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Opportunities for the shared consumption of publicly available products that once might have been considered personal-use only, such as hand sanitizers and shampoos, are proliferating in the consumer environment. This work explores shared product consumption in these underresearched, but now ubiquitous, contexts. The authors suggest and find, over a series of five studies and across a variety of product domains, that sharing a product with strangers (i.e., sharing-out) engenders a lower sense of identification with the product, which leads to lower perceived product efficacy. They further show that the dampening effect of sharing-out on efficacy perceptions is limited to consumers high in self–brand connection. [ABSTRACT FROM AUTHOR]

The relative risk of pregnancy with the levonorgestrel 52 mg IUD is 3 times lower than with optimal combined oral contraceptive use.

Introduction: Coronavirus 2019 (COVID-19) inequitably impacted minority populations and regions with limited access to healthcare resources. The Barnes-Jewish Emergency Department in St. Louis, MO, serves such a population. The COVID-19 vaccine is an available defense to help achieve community immunity. The emergency department (ED) is a potential societal resource to provide access to a vaccination intervention. Our objective in this study was to describe and evaluate a novel ED COVID-19 vaccine program, including its impact on the local surrounding underserved community.Methods: This was a retrospective, post-protocol implementation review of an ED COVID-19 vaccination program. Over the initial six-month period, we compiled data on all vaccinated patients out of the ED to evaluate demographic data and the impact on underserved regional areas.Results: We report a successful ED-based COVID-19 vaccine program (with over 1,000 vaccines administered). This program helped raise regional and state vaccination rates. Over 50% of the population that received the COVID-19 vaccine from the ED were from defined socially vulnerable patient populations. No adverse effects were documented.Conclusion: Operation CoVER (COVID-19 Vaccine in the Emergency Room) Saint Louis was able to successfully vaccinate a socially vulnerable patient population. This free, COVID-19 ED-based vaccine program with dedicated pharmacy support, was novel in emergency medicine practice. Similar ED-based vaccine programs could help with future vaccine distribution.

BackgroundPort wine birthmark (PWB) is a congenital vascular malformation of the skin. Pulsed dye laser (PDL) is the "gold standard" for the treatment of PWB globally. Hematoporphyrin monomethyl ether (HMME or hemoporfin)-mediated photodynamic therapy (HMME-PDT) has emerged as the first choice for PWB treatment, particularly for young children, in many major hospitals in China during the past several decades.AimTo evaluate whether HMME-PDT is superior to PDL by comparing the clinical efficacies of both modalities.MethodPubMed records were searched for all relevant studies of PWB treatment using PDL (1988-2023) or HMME-PDT (2007-2023). Patient characteristics and clinical efficacies were extracted. Studies with a quartile percentage clearance or similar scale were included. A mean color clearance index (CI) per study was calculated and compared among groups. An overall CI (C0 ), with data weighted by cohort size, was used to evaluate the final efficacy for each modality.ResultA total of 18 HMME-PDT studies with 3910 patients in China were eligible for inclusion in this analysis. Similarly, 40 PDL studies with 5094 patients from nine different countries were eligible for inclusion in this analysis. Over 58% of patients in the HMME-PDT studies were minors (

AIM: The study aims to provide insights into the key predictors of grit both before, during and throughout a common crisis event, where other more individualised challenges may not provide these insights. DESIGN: A repeated cross-sectional design. METHODS: Data were collected via an anonymous questionnaire among n = 818 (20.8% response rate) nursing students who were undertaking a three-year baccalaureate degree. Data collection occurred in the mid-year break of 2019, 2020 and 2021. The online questionnaire, which examined student demographics, personality, locus of control-4, general self-efficacy, psychological capital and grit, took 15-25 min to complete. Data were prepared and analysed using Statistical Package for the Social Sciences to undertake Structural Equation Modelling. Reporting methods adhered to the STROBE guidelines. RESULTS: The pathway models of grit prior to, at the time of, and after the global pandemic varied slightly as to their predictor variables, however, neuroticism was consistently present. Locus of control and psychological capital also varied over this period with hope having a positive impact, prior to and after the initial crisis, however, negatively impacted grit afterwards. Understanding the key drivers of grit, particularly those essential at or around the time of a crisis guides our understanding of how to better support nursing or healthcare students. These insights enable a greater focus of energies towards malleable attributes that can increase grit levels and better fortify nursing students for challenges they may encounter in practice. These insights also serve to further prepare healthcare, emergency, or other professionals who may encounter regular crises. Within months of a global pandemic occurring, the key predictors of grit were shown to fundamentally alter. Each pathway model varied slightly suggesting the timing of a crisis impacts students capacity to manage new or novel situations, with hope as a key driver of grit throughout a crisis.

The study aimed to determine the level of self-efficacy of Public Secondary Social Science Teachers in the three selected schools of District V in Quezon City in formulating a basis for a development program for teachers to foster inclusive education. Likewise, the teachers' profiles were also examined as part of the investigation. To achieve this goal, the researcher conducted a study to determine the level of self-efficacy in terms of inclusive instruction, collaboration, and managing behavior among public secondary social science teachers in the three selected public schools of District V in Quezon City. In this manner, the explanatory sequential mixed method was used to measure the teachers' degrees of self efficacy. The researcher also identified the concerns encountered by the public secondary social science teachers in terms of resources, difficulties, appropriateness, and workload. A qualitative design was also utilized to identify the challenges encountered by the respondents. A total of eighty-four (84) social science teachers currently employed in the three selected public secondary schools in District V of Quezon City were involved in this study using purposive sampling. Furthermore, data for the study were collected using two tools: the adapted Teacher Efficacy for Inclusive Practice (TEIP) scale, developed by Sharma et al. (2014), to assess teacher self-efficacy in inclusive education, and an adapted and standardized survey questionnaire, the Concerns about Inclusive Education Scale -- Short Form (CIES-SF), also designed by Sharma et al. (2022), to explore challenges faced by teachers during the qualitative phase. The results revealed that the level of self-efficacy among public secondary social science teachers is high self-efficacy. The result on the significant difference in their level of self-efficacy against the profile variables of teachers revealed no significant difference. Ultimately, a basis for a development program in fostering inclusive education in the classroom was proposed to improve their level of self efficacy in addressing the challenges encountered by public secondary social science teachers. [ABSTRACT FROM AUTHOR]

The study explores the evolution of supervision in educational settings, focusing on the transition from traditional inspection methods to more developmental and clinical supervisory practices. Using a descriptive correlational research design, the study systematically examines the relationship between supervisory practices and teachers' efficacy in the Division of Cabuyao City. A self-constructed questionnaire, validated by experts and utilizing a Likert scale, was administered to public school teachers in Cabuyao to assess their perceptions of supervisory practices and their own efficacy. The findings indicate that supervisors, school heads, and master teachers in Cabuyao City public schools actively engage in pre-observation, classroom observation, and post-conference analysis, which are crucial for fostering a supportive learning environment. These practices include detailed pre-observation preparations, the use of COT-RPMS rating sheets, and constructive feedback during post-observation conferences. Additionally, the study reveals that elementary teachers in Cabuyao City demonstrate high levels of student engagement, effective instructional strategies, and strong classroom management skills. The research identifies a significant correlation between supervisory practices and teachers' efficacy, particularly in areas such as pre-observation conferences and classroom management. This suggests that enhanced supervisory practices lead to improved teacher performance, highlighting the need for a compilation of best supervisory practices to guide effective teacher supervision. The study contributes to the understanding of how supervisory practices impact teachers' professional growth and offers insights for improving educational supervision in public schools. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the benefits of combining omalizumab with specific immunotherapy (SCIT) in the treatment of children with bronchial asthma. Methods: In this study, 83 children with asthma were treated at the Allergy Department of Qingdao University from January 2019 to February 2020. Participants were divided into three groups: SCIT, combination (omalizumab + SCIT), and control (standard asthma medications). We assessed Asthma Control Questionnaire (ACQ) scores, Visual Analogue Scale (VAS) scores, and lung function at baseline, 24 wk, and 48 wk. Additionally, asthma medication scores were compared at 24 and 48 wk. Adverse reactions were monitored in both the SCIT and combination groups. Results: The combination group demonstrated lower ACQ scores at both 24 and 48 wk, and improved VAS scores at 48 wk compared to the other groups. Additionally, lung function parameters (FEV1 and FEF50) showed significant improvement in the combination group. Reduced asthma medication scores were noted in the combination group at 24 and 48 wk. Local adverse reactions were fewer in the combination group, and no systemic adverse reactions were reported. Conclusion: Combining omalizumab with SCIT provides quicker asthma control, lowers medication requirements, and enhances lung function with fewer adverse effects, making it a safe and effective treatment for children with bronchial asthma. [ABSTRACT FROM AUTHOR]

