underscores the potential of LRRC15, EFNA3, TSPAN13, and CA12 as biomarkers for enhancing BC diagnosis and as promising therapeutic targets with reduced side effects and improved efficacy. Breast cancer (BC) is a prevalent form of cancer affecting women worldwide. However, the effectiveness of current BC drugs is limited by issues such as systemic toxicity, drug resistance, and severe side effects. Consequently, there is an urgent need for new therapeutic targets and improved tumor tracking methods. This study aims to address these challenges by proposing a strategy for identifying membrane proteins in tumors that can be targeted for specific BC therapy and diagnosis. The strategy involves the analyses of gene expressions in breast tumor and non-tumor tissues and other healthy tissues by using comprehensive bioinformatics analysis from The Cancer Genome Atlas (TCGA), UALCAN, TNM Plot, and LinkedOmics. By employing this strategy, we identified four transcripts (LRRC15, EFNA3, TSPAN13, and CA12) that encoded membrane proteins with an increased expression in BC tissue compared to healthy tissue. These four transcripts also demonstrated high accuracy, specificity, and accuracy in identifying tumor samples, as confirmed by the ROC curve. Additionally, tissue microarray (TMA) analysis revealed increased expressions of the four proteins in tumor tissues across all molecular subtypes compared to the adjacent breast tissue. Moreover, the analysis of human interactome data demonstrated the important roles of these proteins in various cancer-related pathways. Taken together, these findings suggest that LRRC15, EFNA3, TSPAN13, and CA12 can serve as potential biomarkers for improving cancer diagnosis screening and as suitable targets for therapy with reduced side effects and enhanced efficacy. [ABSTRACT FROM AUTHOR]

Noninfectious scleritis typically takes a chronic course, and systemic corticosteroids or disease-modifying anti-rheumatic drug (DMARD) treatment may be inevitable for a prolonged period. Janus kinase (JAK) inhibitors are a relatively new therapeutic option for inflammatory diseases, and three cases of successful treatment of scleritis with tofacitinib, a substance targeting JAK-1 and -3, have been published up to now. We here describe the case of a 51-years-old female patient with bilateral anterior and posterior scleritis who, after treatment failure of multiple DMARDs, finally achieved clinical quiescence of disease under treatment with upadacitinib, a selective JAK-1 inhibitor. [ABSTRACT FROM AUTHOR]

Objective: Anorexia nervosa (AN) is a serious eating disorder treated using psychological interventions, yet outcomes remain limited. Emotional difficulties are recognised as a treatment target. This research programme developed and evaluated feasibility of an emotion‐focused therapy for adults with AN. Methods: Phase One intervention development utilised 'intervention mapping'. Qualitative research drew on lived experience highlighting objectives for change. Empirical evidence was synthesised into hypotheses of core emotional difficulties and an associated model of change. Relevant psychotherapeutic theory‐based change methods were integrated to form the Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS) intervention, guidebook and clinician training package. Phase Two tested SPEAKS in a single‐arm, multisite feasibility trial across two specialist services, utilising prespecified progression criteria, and embedded process evaluation. Results: SPEAKS was 9–12 months (40 sessions) of weekly individual psychotherapy, drawing on a range of psychotherapeutic modalities, predominantly Emotion Focused Therapy and Schema Therapy. Forty‐six participants consented to feasibility trial participation; 42 entered the trial and 34 completed. Thirteen of 16 feasibility criteria were met at green level and three at amber, highlighting areas for improving model adherence. Conclusions: A randomised controlled trial is indicated. Therapist training and guidebook adjustments to improve model adherence are suggested. Highlights: Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex is an emotion‐focused intervention for adults with Anorexia nervosa following a proposed causal model of emotion change. Theory, tasks and techniques integrate Emotion Focused Therapy and Schema Therapy, alongside other modalities, to facilitate the proposed change processes.SPEAKS was developed using a clear 'intervention mapping' process, utilising mixed methods and seeking to engage and learn from those with lived experience.This feasibility trial suggests SPEAKS is an acceptable, engaging and clinically feasible intervention and progression to a larger randomised controlled trial is indicated. [ABSTRACT FROM AUTHOR]

Simple Summary: Equine-assisted therapies are becoming increasingly popular for addressing physical and psychological disabilities in clients. The role of the horse's welfare in equine-assisted service receives increasing attention in research. Recent research has shown that horses are able to perceive human emotions and respond to human stress responses. However, no research has yet looked at the other side of the coin—whether and how humans perceive and react to equine stress levels during equine-assisted services. In our study, healthy participants interacted once with a stressed horse and once with a relaxed horse and we asked them before and after the interactions about their mood and their current anxiety level. We also assessed participants' and horses' heart rates. The results of our study showed that the stressed horses were stressed during and after the stress manipulation. Participants reported better mood and less anxiety after the interaction with both the previously stressed and the relaxed horse. Thus, our data suggest that humans cannot intuitively recognize the emotional states of horses. Practical implications for equine-assisted services and other equestrian activities are discussed. Equine-assisted therapies are becoming increasingly popular for addressing physical and psychological disabilities in clients. The role of the horse's welfare in equine-assisted service receives increasing attention in research. Several studies have shown that horses are able to perceive human emotions and respond to human stress responses. However, no research has yet looked at the other side of the coin—whether and how humans perceive and react to equine stress levels during equine-assisted services. To fill this gap in the research, we employed a within-subjects design, in which horse-naïve participants had a standardized interaction with both an experimentally stressed horse and an experimentally relaxed horse. We assessed physiological indicators of stress (heart rate, heart rate variability, and salivary cortisol) in participants and horses, as well as psychological indicators of stress (state anxiety and positive and negative affect) in participants. Although our stress and relaxation manipulations were successful (indicated by horses' physiological indicators of stress), we did not find any difference in the participants' physiological or psychological indicators of stress between the interaction with a stressed and the interaction with a relaxed horse. Together with results from previous studies, this suggests that humans cannot intuitively recognize the (physiological) stress level of horses, which has important implications for effective communication and bonding between humans and horses and for the safety of equine activities. [ABSTRACT FROM AUTHOR]

To summarize the research on the effectiveness of virtual reality (VR) therapy for the management of phantom limb pain (PLP). Three databases (SCOPUS, Ovid Embase, and Ovid MEDLINE) were searched for studies investigating the use of VR therapy for the treatment of PLP. Original research articles fulfilling the following criteria were included: (i) patients 18 years and older; (ii) all etiologies of amputation; (iii) any level of amputation; (iv) use of immersive VR as a treatment modality for PLP; (v) self-reported objective measures of PLP before and after at least one VR session; (vi) written in English. A total of 15 studies were included for analysis. Fourteen studies reported decreases in objective pain scores following a single VR session or a VR intervention consisting of multiple sessions. Moreover, combining VR with tactile stimulation had a larger beneficial effect on PLP compared with VR alone. Based on the current literature, VR therapy has the potential to be an effective treatment modality for the management of PLP. However, the low quality of studies, heterogeneity in subject population and intervention type, and lack of data on long-term relief make it difficult to draw definitive conclusions. Virtual reality (VR) therapy has emerged as a new potential treatment option for phantom limb pain (PLP) that circumvents some limitations of mirror therapy. VR therapy was shown to decrease PLP following a single VR session as well as after an intervention consisting of multiple sessions. The addition of vibrotactile stimuli to VR therapy may lead to larger decreases in PLP scores compared with VR therapy alone. [ABSTRACT FROM AUTHOR]

Osteoporotic pelvic ring fractures show a continuously increasing incidence. In addition to the fracture morphology, the clinical situation of the patients is also crucial for therapy. The osteoporotic fracture working group of the spine section of the German Society for Orthopaedics and Trauma Surgery (DGOU) has developed a score for the treatment decision that is based on the OF-Pelvis classification and on essential clinical parameters. The score includes the clinical parameters of mobilization ability, pain situation, fracture-related neurological deficits and risk factors for an increased surgical complication rate. In addition, the fracture morphology is determined according to the OF-Pelvis classification including the fracture modifiers. For each parameter, points are awarded or deducted depending on the characteristics and the total is then calculated. If a parameter cannot be determined, no point are awarded. A score below 8 means a recommendation for conservative therapy, while a score above 8 means a recommendation for surgical therapy. If there are exactly 8 points, conservative or surgical treatment is possible. The OF-Pelvis score was evaluated retrospectively in 5 trauma centers based on records and imaging in 107 patients and compared with the therapy actually carried out. There was an overall agreement of 91 % between the therapy recommendation of the OF-Pelvis score and the therapy actually carried out (conservative versus surgical). Collecting the score took about 5 minutes. The OF-Pelvis score is an easy-to-use decision-making aid for determining the indication for conservative or surgical treatment of osteoporotic pelvic ring fractures. [ABSTRACT FROM AUTHOR]

Vascular smooth muscle cells (VSMCs) have emerged as pivotal contributors throughout all phases of atherosclerotic plaque development, effectively dispelling prior underestimations of their prevalence and significance. Recent lineage tracing studies have unveiled the clonal nature and remarkable adaptability inherent to VSMCs, thereby illuminating their intricate and multifaceted roles in the context of atherosclerosis. This comprehensive review provides an in-depth exploration of the intricate mechanisms and distinctive characteristics that define VSMCs across various physiological processes, firmly underscoring their paramount importance in shaping the course of atherosclerosis. Furthermore, this review offers a thorough examination of the significant strides made over the past two decades in advancing imaging techniques and therapeutic strategies with a precise focus on targeting VSMCs within atherosclerotic plaques, notably spotlighting meticulously engineered nanoparticles as a promising avenue. We envision the potential of VSMC-targeted nanoparticles, thoughtfully loaded with medications or combination therapies, to effectively mitigate pro-atherogenic VSMC processes. These advancements are poised to contribute significantly to the pivotal objective of modulating VSMC phenotypes and enhancing plaque stability. Moreover, our paper also delves into recent breakthroughs in VSMC-targeted imaging technologies, showcasing their remarkable precision in locating microcalcifications, dynamically monitoring plaque fibrous cap integrity, and assessing the therapeutic efficacy of medical interventions. Lastly, we conscientiously explore the opportunities and challenges inherent in this innovative approach, providing a holistic perspective on the potential of VSMC-targeted strategies in the evolving landscape of atherosclerosis research and treatment. [Display omitted] [ABSTRACT FROM AUTHOR]

Simple Summary: With around 15 kD molecular weight, VHHs are considered the smallest antigen-binding fragments. Based on their unique properties, VHHs have broad application prospects such as bio-sensing, molecular imaging, drug delivery, disease treatments, and diagnosis. In this review, we discuss VHH applications for cancer treatments and diagnosis. Meanwhile, an overview of VHH-based agents in clinical trials is provided. The discovery of the distinctive structure of heavy chain-only antibodies in species belonging to the Camelidae family has elicited significant interest in their variable antigen binding domain (VHH) and gained attention for various applications, such as cancer diagnosis and treatment. This article presents an overview of the characteristics, advantages, and disadvantages of VHHs as compared to conventional antibodies, and their usage in diverse applications. The singular properties of VHHs are explained, and several strategies that can augment their utility are outlined. The preclinical studies illustrating the diagnostic and therapeutic efficacy of distinct VHHs in diverse formats against solid cancers are summarized, and an overview of the clinical trials assessing VHH-based agents in oncology is provided. These investigations demonstrate the enormous potential of VHHs for medical research and healthcare. [ABSTRACT FROM AUTHOR]

Background: ABCC8 variants can cause hyperinsulinemia by activating or deactivating gene expression. This study used targeted exon sequencing to investigate genetic variants of ABCC8 and the associated phenotypic features in Chinese patients with hyperinsulinemic hypoglycemia (HH). Methods: We enrolled eight Chinese children with HH and analyzed their clinical characteristics, laboratory results, and genetic variations. Results: The age at presentation among the patients ranged from neonates to 0.6 years old, and the age at diagnosis ranged from 1 month to 5 years, with an average of 1.3 ± 0.7 years. Among these patients, three presented with seizures, and five with hypoglycemia. One patient (Patient 7) also had microcephaly. All eight patients exhibited ABCC8 abnormalities, including six missense mutations (c. 2521 C > G, c. 3784G > A, c. 4478G > A, c. 4532T > C, c. 2669T > C, and c. 331G > A), two deletion-insertion mutations (c. 3126_3129delinsTC and c. 3124_3126delins13), and one splicing mutation (c. 1332 + 2T > C). Two of these mutations (c. 3126_3129delinsTC and c. 4532T > C) are novel. Six variations were paternal, two were maternal, and one was de novo. Three patients responded to diazoxide and one patient responded to octreotide treatment. All there patients had diazoxide withdrawal with age. Two patients (patients 3 and 7) were unresponsive to both diazoxide and octreotide and had mental retardation. Conclusions: Gene analysis can aid in the classification, treatment, and prognosis of children with HH. In this study, the identification of seven known and two novel variants in the ABCC8 gene further enriched the variation spectrum of the gene. [ABSTRACT FROM AUTHOR]