Valbenazine is a highly potent and selective inhibitor of synaptic vesicular monoamine transporter 2. The current therapeutic doses of valbenazine for tardive dyskinesia (TD) are 40, 60, or 80 mg capsules, given orally, once daily (QD). While 40 and 80 mg were investigated in phase 3 KINECT® 3 trial and initially approved, the approval of valbenazine 60 mg was based on the analysis utilizing the Model‐informed drug development (MIDD) approach, facilitated through the US Food and Drug Administration's MIDD Pilot Program. This study aimed to demonstrate the efficacy of 60 mg QD dose through model simulations using an established exposure‐response (E‐R) relationship between valbenazine active metabolite [+]‐α‐dihydrotetrabenazine exposure and the change from baseline in Abnormal Involuntary Movement Scale total score (AIMS‐CFB). A longitudinal E–R model was constructed based on the 40 and 80 mg data from the KINECT 3 trial. The final Emax model adequately predicted dose‐dependent improvement in the primary endpoint and was used to interpolate AIMS‐CFB for 60 mg at week 6. The efficacy of the unstudied 60 mg dose regimen is expected to be within the range of doses studied clinically with predicted mean AIMS‐CFB (95% confidence interval) of −2.69 (−3.30, −2.13) between observed mean AIMS‐CFB for 40 mg of −1.92 and 80 mg of −3.39. Results from this analysis provided the key evidence to establish efficacy of 60 mg QD without the need for an additional clinical trial. The availability of valbenazine 60 mg dose fills an existing medical need for patients with TD who could benefit from this third effective dose. [ABSTRACT FROM AUTHOR]

Objectives: Foot and ankle impairments are major issues in patients with rheumatoid arthritis (RA). Foot deformities often lead to skin disorders, such as callosities, ingrown toenails, and interdigital tinea pedis. This study was aimed at investigating the efficacy and limitations of foot care by experts in patients with RA. Methods: Thirty-one patients with RA who began receiving foot care from nurses at our institution between September 2020 and February 2023 were included. Responses to a survey using the self-administered foot evaluation questionnaire (SAFE-Q) for patient-reported outcome measures were compared at baseline, the second visit (1.3 ± 0.5 months after baseline), and the third visit (3.6 ± 1.6 months after baseline). Results: Scores for 'Pain and pain-related' and 'General health and well-being' components of SAFE-Q markedly improved after foot care. On the other hand, there were no significant differences in the scores for 'Physical functioning and daily living', 'Social functioning', and 'Shoe-related' components during observation periods. Conclusions: Foot care for rheumatoid feet is effective in providing pain relief and improving general health and well-being. However, physical and social functioning and footwear issues did not improve. Clinicians must understand the effects and limitations of foot care in patients with RA. [ABSTRACT FROM AUTHOR]

Introduction: Over the past decade, several randomized controlled trials have compared single-day dexamethasone (dexamethasone-sparing) regimens to the current standard multi-day dexamethasone antiemetic regimen for chemotherapy-induced nausea and vomiting (CINV). The aim of this systematic review and meta-analysis is to compare the efficacy and safety of dexamethasone-sparing regimens to standard multi-day dexamethasone, used for the prophylaxis of CINV. Methods: Ovid Medline and Embase were searched from database inception to March 2024. Studies were included if they reported on randomized controlled trials of adult cancer patients receiving different scheduling of dexamethasone, for the endpoints of complete response, complete control, no nausea, no vomiting, and no use of rescue medication. Safety was also assessed. Meta-analysis, leave-one-out meta-analysis, and cumulative meta-analysis were conducted to generate summary effect estimates and assess the influence of single trials on the summary effect estimate. Results: Ten trials reporting on 2234 patients were included. Dexamethasone-sparing regimens were found to be no different to control arm in the acute (Risk Ratio [RR] 1.01; 95% CI, 0.94–1.08), delayed (RR 0.97; 95% CI, 0.89–1.05) and overall phases (RR 0.98; 95% CI, 0.90–1.06) for complete response. There was likewise no difference for complete control, no nausea, no vomiting, and no use of rescue medication. Safety profile was similar. There was no concern for bias in the published literature. No difference was found between studies reporting on anthracycline/cyclophosphamide-based highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC). Conclusion: In this comprehensive systematic review and meta-analysis, dexamethasone-sparing regimens were found to be no different to current multi-day regimens with respect to efficacy and safety for MEC and anthracycline/cyclophosphamide-based regimens. Clinicians and future guidelines should strongly consider greater adoption and endorsement of dexamethasone-sparing regimens. [ABSTRACT FROM AUTHOR]

Background: Tirbanibulin 1% ointment is approved for the field treatment of Olsen grade I actinic keratoses (AKs) of the face and scalp. Methods: We performed a multicenter retrospective study involving 15 dermatologic units in Italy to investigate the efficacy and tolerability of tirbanibulin in a real‐life setting. 250 patients were enrolled. Tirbanibulin, 1% ointment, was applied daily for five consecutive days. The efficacy of treatment was measured with modifications of the Actinic Keratosis Area and Severity Index (AKASI). A satisfactory response was defined by complete (100% reduction in the number of lesions) or partial clearance (75–99%) of treated AKs. Results: Overall, the AKASI score was significantly reduced in the studied population (mean, from 4.1 ± 2.7 to 1.4 ± 1.5; P < 0.001). A satisfactory response was observed in 222 (88.8%) cases. The proportion of satisfactory responses was higher when follow‐up was performed after 8 weeks (34/35, 97.1%). The reduction in AKASI was significant in patients with Olsen grade II or III lesions (from 5.3 ± 2.8 to 1.6 ± 1.6; P < 0.001). A satisfactory response was observed in 91/104 (87.5%) cases. AKASI reduction was also significant in patients with trunk or limb AKs (from 7.0 ± 1.3 to 2.0 ± 1.6; P = 0.018) since a satisfactory response was observed in 7/8 (87.5%) cases. Tirbanibulin was well tolerated; all adverse events (AEs) included transient local reactions at the site of treatment. Overall, 231 patients had at least one AE. Only 7 (2.8%) grade 4 AEs were recorded. Conclusion: Our retrospective study confirmed that tirbanibulin 1% ointment is effective and well tolerated in a real‐life setting and is also promising for Olsen grade II and grade III AKs and AKs localized on difficult‐to‐treat areas. [ABSTRACT FROM AUTHOR]

Thymic carcinoma (TC) is a rare form of highly invasive tumors. Currently, the standard first-line therapy involves paclitaxel plus carboplatin treatment, while the recommended regimen for second-line therapy remains uncertain. The purpose of this study is to explore the second-line mode of TC patients. We evaluated the outcome of subjects with advanced TC between 2009 and 2023 in three medical centers, retrospectively. Tumor response was evaluated according to the Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1). Kaplan-Meier was used for calculating Progression-free survival (PFS) and overall survival (OS). The factors affecting survival in the real world were evaluated by Cox analysis. Totally 136 patients were included in this study, the median PFS (mPFS) for all subjects was 5.97 months, and the median OS (mOS) was 25.03 months. According to patient's treatment modes, they are divided into monotherapy (n = 95) and combination therapy (n = 41), PFS manifested the difference between two groups (5.17 vs. 9.00 months, P = 0.043). OS also indicated a significant distinction (22.50 vs. 38.00 months, P = 0.017). Furthermore, there was a significant difference in PFS between patients using immunotherapy combined with chemotherapy and those with antivascular therapy (8.57 vs. 13.10 months, P = 0.047). In the second-line therapy for advanced TC, the efficacy of combination therapy was better than monotherapy, especially for immunotherapy combined with antivascular therapy. • One hundred and thirty-six patients were enrolled, including 95 patients with monotherapy and 41 with combination therapy. • The efficacy of combination therapy was better than that of monotherapy. • Immunotherapy combined with anti-angiogenesis therapy showed better efficacy in second-line TC patients. [ABSTRACT FROM AUTHOR]

Objective: In recent years, endoscopic ultrasound‐guided radiofrequency ablation (EUS‐RFA) has emerged as an alternative nonsurgical treatment for pancreatic neuroendocrine tumours. The aim of our study was to assess the long‐term follow‐up of patients treated with EUS‐RFA for a sporadic insulinoma in our centre in terms of efficacy, safety and risk of recurrence. Design, Patients and Measurements: We retrospectively analysed the data of 11 patients with an insulinoma treated by EUS‐RFA in our tertiary centre between June 2018 and April 2022. Clinical and biological, as well as imaging, follow‐up was planned at 3, 6, 12 months and then annually. Results: In our series, there were nine women and two men with a median age of 65 years. All tumours were sporadic, with a mean size of 11 mm. The procedure allowed an immediate and complete symptomatic and biological remission in all patients without notable complications. Complete radiological resolution of the tumour after ablation was observed in seven patients, and persistence of an asymptomatic tumour residue was observed in four patients. During the mean follow‐up period of 26 months, two patients presented a significant but asymptomatic increase of the tumour residue; a second EUS‐RFA session was performed in one patient and the other patient is being closely monitored. Conclusions: EUS‐RFA treatment of benign insulinomas provides a long‐term complete clinical resolution of hypoglycaemia. A long‐term follow‐up is essential if residual tumour persists after initial EUS‐RFA treatment. [ABSTRACT FROM AUTHOR]

This study systematically reviewed the scientific literature on natural remedies for male sexual dysfunction (MSD), including conditions like erectile dysfunction, premature ejaculation, and reduced libido. Limited scientific evidence exists regarding the efficacy and safety of these natural products. To ensure an objective assessment, the study used the Scopus database, followed the PRISMA guidelines, and employed a comprehensive search strategy involving relevant vital concepts, controlled vocabularies, and specific inclusion/exclusion criteria. The analysis included 1504 documents from 624 journals, spanning from 1967 to 2023. The literature showed an annual growth rate of 2.46%, with an average document age of 10.2 years and an average of 23.54 citations per document. India had the highest publication count (319), followed by the United States (164). Conceptual Mapping categorized themes into basic, motor, niche, emerging, and declining categories, including nitric oxide, oxidative stress, phytotherapy, herbal medicine, Asparagus racemosus, and dopamine. This mapping provided a holistic understanding of the field, identified research gaps, and guided the development of new interventions or treatment strategies for MSD. Trend topics include molecular coupling, Ashwagandha, phytochemistry, phosphodiesterase-5, and arginase. The study findings will assist healthcare professionals in making informed decisions when recommending or advising patients about the use of these remedies. [ABSTRACT FROM AUTHOR]

Intraoperative controlled hypotension improves surgical field visibility by reducing blood loss (efficacy) but poses potential risks linked to organ hypoperfusion (safety). The use of controlled hypotension persists despite increasing evidence of associations between intraoperative inadvertent hypotension and adverse outcomes. Therefore, we tested the hypothesis that the focus and results of intraoperative controlled hypertension research differ across anaesthesia and surgery investigators because of differing priorities. We systematically reviewed randomised trials comparing controlled hypotension with usual care with trials categorised by investigators' affiliation. We identified 48 eligible trials, of which 37 were conducted by anaesthesia investigators and 11 by surgery investigators. For the primary outcome, 54% of the anaesthesia-led trials focused on safety, whereas all (100%) surgery-led trials focused on efficacy (P =0.004). Compared with usual care, mean arterial pressure in controlled hypotension was 23% (95% confidence interval [CI] 17–29%) lower in anaesthesia trials and 30% (95% CI 14–37%) lower in surgery trials; estimated blood loss was 44% (95% CI 30–55%) less in anaesthesia trials and 38% (95% CI 30–49%) less in surgery trials. Overall, blood loss was reduced by 43% (95% CI 32–53%), and trial sequential analysis supported an efficacy conclusion. Mean arterial pressure and estimated blood loss reductions were associated (R2=0.41, P =0.002). All trials were underpowered for safety outcomes, and none adequately evaluated myocardial or renal injury. Anaesthesia researchers prioritised safety outcomes, whereas surgery researchers emphasised efficacy in controlled hypotension trials. Controlled hypotension significantly reduces blood loss. In contrast, safety outcomes were poorly studied. Given increasing observational evidence linking inadvertent hypotension to myocardial and renal injury, the safety of controlled hypotension remains to be addressed. PROSPERO (CRD42023450397). [ABSTRACT FROM AUTHOR]

Context: The use of methadone for cancer pain management is gaining wider acceptance. However, switching to methadone treatment can still pose challenges. Consequently, there is ongoing development of its use in low doses in combination with other opioids, despite a lack of clinical evidence regarding its efficacy and safety. Objectives: This study aimed to evaluate the efficacy and tolerability of low-dose methadone in combination with another opioid in patients with moderate-to-severe cancer-related pain in a clinical setting. Patients and methods: This was a prospective, open-label study conducted in 19 pain and/or palliative care centres treating patients with cancer-related pain. Pain intensity, patients' global impression of change, and adverse effects were assessed on day 7 and day 14. The main outcome measure was the proportion of responders. Results: The study included 92 patients. The daily dose of methadone was 3 [3–6] mg at baseline, 9 [4–10] mg on day 7 and 10 [6–15] mg on day 14. The NRS pain ratings significantly decreased from 7 [6–8] at baseline to 5 [3–6] on visit 2 (p <.0001) and 4 [3–6] on visit 3 (p <.0001). Similarly, the VRS pain ratings decreased from 3 [3–3] at baseline to 2 [2–3] on visit 2 (p = 0.026) and 2 [1–3] (p < 0.001) on visit 3. At Visits 1 and 2, half of the patients were considered Responders. Of those responders, 73.5% were High-Responders at Visit 1 and 58.7% were High-Responders at Visit 2. No adverse events related to the risk of QT prolongation, overdose, or drug interactions were reported. Conclusion: For patients experiencing moderate to severe cancer-related pain despite initial opioid treatment, our study found that low-dose methadone, when used in combination with another opioid, was both safe and effective. This supports the use of methadone as an adjunct to opioid-based treatment for cancer pain. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy and safety of dapagliflozin versus placebo as an add‐on in patients with type 2 diabetes who did not achieve adequate glycaemic control with evogliptin and metformin combination. Patients and Methods: In this multicentre, randomized, double‐blind, placebo‐controlled Phase 3 trial, patients with glycated haemoglobin (HbA1c) levels ≥7.0% (≥53 mmol/mol) and ≤10.5% (≤91 mmol/mol) who had received stable‐dose metformin (≥1000 mg) and evogliptin (5 mg) for at least 8 weeks were randomized to receive dapagliflozin 10 mg or placebo once daily for 24 weeks. Participants continued treatment with metformin and evogliptin. The primary endpoint was change in HbA1c level after 24 weeks of treatment from baseline level. Results: In total, 198 patients were randomized, and 195 patients were included in the efficacy analyses (dapagliflozin: 96, placebo: 99). At Week 24, dapagliflozin significantly reduced HbA1c levels. The least squares mean difference in HbA1c level change from baseline after 24 weeks of treatment was −0.70% (−7.7 mmol/mol) (p < 0.0001). The proportion of participants achieving HbA1c <7.0% (≥53 mmol/mol) was higher in the dapagliflozin group than in the placebo group. Compared to placebo, dapagliflozin significantly reduced fasting plasma glucose, mean daily glucose, 2‐h postprandial plasma glucose, fasting insulin, uric acid and gamma‐glutamyl transferase levels, homeostatic model assessment for insulin resistance index, body weight, hepatic steatosis index, and albuminuria. Adiponectin level significantly increased from baseline level after 24 weeks of dapagliflozin treatment. Adverse event rates were similar in the two groups. Conclusion: Dapagliflozin add‐on to evogliptin plus metformin improved glycaemic control and was well tolerated by the target patients. [ABSTRACT FROM AUTHOR]