Simple Summary: Liver metastasis remains a major hurdle to the long-lasting survival of patients with colorectal cancer (CRC). When CRC spreads to the liver, tumor cells undergo a series of changes to adapt to the new environment, leading to evident heterogeneity. Therefore, understanding the features of metastatic tumor cells in the liver is valuable for the overall control of patients with colorectal cancer liver metastasis (CRLM). In this review, we provide a comprehensive overview of the spatial heterogeneity of CRLM at different molecular levels, including genetics, transcriptomics, proteomics, metabolism, and immune levels. While genetic heterogeneity may not be apparent, the other four levels demonstrate significant heterogeneity. Compared to primary CRC, the epithelial–mesenchymal transition (EMT)-related proteins are significantly altered. Moreover, the metabolic activity is enhanced and the infiltration of immuno-suppressive cells is increased in CRLM. All these changes promote the metastasis and colonization of CRC cells. Based on these findings, we also summarize preclinical therapeutic modalities targeting the heterogeneity of CRLM, aiming to provide new directions for clinical interventions and improve the survival rates of these patients. Colorectal cancer liver metastasis (CRLM) is a highly heterogeneous disease. Therapies that target both primary foci and liver metastasis are severely lacking. Therefore, understanding the features of metastatic tumor cells in the liver is valuable for the overall control of CRLM patients. In this review, we summarize the heterogeneity exhibited in CRLM from five aspects (gene, transcriptome, protein, metabolism, and immunity). In addition to genetic heterogeneity, the other four aspects exhibit significant heterogeneity. Compared to primary CRC, the dysregulation of epithelial–mesenchymal transition (EMT)-related proteins, the enhanced metabolic activity, and the increased infiltration of immunosuppressive cells are detected in CRLM. Preclinical evidence shows that targeting the EMT process or enhancing cellular metabolism may represent a novel approach to increasing the therapeutic efficacy of CRLM. [ABSTRACT FROM AUTHOR]

Context: Plantar heel pain is a common problem affecting foot function, causing pain in the foot under the heel. Plantar fasciitis is commonly treated with conservative treatment, such as joint and soft tissue mobilization, self-stretching home programs, foot orthoses, and night splinting or booting. Dry needling (DN) has shown to be an effective method of treating plantar fasciitis (PF) in multiple randomized control trials. Dry needling is a technique that has been reported to be beneficial in managing pain and dysfunction after PF. Still, there is limited published literature on DN, a myofascial sequence as part of the treatment of PF. Case Presentation: The patient was a 38-year-old female runner referred by a podiatrist for evaluation and treatment to include DN and therapy for persistent PF in the right foot. She was treated 4 times over 3 weeks with a home exercise program. Management and Outcomes: The DN intervention was beyond the local plantar fascia and incorporated 11 locations from the foot up the posterior chain and 2 electric stim channels. The patient had reduced pain as measured by a visual analog scale, increased function as measured by the functional ankle disability index, and range of motion increases. Conclusions: This case illustrates the use of DN and a home exercise program to provide a favorable outcome in a patient with PF. [ABSTRACT FROM AUTHOR]

Background: In recent years, there have been great improvements in the therapy of renal cell carcinoma. Nevertheless, the therapeutic effect varies significantly from person to person. To discern the effective treatment for different populations, predictive molecular biomarkers in response to target, immunological, and combined therapies are widely studied. Conclusion: This review summarized those studies from three perspectives (SNPs, mutation, and expression level) and listed the relationship between biomarkers and therapeutic effect, highlighting the great potential of predictive molecular biomarkers in metastatic RCC therapy. However, due to a series of reasons, most of these findings require further validation. [ABSTRACT FROM AUTHOR]

There is scarce research on adapting evidence‐based practices, such as Applied Behavior Analysis (ABA)‐based therapy, for Deaf/Hard of Hearing (DHH) children diagnosed with autism spectrum disorder (ASD). The current case involved delivering intensive ABA‐based intervention for improving communication skills to a 5‐year‐old child, Lilly, with dual diagnoses of DHH and ASD. Teaching procedures were modified to include consideration of deaf cultural norms, incorporation of American Sign Language (ASL)‐specific instructional procedures, and consultation with an ASL interpreter within all intervention sessions. Outcome data measured by the Verbal Behavior Milestones Assessment and Placement Program (VB‐MAPP) reflected rapid skill acquisition across multiple verbal operants within a 7‐month admission. Recommendations on how to deliver intensive ABA‐based intervention services to children with dual diagnoses of DHH and ASD are provided for further research and discussion. Utilizing modified behavior analytic procedures can provide increased access to needed services for this population. [ABSTRACT FROM AUTHOR]

Gastric cancer (GC) is a common malignant tumor with high morbidity and mortality rates that seriously affects human health worldwide. Although surgery is currently the preferred clinical treatment for GC, chemotherapy remains the first choice for perioperative treatment, adjuvant therapy, and palliative care for patients with advanced GC. Cisplatin (DDP) is an antineoplastic agent that has been used clinically for decades, and it is the first-line chemotherapy for many solid tumors. However, the therapeutic efficacy of DDP is often limited by resistance and the complexity of its resistance mechanisms, which involve multiple proteins and signaling pathways. It is well documented that a variety of microRNAs (miRNAs) differentially expressed in DDP-resistant GC cells play important roles in regulating or reversing DDP resistance via various pathways. In this review, we first provide an introduction to the cytotoxicity and major resistance mechanisms of DDP in GC and then discuss the role and mechanism of miRNAs in regulating the DDP resistance process in GC cells. This work demonstrates the potential of relevant miRNAs to become diagnostic and prognostic biomarkers for gastric cancer and targets of action to enhance chemosensitivity and provides directions for future research. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence of alpha hemolytic streptococcal (AHS) infections and related risk factors in patients with newly diagnosed acute myeloid leukemia (AML) undergoing consistent treatment. Study Design: Prospective study. Setting: Jinnah Teaching Hospital and DHQ Charsadda undergoing treatment from Hayatabad Medical Complex Peshawar. Period: June 2022 to February 2023. Material & Methods: AML patients were recruited and algorithmically followed for AHS infections. Core symptoms, diagnostic workups, differential diagnoses, and relevant treatments were assessed in this manner. Results: AHS caused 22% of bacteremic infections in 22% of patients, mostly by blood transmission (87%). After treatment, 32% recurred. AHS had a 60% mortality rate (P < 0.002). Age, precise induction timing, and high-dose cytarabine significantly enhanced AHS incidence (OR 2.0, 1.8-1.9, and 3.8, respectively). AHS infections increased hospital stays (P < 0.0002) and decreased long-term survival (OR 2.8; P < 0.001) and disease-free survival (OR 2.1; P 0.008) in bone marrow transplant patients. Conclusion: The first prospective study investigating AHS frequency in consistently treated individuals revealed increased rates with intensified AML therapy. AHS bacteremia is particularly likely in adults with prior cases and high-dose cytarabine usage. [ABSTRACT FROM AUTHOR]

Introduction Chronic rhinitis (CR) represents a widespread inflammation with a high incidence in the general population. Although it is generally considered a benign condition, CR has a relevant impact on quality of life and requires a specific treatment approach. Objective The aim of the present study was to investigate the efficacy of glycyrrhizin and mannitol intranasal treatment on chronic rhinitis using cytological analysis and subjective evaluation of symptoms. Methods A total of 55 patients suffering from chronic rhinitis were enrolled in the present study, 34 with allergic rhinitis (AR) and 21 with nonallergic rhinitis (NAR). The severity of four different nasal symptoms was determined by using a visual analogue scale (VAS). Specimens obtained by nasal scraping were collected for cytological analysis. Data were acquired before and after a 30-day treatment with glycyrrhizin and mannitol nasal spray. Statistical analyses were performed. Results The VAS scores for all four nasal symptoms considered in the present study, as well as for neutrophil cells, reduced significantly after therapy in both allergic and nonallergic patients. The number of eosinophils was not significantly lower in nonallergic patients. Conclusion A 30-day topical treatment with glycyrrhizin and mannitol may improve nasal symptoms and reduce inflammatory cells in the nasal mucosa in patients with chronic rhinitis without significant contraindications. Further studies could support our results and would better clarify all the aspects of this treatment. [ABSTRACT FROM AUTHOR]

Context The effectiveness of intermittent energy restriction (IER) and periodic fasting (PF) in the management of type 2 diabetes (T2D) remains a subject of discussion. Objective The aim of this systematic review is to summarize current knowledge of the effects of IER and PF in patients with T2D on markers of metabolic control and the need for glucose-lowering medication. Data Sources PubMed, Embase, Emcare, Web of Science, Cochrane Library, CENTRAL, Academic Search Premier, Science Direct, Google Scholar, Wiley Online Library, and LWW Health Library were searched for eligible articles on March 20, 2018 (last update performed November 11, 2022). Studies that evaluated the effects of IER or PF diets in adult patients with T2D were included. Data Extraction This systematic review is reported according to PRISMA guidelines. Risk of bias was assessed through the Cochrane risk of bias tool. The search identified 692 unique records. Thirteen original studies were included. Data Analysis A qualitative synthesis of the results was constructed because the studies differed widely in terms of dietary interventions, study design, and study duration. Glycated hemoglobin (HbA1c) declined in response to IER or PF in 5 of 10 studies, and fasting glucose declined in 5 of 7 studies. In 4 studies, the dosage of glucose-lowering medication could be reduced during IER or PF. Two studies evaluated long-term effects (≥1 year after ending the intervention). The benefits to HbA1c or fasting glucose were generally not sustained over the long term. There are a limited number of studies on IER and PF interventions in patients with T2D. Most were judged to have at least some risk of bias. Conclusion The results of this systematic review suggest that IER and PF can improve glucose regulation in patients with T2D, at least in the short term. Moreover, these diets may allow for dosage reduction of glucose-lowering medication. Systematic Review Registration PROSPERO registration no. CRD42018104627. [ABSTRACT FROM AUTHOR]

Introduction: Dysphagia as a consequence of multiple sclerosis (MS) puts individuals at higher risk of dehydration, malnutrition, and aspiration pneumonia. This study intended to investigate the effects of a combined program of neuromuscular electrical stimulation (NMES) and conventional swallowing therapy to improve swallow safety and efficiency, oral intake, and physical, emotional, and functional impacts of dysphagia in people with dysphagia and MS. Methods: In this single-case experimental study with ABA design, two participants with dysphagia caused by MS underwent 12 sessions therapy during 6 weeks following a baseline of 4 evaluation sessions. They were evaluated 4 more times in the follow-up phase after therapy sessions. Scores of Mann Assessment of Swallowing Ability (MASA), DYsphagia in MUltiple Sclerosis (DYMUS), and timed test of swallowing capacity were obtained at baseline, during treatment, and in the follow-up phases. The Dysphagia Outcome and Severity Scale (DOSS) based on videofluoroscopic swallow studies, Persian-Dysphagia Handicap Index (Persian-DHI), and Functional Oral Intake Scale (FOIS) were also completed before and after treatment. Visual analysis and percentage of nonoverlapping data were calculated. Results: MASA, DYMUS, FOIS, and DHI scores indicated significant improvement in both participants. Although the scores of the timed test of swallowing capacity in participant 1 (B.N.) and DOSS in participant 2 (M.A.) showed no changes, considerable improvements including reducing the amount of residue and the number of swallows required to clear bolus were seen in the posttreatment videofluoroscopic records of both participants. Conclusion: NMES in conjunction with conventional dysphagia therapy based on motor learning principles could improve the swallowing function and decrease disabling effects of dysphagia on different aspects of life in participants with dysphagia caused by MS. [ABSTRACT FROM AUTHOR]

Psoriasis management remains a challenge due to the difficulty of achieving therapeutic targets which are influenced by factors such as varying degrees of psoriasis, lack of therapeutic efficacy, and side effects of therapy. Various efforts are being made to find the best and most effective therapy. Pathogenesis of psoriasis is influenced by T cells, skin vascular disorders also play an important role. Angiogenesis in psoriasis is mediated by vascular endothelial growth factor (VEGF), angiopoietin, tumor necrosis factor-a (TNF-a), interleukin-8 (IL-8), and interleukin-17 (IL-17). VEGFA inhibitors still have not received approval in psoriasis therapy, however two case reports of psoriasis patients with 40% and 50% lesion areas experienced significant improvement after bevacizumab administration. The angiogenic factor of VEGF acts as an important biomarker in psoriasis vulgaris and is histopathologically found in keratinocytes. The standard therapy of psoriasis vulgaris has been known to have good efficacies, but both long-term efficacy and treatment failures often occur, patients could not prevent relapse and serious side effects. Therapeutic agents that target VEGF directly including anti-VEGF monoclonal antibodies, VEGF receptor antagonist fusion proteins, receptor tyrosine kinase inhibitors, NVP-BAW2881, and traditional therapeutic agent PSORI-CM02. These therapies are quite promising, though there are various side effects associated with systemic administration of VEGF inhibitors, including proteinuria, hypertension and impaired wound healing. Thus, the development of anti-VEGF as a therapy in the management of psoriasis requires careful evaluation especially to minimize the toxicity of the treatment. Although these therapies appear to be promising, there are a number of side effects associated with systemic VEGF inhibitor use, including proteinuria, hypertension, and poor wound healing. Consequently, the development of anti-VEGF as a therapeutic in the treatment of psoriasis necessitates careful consideration, particularly to limit treatment toxicity. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic significantly affected both existing and undiagnosed Tuberculosis (TB) patients worldwide. The impact of the pandemic on the treatment outcomes of these patients in India remains unclear. Aim: To assess the difference in TB treatment outcomes before and during the COVID-19 pandemic in an economically disadvantaged urban area in Southern India. Materials and Methods: A retrospective observational study was conducted at a TB Unit in South Bangalore, Southern India, serving a population of 2,50,000 from January 2022 to December 2022. Purposive sampling was employed to select 516 patients who had registered for TB treatment during the years 2019 and 2020. The socio-demographic details and TB profiles of the patients were collected and tabulated. Treatment outcomes were classified according to World Health Organisation (WHO) definitions after a case record analysis. Data were entered into Microsoft Excel 2018 and analysed using Open Epi software. Descriptive statistics, such as mean and standard deviation, were used to report socio-demographic profiles, and the Chisquare test was utilised to evaluate the differences in treatment outcomes. A p-value <0.05 was considered statistically significant. Results: The study included a total of 516 subjects. There were fewer cases registered in 2020 (n=202), especially after the first quarter, compared to the number registered in 2019 (n=314). The majority of the cases during both years were new instances of microbiologically confirmed pulmonary TB with no co-morbidities. Treatment success rates were 85.35% in 2019 and 88.61% in 2020, which was not statistically significant. Conclusion: There was a noticeable reduction in the number of cases registered during 2020, indicating that the COVID-19 pandemic had a definite effect on TB case notification. However, treatment success rates increased during the COVID-19 pandemic. This increase in the treatment success rate from 85.35% to 88.61% could be attributed to the decrease in the number of registered cases during the pandemic. The study thus found no significant impact on TB treatment success rate due to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Complex Regional Pain Syndrome (CRPS) is a disabling and distressing chronic pain condition characterised by a range of sensory, motor, autonomic and trophic symptoms. Guidelines recommend early referral for therapies that promote movement of the painful limb. However, evidence suggests a lack of defined therapy pathways for CRPS. Aims: The current study aims to explore CRPS therapy management in centres of excellence in England, and outside of these settings, to understand what facilitates and hinders best practice. The overall aim is to develop a draft stratified package of care to expedite patient access to optimal CRPS therapy across the management pathway. Methods and Analysis: Semi‐structured interviews will be conducted with therapists working in CRPS centres of excellence and with therapists in other settings. Observations of therapy interventions in CRPS centres of excellence and interviews with patients who have received this care, will also help to identify potential key care package components. Interview data will be analysed using thematic analysis, mapped to the Theoretical Domains Framework (TDF), and Intervention Mapping Adapt (IMA) framework. Observations will be described and documented using the TDF headings. Conclusion: A triangulation protocol for qualitative health research will be used to integrate all data. Online stakeholder events will be held using consensus methods to agree a draft package of care for future implementation following further refinement, testing and evaluation. Clinical Trial Registration: The trial was registered with ISRCTN registry on 24 February 2022 (ISRCTN16917807). [ABSTRACT FROM AUTHOR]