Treatment options for epidermal growth factor receptor (EGFR)-mutant advanced non-small cell lung cancer (NSCLC) following tyrosine kinase inhibitor (TKI) failure are limited, and platinum-based chemotherapy remains the main treatment. The development of effective immunotherapy for this disease has been challenging. In the present study, 37 patients with EGFR-mutant advanced NSCLC who were treated with programmed cell death-1 (PD-1) inhibitor-based combinations after TKI failure were reviewed. The total cohort had a median progression-free survival (mPFS) of 5.2 months (95% CI, 4.077-6.323 months) and a median overall survival (mOS) of 18.3 months (95% CI, 12.932-23.668 months). Patients with Eastern Cooperative Oncology Group performance-status (ECOG-PS) scores of 0 or 1 had longer mPFS than those with ECOG-PS scores of 2 (5.4 vs. 2.4 months; P=0.006). In addition, a PFS benefit was observed in patients with EGFR T790M-negative compared with EGFR T790M-positive tumors (mPFS 6.2 vs. 4.4 months; P=0.041). Patients treated with immunotherapy-based combinations as a front-line therapy had a longer mPFS than those in which the combinations were used as a late-line therapy (6.2 vs. 2.4 months; P<0.001). PD-1 inhibitor combined with chemotherapy and bevacizumab did not show a clear advantage over PD-1 inhibitor combined with chemotherapy alone (mPFS, 6.2 vs. 4.4 months; P=0.681), although it resulted in an improved overall response rate (ORR) and disease control rate. Notably, the 7 patients with a programmed cell death ligand-1 (PD-L1) tumor proportion score of ≥50% had an ORR of 100% and an mPFS of 8.3 months. Therefore, it is suggested that PD-1 inhibitor-based combinations should be a priority treatment option in selective populations, such as those with low ECOG-PS scores, T790M-negative status or high PD-L1 expression in EGFR-mutant NSCLC after TKI failure. The use of immunotherapy and chemotherapy in combination with antiangiogenic agents appears to be a promising combination therapy for such patients. [ABSTRACT FROM AUTHOR]

Background: A challenge to implementation is management of the adaptation-fidelity dilemma or the balance between adopting an intervention with fidelity while assuring fit when transferred between contexts. A prior meta-analysis found that adapted interventions produce larger effects than novel and adopted interventions. This study attempts to replicate and expand previous findings. Methods: Meta-analysis was used to compare effects across a whole-population of Swedish outcome studies. Main and subcategories are explored. Results: The 523 studies included adapted (22%), adopted (33%), and novel (45%) interventions. The largest effect was found for adapted followed by novel and adopted interventions. Interventions in the mental health setting showed the highest effects, followed by somatic healthcare and social services. Conclusions: These results replicate and expand earlier findings. Results were stable across settings with the exception of social services. Consistent with a growing body of evidence results suggest that context is important when transferring interventions across settings. [ABSTRACT FROM AUTHOR]

Ideally, interest groups form a link between citizens and politics. However, this link is often flawed in practice. Many citizens also feel that the average citizen is not heard and that special interests exert undue influence on policymaking. One proposal to address this problem is the stimulation of so-called citizen lobby: Ordinary citizens can use lobbying strategies to achieve influence on decision-makers. This benefits both policymakers and citizens as it can empower citizens to make their voices heard and it can help policymakers to build perceived legitimacy among citizens that are dissatisfied with existing decision-making processes. Formal channels for citizen lobby often exist but remain underused. However, what happens when governments actively engage with citizen lobby? We conducted two survey experiments in the Netherlands (N = 1218) and showed that engagement with citizen lobby has no systematic effect on internal political efficacy but has robust positive effects on political support. [ABSTRACT FROM AUTHOR]

To retrospectively evaluate the efficacy and safety of ultrasound-guided microwave (MWA), radiofrequency (RF), and high-intensity focused ultrasound (HIFU) ablation in the treatment of uterine leiomyoma and to provide a suggestion for the selection of clinical treatment of uterine leiomyoma. The retrospective cohort studies on the efficacy of high-intensity focused ultrasound in treating uterine leiomyoma was collected through a literature search in Pubmed, Embase, Cochrane library, Scopus, and Web of Science, and selected according to the specified inclusion criteria and exclusion criteria. Evaluate the study quality, extract relevant data, and RevMan 5.4.1 was used to conduct this meta-analysis. Compared with HIFU therapy, the complete or partial ablation rate and recurrence rate of uterine leiomyoma treated with RFA/MWA were statistically different (P < 0.05). Compared with RF, the overall efficacy of HIFU in treating uterine leiomyoma was not as good as that of RF. There was no significant difference between the RFA therapy and the MWA. HIFU still has mild and short-term complications, such as abdominal pain, bloody vaginal discharge, sacral pain, and fever. Although myomectomy is usually the first choice for uterine preservation, RFA/MWA and HIFU have also been shown to relieve clinical symptoms significantly, shorten treatment time, reduce complications, and improve prognosis. [ABSTRACT FROM AUTHOR]

Objective: This post-hoc analysis of data extracted from a prospective study aimed to explore for the first time if the efficacy of fremanezumab in preventing difficult-to-treat migraine, according to ICHD-III, would differ between pre-menopausal and post-menopausal women. Methods: A total of 171 (aged 18–70 years) fremanezumab-treated female migraine patients for six consecutive months were classified to those at pre-menopausal (n = 82) or post-menopausal (n = 89). Monthly headache days (MHD), disability, and quality of life (QOL) outcomes were assessed at baseline and at week 24 post-fremanezumab within subgroups and were then compared between them. Safety and tolerability were also assessed. Results: In both groups, fremanezumab demonstrated significant reductions in MHDs, reduced disability, and higher QOL scores at week 24 post-treatment, compared to baseline. However, the between-subgroup comparison documented that pre-menopausal women and those at post-menopausal comparably benefited with significant reductions in overall MHDs (p = 0.883). Less disability, according to MIDAS (p = 0.696) and HIT-6 scores (p = 0.912), as well as higher QOL scores at week 24 post-fremanezumab, were also comparably evident in both groups. Safety was excellent across both subgroups. Conclusion: Fremanezumab can be considered a very effective treatment option for preventing migraines in difficult-to-treat women, aged 18–70 years, regardless of their menopausal status. [ABSTRACT FROM AUTHOR]

Introduction: Iparomlimab (QL1604) is a humanized immunoglobulin G4 mAb against programmed cell death protein 1 (PD-1). Here, we report the preliminary efficacy, safety, pharmacokinetics, and immunogenicity of iparomlimab in patients with advanced solid tumors. Methods: In this open-label, phase 1c study, patients with advanced or metastatic solid tumors, either failed or had no standard therapies available, were enrolled and received intravenous iparomlimab at 3 mg/kg once every 3 weeks. The primary efficacy endpoint was the objective response rate (ORR) assessed by the investigator per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Results: Between July 20, 2020, and September 6, 2021, 71 patients were enrolled and received at least one dose of iparomlimab. The ORR was 9.9% (7/71) and disease control rate was 36.6% (26/71). Median duration of response of all responders was 10.7 months [95% confidence interval (CI), 1.4-not estimable]. Additionally, the median time to progression, progression-free survival, and overall survival were 1.4 months (95% CI, 1.4–2.8), 1.4 months (95% CI, 1.4–2.7), and 9.7 months (95% CI, 7.2–15.3), respectively. A total of 52 (73.2%) patients experienced treatment-related adverse events (TRAEs) (grade ≥ 3, 19.7%). The most common TRAE (≥ 10%) was anemia (18.3%). A total of 20 (28.2%) experienced immune-related adverse events (grade ≥ 3, 7.0%). TRAEs leading to discontinuation of study drug occurred in 4 (5.6%) patients, including immune-mediated myocarditis (2 patients), Guillain–Barré syndrome (1 patient), and diarrhea (1 patient). Conclusions: Iparomlimab showed preliminary clinical activity and had a manageable safety profile in patients with advanced solid tumors. These results support further investigation of iparomlimab as monotherapy or in combination therapy in advanced solid tumors. Trial Registration: ClinicalTrials.gov identifier, NCT05801094. Retrospectively registered in 2023–03–24. [ABSTRACT FROM AUTHOR]

Product adherence is critical to obtaining objective estimates of efficacy of pre-exposure prophylactic interventions against HIV-1 infection. With imperfect adherence, intention-to-treat analyses assess the collective effects of complete, sub-optimal and non-adherence, providing a biased and attenuated estimate of the average causal effect of an intervention. Using data from the MTN-020/ASPIRE phase III trial evaluating HIV-1 efficacy of the dapivirine vaginal ring, we conducted per-protocol, and adherence-adjusted causal inference analyses using principal stratification and marginal structural models. We constructed two adherence cut offs of ≥ 0.9 mg (low cutoff) and > 4.0 mg (high cutoff) that represent drug released from the ring over a 28-day period. The HIV-1 efficacy estimate (95% CI) was 30.8% (3.6%, 50.3%) (P = 0.03) from the per-protocol analysis, and 53.6% (16.5%, 74.3%) (P = 0.01) among the highest predicted adherers from principal stratification analyses using the low cutoff. Marginal structural models produced efficacy estimates (95% CIs) ranging from 48.8 (21.8, 66.4) (P = 0.0019) to 56.5% (32.8%, 71.9%) (P = 0.0002). Application of adherence-adjusted causal inference methods are useful in interpreting HIV-1 efficacy in secondary analyses of PrEP clinical trials. [ABSTRACT FROM AUTHOR]

Beekeepers in order to control the Varroa population, apply oxalic acid (OA) by trickling, spraying, evaporating, or fumigating, onto broodless colonies for higher efficacy. Recently, a new method was developed using strips with OA and glycerin during brood-rearing periods. However, there has been little research regarding the optimum concentration of the active ingredient and the suitable solvents to reach maximum efficacy. Thus, in the present study, we applied strips with different concentrations of OA in different mixtures of glycerin, assessed the efficacy of the method throughout a 4-year experiment, and compared it with others, commonly followed by beekeepers. Among the tested concentrations of OA, the optimum was 21% (w/v) (60 g OA, 130 mL glycerin, and 100 mL water), while the presence of water made the strips more manageable. The corrected efficacy of the method ranged from 90.4% to 94.5%, despite the different climate conditions prevailing each year and the presence of brood. All the tested concentrations presented a high number of fallen mites in the first 15–18 days, as glycerin releases OA slowly into the hive. On the other hand, synthetic acaricides or other methods (fumigation, essential oils) presented a corrected efficacy range from 10.1% to 85.6%, requiring more in some formulations repetitions. No bees' toxicity was observed in all study cases. The results showed that the application of strips with 21% (w/v) OA diluted in glycerin and water seems to be more practical, leading to a successful Varroa control even in seasons with brood presence. [ABSTRACT FROM AUTHOR]

ABSTRACT Clinical studies of tenofovir amibufenamide (TMF) and tenofovir alafenamide (TAF) treatment in patients with HBV‐related decompensated cirrhosis (HBV‐DC) are limited. This study evaluated the efficacy and safety of TMF versus TAF in naive‐treated patients with first‐time HBV‐DC. Based on the antiviral drug used, patients were categorised into the TMF group and the TAF group. Virological and serological responses, hepatic and renal functions and blood lipid changes in both groups were evaluated during 48 weeks of treatment. A total of 98 patients were enrolled, 45 in the TMF group and 53 in the TAF group. At 48 weeks of treatment, the proportions of patients who achieved complete virological response (CVR) were 85.7% and 90.7%, respectively (p = 0.791). Improvement of at least 2 points in Child–Turcotte–Pugh scores was observed in 64.3% versus 79.1% (p = 0.169) of the patients. There were no significant changes in serum creatinine, estimated glomerular filtration rate or total cholesterol from baseline to week 48 between the two groups. Cystatin C remained stable in the TMF group but increased over time in the TAF group (p < 0.001). Low‐density lipoprotein cholesterol remained stable in the TMF group but increased significantly in the TAF group at week 48 (p = 0.015). These results suggest that both TMF and TAF can rapidly suppress HBV replication, improve hepatic function and have no negative effects on renal function among patients with HBV‐DC. Regarding lipid metabolism, both showed a better safety, while regular monitoring of blood lipid levels is recommended. [ABSTRACT FROM AUTHOR]

Tofacitinib is an oral Janus kinase inhibitor for the treatment of psoriatic arthritis (PsA). These post hoc exposure–response (E–R) analyses of pooled data from two Phase 3 studies (NCT01877668 and NCT01882439) characterized the relationships between tofacitinib exposure and efficacy (American College of Rheumatology [ACR] criteria), and changes in hemoglobin (Hgb) in patients with PsA. Efficacy data for the proportion of patients receiving tofacitinib 5 or 10 mg twice daily, or placebo, achieving ACR ≥20%, ≥50%, or ≥70% response criteria (ACR20, ACR50, and ACR70, respectively) at Month 3, were modeled jointly using a four‐category ordered categorical exposure–response model (ACR20 non‐responder, ACR20 responder but not ACR50 responder, ACR50 responder but not ACR70 responder, and ACR70 responder). A maximum drug effect (Emax) model (using average concentrations of tofacitinib at steady state [Cavg]) adequately described the exposure–ACR response rate relationship. Model‐predicted response rates for tofacitinib 5 and 10 mg twice daily were 51% and 58%, respectively, for ACR20; 29% and 36% for ACR50; and 15% and 20% for ACR70. The E–R relationship between tofacitinib exposure and changes in Hgb was assessed using an indirect response model, which generally predicted Hgb concentration–time profiles across treatments well. The proportions of patients experiencing a decrease in Hgb of >2 g/dL were similar with tofacitinib 5 mg twice daily or placebo. These results were generally consistent with previous analyses in rheumatoid arthritis and psoriasis, and support the use of tofacitinib 5 mg twice daily for active PsA. [ABSTRACT FROM AUTHOR]

Background: Docetaxel (DOC) and ramucirumab (RAM) is one of the most effective regimens for advanced non-small cell lung cancer (NSCLC) treatment. In our previous study, baseline anemia was identified as a preventive factor against the development of severe adverse effects during the first treatment cycle. It was hypothesized that anemia directly promotes tumor angiogenesis, leading to the elevation of RAM efficacy with increased DOC delivery to tumors, while reducing DOC delivery to other organs, potentially mitigating severe adverse effects. If this hypothesis is correct, patients with baseline anemia may have better clinical outcomes than those with normal hemoglobin levels. In this study, we aimed to investigate the effect of baseline anemia on the efficacy of DOC + RAM in treating advanced NSCLC in a real-word setting. Methods: Patients with advanced NSCLC receiving DOC + RAM (n = 72) were retrospectively assessed. They were categorized into a control group with normal baseline hemoglobin levels and an anemia group with baseline anemia. The primary endpoint was progression-free survival (PFS) evaluation. Results: Patients in the anemia group had a significantly shorter PFS than that of patients in the control group (median PFS: 3.2 and 6.2 months; 95% confidence interval [CI]: 2.2–4.8 and 4.3–9.9 months, respectively;P = 0.008). In addition, the disease control rate in the anemia group was 65.8%, which was significantly lower than that in the control group (93.6%; P = 0.007). Overall survival tended to be shorter in patients with anemia than in controls, although the difference was not statistically significant (P = 0.07). Multivariate Cox hazard analysis suggested that baseline anemia was a singular risk factor for poor PFS (adjusted hazard ratio 1.84, 95% CI 1.08–3.13; P = 0.02). The incidence of severe adverse effects did not differ between the two groups. Conclusions: This study suggests that the PFS of patients with anemia treated with DOC + RAM for advanced NSCLC is shorter than that of those without the symptoms. [ABSTRACT FROM AUTHOR]

Background: Thymoma is a primary tumor of the thymus, commonly located in the anterior mediastinum. Most thymomas are benign or low‐grade malignant, but they can invade surrounding organs or metastasize. The primary treatment for thymoma is surgical resection. Traditional methods involve open thoracotomy, but it is traumatic, with slow recovery and many complications. In recent years, with the development of thoracoscopic techniques, thoracoscopic total thymectomy has gradually become the preferred method for small size thymomas due to its minimally invasive, safe, and effective. Methods: This paper introduces a thoracoscopic extend thymectomy technique, the subxiphoid video–assisted thoracoscopic extend thymectomy with sternal suspension. This method involves placing hooks at the upper and lower ends of the sternum to suspend the sternum upward, increasing the thoracic cavity space and facilitating thoracoscopic operations. This research reviews the clinical data of 59 patients with early‐stage thymomas treated with this technique at our center since 2020 and analyzes the perioperative therapeutic efficacy and safety. It also compares the outcomes with those of 17 patients who underwent thoracoscopic approaches. Results: The results show that subxiphoid video–assisted thoracoscopic total thymectomy with sternal suspension is an innovative and effective surgical method, achieving the same tumor eradication as other thoracic surgeries. The flexible switching of observation ports provides a more comprehensive surgical field, reduces surgical trauma and complications, and improves the surgical outcomes and quality of life for patients. [ABSTRACT FROM AUTHOR]