The aim was to investigate the effectiveness of Kinesio taping for lymphedema following head and neck cancer therapy and its effect on patient compliance and quality of life. A total of 66 patients with lymphedema following head and neck cancer therapy were randomly allocated to the therapeutic Kinesio taping group (n = 33) and the sham Kinesio taping group (n = 33). All participants received manual lymphatic drainage, Kinesio taping, and home exercises for the first four weeks, and only home exercises for the second four weeks. The tape measurements, a scale of external lymphedema, a scale of the internal lymphedema, and quality of life were evaluated in both groups. The perceived discomfort consisting of limitation of daily living activities, pain, tightness, stiffness, and heaviness were also recorded. When the group x time effect was evaluated, it was observed that external lymphedema was significantly reduced in both groups according to neck and face composite measurements (p <.001). However, in these measurements, a significant difference was found between the groups in favor of the KT group (p =.001, p =.032, respectively). At the end of the study, there was no significant difference in terms of internal lymphedema in both groups (p =.860). The quality of life parameters such as global health status and swallowing were significantly better in the Kinesio taping group (p <.001). There was no significant difference in the parameters of perceived discomfort between the two groups (p =.282, p =.225, p =.090, p =.155, p =.183, respectively). Kinesio taping is effective in tape measurements and positively affects the quality of life in lymphedema following head and neck cancer therapy. [ABSTRACT FROM AUTHOR]

Simple Summary: The emergence of new therapeutic agents for multiple myeloma (MM) over the last 2 decades has resulted in a significant improvement in overall survival (OS). However, this improvement might be associated with the increased incidence of second primary malignancies (SPMs). Most studies in the field reviewed patients that participated in phase 2–3 clinical studies, focusing on the incidence of SPMs. The current study evaluated the characteristics, management, and outcomes of MM patients diagnosed with SPMs outside clinical studies. In our study, we present real-world data of 165 MM patients that were diagnosed with SPM during the course of their disease; we offer detailed data on SPM characteristics and management, as well as valuable insights into the management of MM post-SPM detection and the actual prognosis of MM patients following SPM diagnosis. Background: There is an increased risk of second primary malignancies (SMPs) in patients with multiple myeloma (MM). This multinational 'real-world' retrospective study analyzed the characteristics and outcomes of MM patients that developed SPMs. Results: 165 patients were analyzed: 62.4% males; 8.5% with a prior cancer; 113 with solid SPMs, mainly ≥stage 2; and 52 with hematological SPM (hemato-SPM), mainly MDS/AML. Patients with hemato-SPM were younger (p = 0.05) and more frequently had a prior AutoHCT (p = 0.012). The time to SPM was shorter in the older (>65 years) and more heavily pretreated patients. One hundred patients were actively treated at the time of SPM detection. Treatment was discontinued in 52, substituted with another anti-MM therapy in 15, and continued in 33 patients. Treatment discontinuation was predominant in the patients diagnosed with hemato-SPM (76%). The median OS following SPM detection was 8.5 months, and the main cause of death was SPM. A poor ECOG status predicted a shorter OS (PS 3 vs. 0, HR = 5.74, 2.32–14.21, p < 0.001), whereas a normal hemoglobin level (HR = 0.43, 0.19–0.95, p = 0.037) predicted longer OS. Conclusions: With the continuing improvement in OS, a higher proportion of MM patients might develop SPM. The OS following SPM diagnosis is poor; hence, frequent surveillance and early detection are imperative to improve outcomes. [ABSTRACT FROM AUTHOR]

The infectious diseases resulting from pathogenic microbes are highly contagious and the source of infection is difficult to control, which seriously endangers life and public health safety. Although the emergence of antibiotics has a good therapeutic effect in the early stage, the massive abuse of antibiotics has brought about the evolution of pathogens with drug resistance, which has gradually weakened the lethality and availability of antibiotics. Cancer is a more serious disease than pathogenic bacteria infection, which also threatens human life and health. Traditional treatment methods have limitations such as easy recurrence, poor prognosis, many side effects, and high toxicity. These two issues have led to the exploration and development of novel therapeutic agents (such as conjugated polymers) and therapeutic strategies (such as phototherapy) to avoid the increase of drug resistance and toxic side effects. As a class of organic polymer biological functional materials with excellent photoelectric properties, Conjugated polymers (CPs) have been extensively investigated in biomedical fields, such as the detection and treatment of pathogens and tumors due to their advantages of easy modification and functionalization, good biocompatibility and low cost. A rare comprehensive overview of CPs-based detection and treatment applications has been reported. This paper reviews the design strategies and research status of CPs used in biomedicine in recent years, introduces and discusses the latest progress of their application in the detection and treatment of pathogenic microorganisms and tumors according to different detection or treatment methods, as well as the limitations and potential challenges in prospective exploration. [ABSTRACT FROM AUTHOR]