Palmoplantar pustulosis (PPP) is often considered as pustular psoriasis of extremities. Benvitimod has been approved for mild to moderate psoriasis. We thus designed this study to evaluate the efficacy and safety of benvitimod for treating PPP. Of 47 PPP patients recruited from 4 hospitals, 40 finished 8 weeks visit and completed 4 weeks safety follow‐up visit. The Palmoplantar Pustular Psoriasis Area and Severity Index (PPPASI) and Dermatology Life Quality Index (DLQI) scores fell continuously. At week 8, mean ± SD PPPASI and DLQI were 3.39 ± 3.86 (p < 0.0001) and 2.49 ± 3.34 (p < 0.0001), respectively. At week 8, 70% (28/40) achieved PPPASI‐50 response, 35% (14/40) achieved PPPASI‐75 response, and 17.5% (7/40) achieved PPPASI‐90 response. Relapse occurred in 7.5% (3/40) of the patients. Of 47 patients enrolled, self‐reported compliance was 12.77% (6/47). Common drug‐related adverse events (5/47) included xerosis cutis. Only one patient's disease progressed during treatment. Our study demonstrated the efficacy and safety of benvitimod. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND METHODS RESULTS IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY CONCLUSION Teachers can face demanding and stressful working conditions. Classroom environments in elementary schools are dynamic and challenging, which can be mentally and emotionally exhausting for teachers. This study aimed to investigate the prevalence of psychological distress and identify associated factors among elementary school teachers.This is an analytical, observational cross‐sectional study. The participants consisted of 450 teachers selected using the cluster sampling method from elementary schools of Tabriz, Iran. Multiple regression analysis was performed to examine the associations between teachers' psychological distress and potential factors.The study found a significant proportion of participants (54.2%) experiencing psychological distress. Multiple regression analysis revealed age, sex, work experience, school type, family income status, teachers' efficacy, emotional labor, and presenteeism were statistically associated with teachers' psychological distress.To address teachers' psychological distress, schools need to adopt policies that promote teacher well‐being and mental health support.The high prevalence of psychological distress among elementary school teachers raises concerns and highlights the need for attention. Schools and administrators must provide teachers with the resources and support they need to succeed in their roles. Interventions targeting the identified associated factors must be planned to improve the mental health of elementary school teachers and enhance their overall performance. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Tisotumab vedotin (TV) holds promise for treating recurrence or metastatic cervical cancer (r/mCC), with recent FDA approval for second‐line use in recurrent or metastatic cases. Our research aims to evaluate TV's efficacy and safety in these patients, focusing on overall survival (OS) and progression‐free survival (PFS) outcomes.We searched five electronic databases in February 2024, retrieved articles, screened them based on inclusion and exclusion criteria, and assessed their quality. A meta‐analysis of the extracted data was performed and applied a random‐effects model for our analysis.The search identified 86 articles, with six meeting the inclusion criteria. Meta‐analysis revealed 80.8% and 48.0% OS at 6 and 12 months, and a 29.9% PFS at 6 months. Combined treatment with carboplatin or pembrolizumab showed 33.0% PFS at 1 year and 15.1% at 2 years. The objective response rate (ORR) was 21.0%, reaching 43.3% with combined treatment. Confirmed disease control rate (CDCR) was 70.0% overall and in combination. The median duration of response (DOR) was 6.1 months, increasing to 9.5 months in combined treatment, with a consistent time to response (TTR) of 1.4 months. Adverse events included ocular issues (conjunctivitis 30.3%, dry eye 18.7%) and common side effects (nausea 38.4%, epistaxis 35.7%).This systematic review and meta‐analysis highlights the potential of TV as a treatment option for r/mCC patients. However, healthcare providers must communicate safety profiles and recommend prophylactic measures for optimal patient outcomes. Further studies, particularly assessing combination treatments, are needed to clarify TV's role in treatment algorithms and improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Objective: The primary objective of this clinical trial is to investigate the effect of low-intensity pulsed ultrasound (LIPUS) on patients suffering from comorbid erectile dysfunction (ED) and chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods: The clinical trial was conducted in the andrology outpatient treatment room of the Department of Urology, Xiangya Hospital, Central South University from August to November 2022 A total of 60 patients who met the research criteria for comorbid ED combined with CP/CPPS were recruited and randomly assigned to three treatment groups. They were treated with LIPUS (Group A), drug therapy(Group B), and LIPUS combined with drug therapy (Group C), respectively. Each group comprised 20 patients. Statistical analysis was performed on the five-item version of International Index of Erectile Function (IIEF-5), Erection Hardness Score (EHS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the nine-item Patient Health Questionnaire (PHQ-9), the seven-item Generalized Anxiety Disorder Scale (GAD-7), and the incidence of adverse events to comprehensively evaluate the efficacy and safety of LIPUS. Results: The positive response rate of ED and CP/CPPS treatment in Group A is 40%(8/20) and 45%(9/20), while those in Group B is 55%(11/20) and 60%(12/20), and those in Group C is 85%(17/20) and 85%(17/20). A notable increase in IIEF-5 scores was observed across the three groups post-treatment (10.45 ± 2.50 vs. 13.65 ± 3.03, P = 0.008; 11.80 ± 3.21 vs. 16.40 ± 3.20, P = 0.011; 12.90 ± 3.92 vs. 19.40 ± 2.35, P = 0.042) with a concomitant significant decrease in NIH-CPSI scores (16.75 ± 4.53 vs. 14.65 ± 4.51, P = 0.016; 16.35 ± 4.32 vs. 12.20 ± 4.74, P = 0.007; 16.00 ± 4.40 vs. 8.15 ± 4.28, P = 0.021). Notably, the most pronounced changes were seen in the group receiving LIPUS combined with tadalafil and doxazosin. Additionally, all groups exhibited marked improvements in anxiety and depression symptoms post-treatment. No adverse events were observed during treatment. Conclusion: LIPUS can improve erectile function and CP/CPPS symptoms with good safety, and LIPUS combined with tadalafil and doxazosin is more effective during the treatment. However, its long-term efficacy remains to be seen. Trial Registration: Chinese Clinical Trial Registry; approval number: ChiCTR2200063038 (https://www.chictr.org.cn/) on August 29, 2022. [ABSTRACT FROM AUTHOR]