BACKGROUND: Extracorporeal shock wave therapy (ESWT) combined with Kinesio Tape (KT) for plantar fasciitis (PF) is lacking in the literature. OBJECTIVE: This study aimed to investigate the effect of ESWT combined with KT on foot pain and function in patients with PF based on ultrashort wave therapy and stretching. METHODS: A total of 91 patients with PF were randomly divided into the ESWT group (ETG, n = 23), KT group (KTG, n = 23), combined treatment group (CTG, n = 22) and control group (CG, n = 23). Herein, changes in visual analysis scale (VAS) score, plantar fascia thickness (PFT) and American Orthopaedic Foot and Ankle Society (AOFAS) score were examined. RESULTS: The groups were compared after 4 weeks and the results showed that the VAS scores of ETG, KTG and CTG were significantly smaller than that of CG (P < 0.05). In addition, the VAS score of CTG was significantly smaller than that of KTG (P < 0.001). Meanwhile, the AOFAS scores of ETG and CTG were significantly greater than that of CG (P < 0.001). Moreover, the AOFAS score of CTG was significantly greater than those of ETG and KTG (P < 0.01). Comparisons within groups were also conducted at weeks 0 and 4 and the results showed that the VAS scores of ETG, KTG and CTG significantly decreased (P < 0.001); the PFT of ETG and CTG significantly decreased (P < 0.05); and the AOFAS score of ETG, KTG and CTG significantly increased (P < 0.001). CONCLUSION: Based on ultrashort wave therapy and stretching, ESWT and KT therapy could improve the foot pain and function of patients with PF, and the combined modality therapy is more effective. ESWT and combined treatment has a positive effect on patients' PFT. However, single KT treatment has a limited effect on PFT. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sleep bruxism has been associated with temporomandibular dysfunction, pain, fatigue, and poor sleep quality. OBJECTIVE: The aim of this study was to determine the gender and age distribution of sleep and oral habits of children with sleep bruxism and to examine the effect of a sleep hygiene and physiotherapy program. METHODS: In this cross-sectional study, 82 children aged 6–13 years with sleep bruxism were initially screened between March 2020 and June 2021, from which 37 of them voluntarily attended an 8-week sleep hygiene and physiotherapy program. Evaluations were made using a Visual Analogue Scale (VAS), the Children's Sleep Habits Questionnaire (CSHQ), and the Oral Habits Questionnaire (OHQ) at the beginning and at the end of the 8-week program. RESULTS: Statistically significant differences were determined between the 6–9 years and 10–13-year age groups in respect of the sleep habits subcategories of resistance to bedtime (p = 0.001), sleep anxiety (p = 0.043), parasomnia (p = 0.040), and sleep respiratory disorder (p = 0.041). Following the 8-week treatment program, a significant reduction was obtained in the VAS value (p < 0.05), CSHQ subcategories of resistance to bedtime (p = 0.001), sleep duration (p = 0.008), parasomnia (p = 0.000), and in the OHQ score (p = 0.000). CONCLUSION: There was no relationship between sleep bruxism and gender, but a relationship was found with age. The rate of bruxism was seen to decrease with an increase in age. It was determined that oral, sleep habits, and bruxism are closely related, and the rates at which bruxism is seen are affected by the oral habits. Sleep hygiene and physiotherapy have been effective in children with sleep bruxism. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this report is to describe the course of chiropractic care for an adult male experiencing persistent anterolateral thigh pain due to bilateral meralgia paresthetica. Clinical features: A 40-year-old male U.S. Veteran was referred to chiropractic care for a two-year history of bilateral anterolateral thigh pain and paresthesia that worsened with inguinal pressure and hip extension activities. Intervention and outcomes: A total of six chiropractic visits, including a combination of telehealth and inperson appointments, took place over a period of 10 weeks. Treatments included patient education, soft-tissue therapy, therapeutic exercise prescription, and spinal manipulation directed toward the lumbar spine. The patient's pain was reduced from a 6/10 rating to a 0/10, he was able to reengage in recreational activities without discomfort, and sustained improvement was reported. Summary: In this case, a trial of chiropractic care was associated with a resolution of the patient's bilateral meralgia paresthetica symptoms. [ABSTRACT FROM AUTHOR]

Pathogenic variants in the PHEX gene cause rare and severe X-linked dominant hypophosphataemia (XLH), a form of heritable hypophosphatemic rickets (HR) characterized by renal phosphate wasting and elevated fibroblast growth factor 23 (FGF23) levels. Burosumab, the approved human monoclonal anti-FGF23 antibody, is the treatment of choice for XLH. The genetic and phenotypic heterogeneity of HR often delays XLH diagnoses, with critical effects on disease course and therapy. We herein report the clinical and genetic features of two Italian female infants with sporadic HR who successfully responded to burosumab. Their diagnoses were based on clinical and laboratory findings and physical examinations. Next-generation sequencing (NGS) of the genes associated with inherited HR and multiple ligation probe amplification (MLPA) analysis of the PHEX and FGF23 genes were performed. While a conventional analysis of the NGS data did not reveal pathogenic or likely pathogenic small nucleotide variants (SNVs) in the known HR-related genes, a quantitative analysis identified two different heterozygous de novo large intragenic deletions in PHEX, and this was confirmed by MLPA. Our molecular data indicated that deletions in the PHEX gene can be the cause of a significant fraction of XLH; hence, their presence should be evaluated in SNV-negative female patients. Our patients successfully responded to burosumab, demonstrating the efficacy of this drug in the treatment of XLH. In conclusion, the execution of a phenotype-oriented genetic test, guided by known types of variants, including the rarest ones, was crucial to reach the definitive diagnoses and ensure our patients of long-term therapy administration. [ABSTRACT FROM AUTHOR]

Background and objective: Evidence for the treatment of multisystem inflammatory syndrome in children (MIS-C) is lacking. Anakinra, which targets IL-1-mediated inflammation, is reserved for refractory cases of MIS-C; however, its use in the treatment of MIS-C is not clearly established. Patients and methods: To examine a role for anakinra in MIS-C, we performed a single center observational cohort study of all MIS-C patients diagnosed at our children's hospital from May 15 to November 15, 2020. Demographics, clinical features, diagnostic testing, and cardiac function parameters were compared between MIS-C patients treated with intravenous immunoglobulin (IVIG) monotherapy and IVIG with anakinra (IVIG + anakinra). Results: Among 46 patients with confirmed MIS-C, 32 (70%) were in the IVIG + anakinra group, of which 9 (28%) were also given corticosteroids (CS). No patients were treated with anakinra alone. MIS-C patients in the IVIG + anakinra group were enriched in a CV shock phenotype (p = 0.02), and those with CV shock were treated with higher doses of anakinra for a longer duration. Furthermore, MIS-C patients in the IVIG + anakinra group exhibited improvements in fever and cardiac function with or without CS. No significant adverse events were observed, and no differences in IL-1β levels were found among MIS-C patients in the IVIG + anakinra group. Conclusions: Anakinra treatment, which was co-administered with IVIG primarily in patients with severe MIS-C, was associated with improvements in fever and cardiac function, and demonstrated a favorable side-effect profile. These findings suggest a role for adjunctive anakinra in the treatment of severe MIS-C. [ABSTRACT FROM AUTHOR]