Background: Chronic hepatitis C virus (CHC) infection represents a crucial health problem, especially among children and adolescents. The ledipasvir (LDV)/sofosbuvir (SOF) regimen has been approved to treat adolescents (aged 12 to 17 years old) infected with hepatitis C virus (HCV) genotypes 1, 4, 5, and 6 and then extended to include children above or equal to 3 years old. The current study aims to evaluate the safety and efficacy of SOF/LDV combination in treating CHC-infected 12- to 17-year-old adolescents. Patients and methods: This retrospective cohort study was performed on 147 Egyptian adolescents with CHC. The patients were treated with SOF 400 mg/LDV 90 mg combination once daily for 12 weeks. Possible side effects and laboratory data including HCV ribonucleic acid polymerase chain reaction (RNA PCR), complete blood count (CBC), and liver tests were recorded at baseline and week 12 after the end of treatment (EOT). Results: Sustained virological response 12 weeks (SVR12) after end of treatment (EOT) was observed in 146 out of 147 patients (99.3%). The treatment regimen was efficiently tolerated with no reported cases of discontinuation caused by intolerability. Moreover, the side effects were minimal; 71.4% of the patients did not report any side effects related to the treatment. However, the rest mentioned fatigue, headache, or both of them. Fatigue was the main side effect reported in 16.3% of the patients. Furthermore, ALT and AST levels were normalized after treatment. FIB-4 and APRI scores were statistically significantly decreased 2 years post-SVR, in comparison to their levels before treatment, from 0.34 and 0.36 to 0.25 and 0.17, respectively. Conclusion: The LDV/SOF regimen is one of the safe regimens used to treat adolescent patients with CHC infection. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the safety and efficacy of transurethral holmium laser enucleation of the prostate (HoLEP) compared to bipolar transurethral resection of the prostate (bTUR-P) in the treatment of benign prostatic hyperplasia (BPH). Methods: A total of 220 BPH patients hospitalized from January 2022 to September 2023 were included in this study. These patients were randomly assigned to HoLEP and bTUR-P groups, with 110 participants in each group. We collected preoperative general information, perioperative data, complications, and postoperative follow-up indicators from both groups of patients. Results: The baseline characteristics of patients in both groups were similar, with no statistical significance (P > 0.05). Compared to the bTUR-P group, the HoLEP group exhibited significantly less intraoperative bleeding (P < 0.001), shorter bladder irrigation time (P = 0.002), shorter catheter retention time (P < 0.001), and reduced postoperative hospitalization (P = 0.002). Additionally, the pain score during urination after catheter removal was significantly lower in the HoLEP group (P < 0.001). Postoperative complications occurred in both groups; however, they were less frequent in the HoLEP group (4 cases), primarily consisting of urinary retention and postoperative bleeding. The bTUR-P group experienced more complications (9 cases). Significant reductions in postoperative residual urine volume (RUV) were observed in both groups (P < 0.001). Both groups also showed significant improvements in Quality of Life (QoL) scores and International Prostate Symptom Scores (IPSS), with the HoLEP group demonstrating a more significant decrease in IPSS (P < 0.001). Conclusion: After comprehensive evaluation, HoLEP was superior to bTUR-P in terms of safety and efficacy. Therefore, HoLEP may be a preferable choice for the treatment of BPH. [ABSTRACT FROM AUTHOR]

Scholars acknowledge that adolescents' political discussions with peers and adults contribute to political development, yet longitudinal relationships between discussions and political motivation remain unclear. To address this issue, we analyzed data from students enrolled in government courses at three Midwestern high schools, who completed political engagement surveys at the beginning and end of the spring 2016 semester (N = 350; 47.8% Hispanic; 37.2% White; 53.7% male). Informed by theories of motivation and political socialization, we used cross‐lagged panel models to examine the longitudinal associations between the frequency of political discussions (with friends, classmates, teachers, and parents) and motivational constructs (political interest, internal and external political efficacy). Multigroup analyses examined differential effects for students with low, average, and high political open‐mindedness. Results indicated that frequency of political discussions with parents predicted later political motivation for adolescents with low open‐mindedness. Interest, internal and external political efficacy distinctively predicted types of discussions over time, with interest emerging as the most consistent predictor. Findings suggest that educational practices could better cultivate youth political motivation by considering fadeout effects for different types of conversational partners and tailoring discussions to suit adolescents' open‐mindedness. [ABSTRACT FROM AUTHOR]

Schistosomiasis is a group of both acute and chronic parasitic trematode infections of the genus Schistosoma. Research into schistosomiasis has been minimal, leading to its classification as a neglected tropical disease, yet more than 140 million people are infected with schistosomes globally. There are no treatments available for early-stage infections, schistosomal dermatitis, or Katayama syndrome, other than symptomatic control with steroids and antihistamines, as the maturing organisms seem to be mostly resistant to typical antiparasitics. However, praziquantel (PZQ) has been the drug of choice for schistosomiasis for decades in the latter stages of the disease. Though it is effective against all three clinically relevant species, heavy reliance on PZQ has led to concerns of schistosome resistance, especially in areas that have implemented this drug in mass drug administration (MDA) programs. This article summarizes the available literature concerning the available evidence for and against a warranted concern for PZQ resistance, genomic studies in schistosomes, proposed mechanisms of resistance, and future research in alternative methods of schistosomiasis treatment. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion Acne is a chronic inflammatory skin disease that negatively affects patients' quality of life. Increasing antibiotic resistance is making acne less responsive to treatment. Probiotics are live microorganisms that can provide health benefits by fighting pathogens and maintaining intestinal homeostasis and skin microbiome balance. This study investigates the effects of probiotics in the treatment of acne vulgaris.In this randomized controlled clinical trial, 80 patients with moderate acne were divided into two groups of 40. All patients received the same topical treatment, which consisted of a daily antibacterial face wash and Adapalene gel every other night. The control group received one capsule of doxycycline (100 mg) daily, whereas the intervention group received one probiotic capsule daily in addition to doxycycline. Patients underwent photography of facial acne lesions, and treatment response was assessed using the global acne grading system (GAGS) and acne grading method at baseline, as well as during follow‐up visits at 1, 2, and 3 months.The global acne grading system indicated that both groups showed improvement. However, analyses revealed that outcomes were significantly better in the doxycycline plus probiotics group for the forehead (p = 0.018), chin (p = 0.021), and nose (p = 0.021). No significant differences were observed for the left and right cheeks, back, and chest areas, with the mean GAGS score reduction between the two groups differing by only 2%. Treatment with probiotics significantly reduced the severity of lesions compared to the control group (p < 0.001). The acne grading method also indicated that the intervention group had a significantly better treatment response than the control group (p < 0.001). Furthermore, treatment with probiotics did not result in any side effects.Probiotics can serve as an effective and safe treatment option, enhancing the outcomes of routine acne treatments, particularly for patients with acne on the forehead, chin, and nose. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Methods Results Conclusions Rosacea is a chronic inflammatory skin disease characterized by flushing, erythema, papules, and pustules on the central face. It affects patient appearance and is noted for its chronicity, recurrence, and resistance to treatment. Effective rosacea treatment requires repairing the skin barrier, reducing inflammation, and promoting vasoconstriction.This study aims to evaluate the efficacy of topical ferulic acid in treating papulopustular rosacea and its impact on skin barrier function.Sixty patients with mild to moderate papulopustular rosacea were selected from the Department of Dermatology at the Affiliated Hospital of Shandong Second Medical University between January 2023 and December 2023. Patients were randomly assigned to either a control group or an observation group, with 30 patients in each group. The observation group applied ferulic acid solution to the affected areas, while the control group used normal saline, both twice daily for 6 weeks. Both groups also received 0.1 g doxycycline hydrochloride tablets orally once daily. Skin lesions and skin barrier function were assessed using VISIA imaging and self‐rating scales before and during treatment, and adverse reactions were recorded.After 6 weeks, both skin lesion assessments and self‐assessment scores improved significantly from baseline, with greater improvement in the observation group compared to the control group (p < 0.05). Indicators of skin barrier function and VISIA imaging results demonstrated the efficacy of ferulic acid in treating rosacea. The total effective rate was significantly higher in the observation group (80.00%) compared to the control group (63.33%) (p < 0.05). In the observation group, nine patients (30.00%) experienced a greasy sensation initially, one patient (3.33%) reported tingling and itching, and no serious adverse reactions were observed.Ferulic acid is effective as an adjuvant treatment for papulopustular rosacea, significantly improving skin lesions and repairing skin barrier function with minimal adverse reactions. [ABSTRACT FROM AUTHOR]

Summary Idiopathic multicentric Castleman disease (iMCD) is a rare and heterogeneous lymphoproliferative disorder that lacks standardised treatment options for patients with refractory or relapsed (r/r) disease. Blocking Bruton's tyrosine kinase (BTK) has emerged as a promising therapeutic approach for iMCD without depleting B cells. This single‐centre, retrospective study enrolled 10 patients with r/r iMCD who were treated with orelabrutinib, a novel, next‐generation BTK inhibitor. The median age at orelabrutinib initiation was 48 (range: 31–58) years. The overall response rate was 70% (7/10 patients, 95% CI: 34.8–93.3), with 20% (n = 2) achieving complete response and 50% (n = 5) achieving partial response. The median time to response was 9.8 (range: 5.9–20.5) months. Patients in the non‐responder group also demonstrated a continuous improvement in haemoglobin (91–105 g/L) and albumin (32–38 g/L) levels at month 12 of treatment despite not fulfilling response criteria. No grade 3 or higher adverse events occurred during the median time to the next treatment of 29.0 (range: 15.0–36.2) months. No patient mortality was recorded during the median follow‐up duration of 32.8 (range: 15.0–36.9) months. In conclusion, orelabrutinib is a safe and effective regimen for r/r iMCD. [ABSTRACT FROM AUTHOR]