Simple Summary: No guidelines regarding optimal treatment exist for primary cervical lymphomas. We have performed a systematic review of the literature about the management of this rare pathology. Conservative treatment with the combination of surgery and chemotherapy or surgery and radiotherapy has been reported in a few cases with apparent success. Furthermore, we have reported pregnancy outcome in patients treated with a fertility sparing approach. The female genital tract can be involved as a secondary manifestation of disseminated lymphomas or leukaemia but can rarely be the primary site of so-called extranodal lymphomas. Primary lymphomas of the female genital tract can affect the uterine corpus, uterine cervix, vulva, vagina, or adnexa. Only about 0.008% of all cervical tumours are primary malignant lymphomas. The most common clinical presentation of primary cervical lymphomas is a history of prolonged minor abnormal uterine bleeding, while unstoppable bleeding at presentation is rarely reported in the literature. "B" symptoms related to nodal lymphomas are usually absent. Since vaginal bleeding is a nonspecific symptom, the first diagnostic hypothesis is usually of one of the more common female genital conditions such as cervical or endometrial carcinoma or sarcoma, fibroids, adenomyosis, or endometriosis. Cervical cytology is usually negative. Preoperative diagnosis requires deep cervical biopsy. No guidelines regarding optimal treatment exists; radiotherapy, chemotherapy, and surgery are used in different combinations. Conservative treatment with the combination of surgery and chemotherapy or surgery and radiotherapy has been reported in a few cases with apparent success. With this review, we aim to understand what the best therapeutic approaches for this rare pathology in young and elderly women are. Moreover, we find favorable pregnancy outcome in patients treated with a fertility sparing approach. [ABSTRACT FROM AUTHOR]

Background: The aim of this paper is the systematic review of psychological/psychosocial interventions for gender diverse youth under 18 years of age and their families, based on the published protocol: PROSPERO 2020 CRD42020163995. Methods: A search strategy was developed using key terms. An electronic literature search was completed using the following data bases (OVID MEDLINE; EBSCO CINAHL; ProQuest MEDLINE; OVID PsycINFO). Only studies published in English between 2001–2021 were included. This review is based on PRISMA guidance. Studies meeting inclusion criteria were quality appraised using the Mixed Methods Assessment Tool (MMAT). Results: 8405 studies were independently screened. Four studies met the inclusion criteria for the study. Parents of transgender youth attended between one and 11 psychological/psychosocial group interventions. Parents reported reduced isolation and increased knowledge, which enabled them to advocate for their young person's needs. Psychological/psychosocial group interventions were creating challenges in terms of group processes, with some parents dominating interactions. Psychological/psychosocial group interventions were positive for parents, but no outcomes were collected for transgender young people. Conclusion: More research is required to understand the role of group facilitators, the optimal group size and the number of psychological/psychosocial intervention sessions required. [ABSTRACT FROM AUTHOR]

Introduction: To support clinicians who treat children with upper-limb differences, we must first understand how these children are treated around the world. Study Design: A descriptive survey was carried out in this study. Objectives: The aim was to describe how treatment for children with upper-limb difference is provided in different parts of the world. Methods: A web-based survey was used to gather data. The survey was shared on the Handsmart website, through providers and members using snowball sampling. Results: Sixty-eight respondents from 18 countries, with most being occupational therapists and prosthetists, participated. All respondents reported that they provide prosthetic treatment and most fit a passive prosthesis before 1 year of age. Respondents from 13 countries reported having governmental funding for the provision of care for people with upper-limb loss. Intervention is guided by the presentation of the limb as well as availability of funding and other resources. In 12 countries, no treatment other than fitting of prostheses is provided for the children. The children who do not receive a prosthesis continue to see an occupational or physical therapist for other treatment (other devices, follow-up). Respondents stated that they would like to see clear treatment guidelines used by multidisciplinary teams to fit children and that treatment should include regular follow-up. Conclusions: Children are treated differently in various parts of the world based on different funding, family support, and therapy resources. Further studies should encompass a geographically representative sample of children's clinics. Clinical Relevance: This study provides information regarding treatment practices for children with upper-limb loss/difference in various parts of the world; prosthetic treatment is common for children, although ages for fitting vary among clinics and countries. Results will contribute by supporting clinicians to provide better treatment for children with upper-limb loss/difference. [ABSTRACT FROM AUTHOR]

With an increasing public interest in the roleplaying game 'Dungeons & Dragons' (D&D) comes the claim it holds psychological benefits. While the therapeutic roleplay is empirically well established, the evidence surrounding D&D is unclear. The current study aims to summarize the literature pertaining to this topic and present possible avenues for the implementation of D&D in psychological interventions. A Rapid Evidence Assessment (REA) was conducted following the standards by the Center for Evidence-Based Management. Relevant search strings were entered into seven databases (e.g., PsycArticles, PsycInfo, Child Development & Adolescent Studies). Only papers published in the English language till September 2020 were considered and their quality appraised. The thematic analysis of 13 studies yielded four themes: No unified personality type of D&D players, stakeholders' attitude about D&D, lack of maladaptive coping associated with D&D, and potential psychological benefits of D&D. The results appear promising, but preliminary. Practical implications are contextualized with the wider literature. [ABSTRACT FROM AUTHOR]

Microbubbles are 1–10 μm diameter gas-filled acoustically-active particles, typically stabilized by a phospholipid monolayer shell. Microbubbles can be engineered through bioconjugation of a ligand, drug and/or cell. Since their inception a few decades ago, several targeted microbubble (tMB) formulations have been developed as ultrasound imaging probes and ultrasound-responsive carriers to promote the local delivery and uptake of a wide variety of drugs, genes, and cells in different therapeutic applications. The aim of this review is to summarize the state-of-the-art of current tMB formulations and their ultrasound-targeted delivery applications. We provide an overview of different carriers used to increase drug loading capacity and different targeting strategies that can be used to enhance local delivery, potentiate therapeutic efficacy, and minimize side effects. Additionally, future directions are proposed to improve the tMB performance in diagnostic and therapeutic applications. [ABSTRACT FROM AUTHOR]

Simple Summary: Actinic keratosis (AK) is a premalignant skin lesion caused by chronic sun damage, which usually arises in older people on chronically sun-exposed areas of the body, such as the face, scalp, ears, neck, back of the forearms and hands. Actinic keratosis rarely occurs as a single lesion; most often it can involve multiple lesions in a field of cancerization. Since the AKs may progress to invasive squamous cell carcinoma, treatment of any AK regardless of clinical severity is strongly recommended. The goals of AK therapy are to eradicate clinical and subclinical lesions, prevent the progression into invasive squamous cell carcinoma, provide a good cosmetic outcome and reduce the risk of relapses. Multiple treatment options are available for this condition; however, no gold standard therapy has been established. A novel formulation of 4% 5-Fluorouracil with once daily application proved to be a highly effective and safe treatment for multiple actinic keratoses. Background: Actinic keratosis (AK) is one of the most common skin diseases, with a low risk of progression into invasive squamous cell carcinoma. We aim to assess efficacy and safety of a novel formulation of 5-Fluorouracil (5-FU) 4% with once daily application for the treatment of multiple AKs. Methods: A pilot study was performed on 30 patients with a clinical and dermoscopic diagnosis of multiple AKs, enrolled between September 2021 and May 2022 at the Dermatology Departments of two Italian hospitals. Patients were treated with 5-FU 4% cream once daily for 30 consecutive days. The Actinic Keratosis Area and Severity Index (AKASI) was calculated before starting therapy, and at each follow-up, to assess objective clinical response. Results: The cohort analyzed included 14 (47%) males and 16 (53%) females (mean age: 71 ± 12 years). A significant decrease in AKASI score at both 6 and 12 weeks (p < 0.0001) was observed. Only three patients (10%) discontinued therapy, and 13 patients (43%) did not report any adverse reactions; no unexpected adverse events were observed. Conclusions: In the setting of topical chemotherapy and immunotherapy, the new formulation of 5-FU 4% proved to be a highly effective treatment for AKs and field cancerization. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Arts‐based research is an established and accepted research approach and systematic reviews have been published on this methodology. There are many possible data collection techniques and study designs within arts‐based research, which have been implemented but not yet systematically reviewed.Rationales and challenges for arts‐based research have covered participants' experiences of being in arts‐based studies in health service research. What the paper adds to existing knowledge?: The main results of this systematic review are that mental health recovery concepts are effectively communicated by visual arts‐based research and participation in these studies is progressive and connecting for mental health consumers.This paper adds new knowledge about participants' experiences specifically in visual arts‐based studies, where the participants are mental health consumers. The results are significant because they support visual arts‐based research in its development and popularity, both as a research approach and as an empowerment intervention. What are the implications for practice?: The results of this systematic review can enhance the fields of qualitative research methods and mental health nursing. Recommendations for professional development can be advanced from consumers' ideas and experiences of recovery reported in this review.Nurse scientists and consumer researchers can take into consideration visual arts‐based data collection techniques for use as research and empowerment interventions with mental health consumer participants. Introduction: Art creation has been found to be therapeutic to mental health consumers, making the prospect of art creation's conceivable benefits as a mental health research strategy worthy of consideration. Aim: This systematic review aims to explore experiences of recovery among adults with a mental illness using visual art methods. Method: Following a comprehensive database search, 14 suitable studies were identified. These involved adult participants with a formal mental health diagnosis, or who self‐identify as having a mental illness. The studies employed arts‐based methodologies with participant‐created, visual art as their data. Articles underwent data extraction and quality appraisal with the JBI‐QARI (Qualitative Assessment and Review Instrument). Results: Results were categorised and further aggregated into two synthesised findings according to Joanna Briggs Institute (JBI) guidelines. The synthesised findings are: (1) Creative artmaking enables the use of visual metaphors which can aid expression of feelings, externalisation of identity, and personal learning, and (2) Interpersonal and self‐connectedness through inclusion in community, receiving support when needed, and progressing through loss, are beneficial for mental health recovery. Discussion: These findings are comparable to those already existing in the literature, and suggest that visual arts‐based research methods are as dependable as other qualitative research methods. Additionally, this systematic review reveals that when conducting research studies, there are benefits for mental health consumer participants when visual arts‐based methods are used. Implications for practice: A visual arts‐based research intervention can be concluded to have the effect of an empowerment intervention, as well as being a credible research method. [ABSTRACT FROM AUTHOR]

Aim: To answer the following PICOS question: "In patients with peri‐implantitis, what is the efficacy of surgical therapy with adjunctive systemic or local antimicrobials, in comparison with surgical therapy alone, in terms of pocket probing depth reduction, as assessed in randomized controlled trials (RCTs) with at least 6 months of follow‐up?" Materials and Methods: A systematic literature search was conducted. Reduction in mean probing pocket depth (PPD) was the primary outcome. Secondary clinical outcomes were changes in suppuration (%), changes in bleeding on probing (BOP) (%), marginal bone level changes (mm), disease resolution (%), and implant/prosthesis loss (%). Patient‐reported outcome measures, possible adverse effects, and oral‐health‐related quality of life were also extracted if such data were available. Results: Four RCTs assessing the use of locally (two RCTs) and systemically (two RCTs) administered antimicrobial adjuncts to surgical treatment of peri‐implantitis, with 6–36‐month follow‐up, were included. Because of the substantial heterogeneity of interventions between the studies, meta‐analysis could not be performed. A reduction in the mean PPD was observed following all the involved surgical treatments, irrespective of the addition of antimicrobials. Except for the effect of systemic antimicrobials on marginal bone level changes and local antimicrobials on BOP, the effect of systemic and local antimicrobials was equivocal for all secondary outcome measures. Conclusions: Based on the limited available evidence, the adjunctive use of the currently tested systemic or local antimicrobials during surgical therapy, in comparison with surgical therapy alone, in patients with peri‐implantitis does not seem to improve the clinical efficacy. With regard the use of systemic antimicrobials, only 50% of the cases showed disease resolution after 1 year. There is a lack of studies that consider the sole use of local antimicrobials. Therefore, their true effect remains unclear. [ABSTRACT FROM AUTHOR]

Aim: To answer the following PICOS question: In adult patients with peri‐implantitis, what is the efficacy of sub‐marginal instrumentation combined with chemical surface decontamination in comparison with sub‐marginal instrumentation with or without placebo, in terms of changes in probing depth (PD) and/or bleeding on probing, as reported in prospective randomized controlled trials, non‐randomized controlled trials, or prospective cohort studies, with a minimum of 6‐month "follow‐up". Materials and Methods: A systematic literature search was performed in PubMed, Web of Science, Embase, Scopus, Ovid Medline, and The Cochrane Library of the Cochrane Collaboration (CENTRAL) for articles published until March 2022. Data addressing the primary and secondary outcomes were extracted. Results: The search gave 2033 results of which 3 fulfilled the inclusion criteria. Two studies investigated the use of anti‐microbial photodynamic therapy as adjunct to sub‐marginal instrumentation and the third study assessed the adjunctive use of a desiccant material. A meta‐analysis was not deemed meaningful because of the large heterogeneity among the studies. All three studies showed favourable results in terms of PD reduction for chemical surface decontamination over control approaches, but were inconsistent or showed no differences for the other outcome variables. Conclusions: Adjunctive chemical approaches for implant surface decontamination may offer an advantage over sub‐marginal instrumentation alone, in terms of improved PD. [ABSTRACT FROM AUTHOR]