Key points Omalizumab enables children who are intolerant to AIT to initiate AIT successfully. Combination therapy better improves asthma and rhinitis symptoms, FeNO, and lung function compared to single SCIT or omalizumab treatment. Combination therapy reduces the incidence of adverse reactions during the initial phase of SCIT and enhances its safety. Omalizumab enables children who are intolerant to AIT to initiate AIT successfully.Combination therapy better improves asthma and rhinitis symptoms, FeNO, and lung function compared to single SCIT or omalizumab treatment.Combination therapy reduces the incidence of adverse reactions during the initial phase of SCIT and enhances its safety. [ABSTRACT FROM AUTHOR]

Relapsed/refractory (R/R) primary and secondary central nervous system lymphomas (PCNSL, SCNSL) are associated with short survival and represent an unmet need, requiring novel effective strategies. We retrospectively compared the safety and efficacy of CD19/22 CAR-T-cell therapy following ASCT (ASCT + CAR-T group), CD19/22 CAR-T-cell cocktail therapy (CAR-T group) and chemoimmunotherapy (CIT group) in treating R/R CNSL patients. Analysis of the differences in clinical characteristics among the three groups revealed that the median age in the CIT group was older than that in the ASCT + CAR-T group and CAR-T group, and the median number of prior lines of therapy in the CIT group was less than that in the other groups. Patients in the two CAR-T-therapy groups exhibited comparable incidences and severities of CRS and ICANS. Grade 4–5 CRS and ICANS were not observed in either CAR-T-cell therapy group. The incidence of Grade 3/4 hematological toxicity in the ASCT + CAR-T and CAR-T groups was greater than that in the CIT group. The ORR was 82.75% in the ASCT + CAR-T group, 60.00% in the CAR-T group and 58.83% in the CIT group. As of December 31, 2022, the median follow-up after therapy was 16.73 months (range, 0.67-42.00 months). The median durations of PFS and OS were not reached in the ASCT + CAR-T group. The median PFS in the CAR-T group was 4.72 months, and OS was not reached. In the CIT group, the median PFS and OS were 6.63 months and 16.77 months, respectively. The 2-year PFS rate of patients in the ASCT + CAR-T group (65.52%) was significantly greater than that of patients in the CAR-T group (30.00%, P = 0.0321) and CIT group (23.53%, P = 0.0043). Our results support the development of CAR-T-cell therapy for R/R CNSL. With the durability of remission and low toxicity, ASCT combined with CAR-T-cell therapy appears to be a more effective and safer treatment option for primary and secondary R/R CNS lymphoma. [ABSTRACT FROM AUTHOR]

Background: Chimeric antigen receptor T-cell (CAR-T) therapy has offered new opportunities for patients with relapsed/refractory B-cell lymphoblastic leukemia (r/r B-ALL). However, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are the two most common toxicities following CAR-T cell therapy. At present, whether the occurrence of CRS and ICANS will impact CAR-T activity remains unknown; this affects the therapeutic efficacy of CAR-T. Methods: In this multicenter retrospective study, we enrolled 93 patients with r/r B-ALL receiving anti-CD19 CAR-T cell therapy at four medical centers. We evaluated their complete response (CR) rates, minimal residual disease (MRD)-negative CR rates, and survival outcomes. Results: Among the included patients, 76 (81.7%) developed CRS and 16 (5.3%) developed ICANS. Fifteen patients experienced concurrent CRS and ICANS. However, no significant differences were noted in CR or MRD-negative CR rates between patients with and without CRS/ICANS. Furthermore, no significant difference was noted in leukemia-free survival (LFS) (p = 0.869 for CRS and p = 0.276 for ICANS) or overall survival (OS) (p = 0.677 for CRS and p = 0.326 for ICANS) between patients with and without CRS/ICANS. Similarly, patients with concurrent CRS and ICANS exhibited no differences in OS and LFS when compared with other patients. Multivariate analysis showed that the development of CRS and ICANS was not associated with any difference in OS and LFS. Conclusion: Patients with CRS/ICANS experience similar clinical outcomes compared with those without CRS/ICANS following anti-CD19 CAR-T therapy. [ABSTRACT FROM AUTHOR]

This study aimed to determine the efficacy of the World Food Program to the pupils' performance of Binidayan Elementary School. This study utilized the descriptive qualitative, in which there were thirty (30) randomly selected Grades IV to VI pupils in Binidayan Elementary School, Binidayan District, Lanao del Sur II, ARMM. Findings revealed that the World Food Program has an effect on the increased of the academic performance, the behavior, the attendance, the nutritional status, and the enrollment of the respondent. There was no significant relationship between the status of World Food Program implementation to the academic performance, behavior, attendance, nutritional status (BMI) and enrollment of the respondent. One of the primary goals of World Food Programs was to provide meals or snacks to reduce short-term hunger in the classroom so that the students can concentrate and learned better, and to attract children to school and have them attend class regularly. An action plan is recommended to be followed to sustain the World Food Program. [ABSTRACT FROM AUTHOR]

Objective: Given the lack of global consensus on anesthesia selection for peritoneal dialysis catheter (PDC) placement via open surgery, this study investigates the safety and efficacy of combining local infiltration anesthesia (LIA) with monitored anesthesia care (MAC) in patients with end-stage renal disease (ESRD). Methods: This retrospective analysis of ESRD patients who underwent open surgical placement of PDC in the Department of Nephrology, the First Affiliated Hospital of the Army Medical University from 1 August 2020 to 31 May 2022. Patients were categorized into two groups based on anesthesia method: LIA group and LIA + MA group. MA was defined as preoperative sedation (0.2–0.7 µg/kg/h) with dexmedetomidine injection (Huidrican trade name, DEX), and intraoperative analgesia with dexrazoxane injection (Garonin trade name, DEZ) as appropriate according to the patients' pain scores. We compared the general clinical data of the two groups of patients, the changes in blood pressure and heart rate during the whole operation, the intraoperative and postoperative pain, the total duration of the operation and the immediate postoperative complications. Results: The study included 123 patients (59 in the LIA + MAC group and 64 in the LIA group). The LIA + MA group exhibited lower pain scores measured by Visual Analogue Scale(VAS) during surgery (skin incision, subcutaneous adipose tissue dissection, anterior fascia, muscle traction, posterior fascia, peritoneum, and catheterization) compared to the LIA group(p<0.05). In terms of surgical incisions, to intraoperative pain scores (VRS), the LIA + MA group showed higher score level I and lower score level II compared to the LIA group (p = 0.002, 0.004, respectively). The LIA + MA group experienced lower postoperative resting pain (NRS) and VAS than the LIA group (p = 0.001,0.003, respectively). The surgical duration for the LIA + MA group was shorter than that of the LIA group (p<0.001). Preoperative systolic and diastolic blood pressures (SBP and DBP) were higher in the LIA + MA group compared to the LIA group (p<0.001,<0.001, respectively). Postoperative heart rate and DBP were lower in the LIA + MA group (p<0.001, 0.004, respectively). The LIA + MA group exhibited greater changes in heart rate, SBP, and DBP during and after surgery compared to the LIA group (p = 0.009, <0.001,<0.001, respectively). In terms of immediate postoperative complications, the proportion of patients requiring analgesics within 24 h post-surgery was significantly lower in the LIA + MA group (p = 0.031). Conclusion: Open surgery for PDC placement under LIA + MAC is both safe and effective. The key points: There is no global consensus on the preferred anesthesia method for PDC placement. DEX combined with analgesics may yield synergistic effects and serve as a backup rescue analgesic. PDC placement under LIA + MA is safety and efficacy. [ABSTRACT FROM AUTHOR]

Introduction: The left dorsolateral prefrontal cortex (lDLPFC) is a commonly targeted brain region for repetitive transcranial magnetic stimulation (rTMS) for depression. The lDLPFC has been identified using the “5-cm rule.” However, identification of the lDLPFC may deviate from the ideal stimulation site localized by neuronavigation. Therefore, we aimed to compare this method with other methods and examine the relationship between deviation from the ideal stimulation site and treatment effects. While most existing studies have focused on participants of European descent, this study focused on Japanese participants. Methods: The study participants were 16 patients who underwent rTMS and had the stimulus location identified using the 5-cm method. The lDLPFC was identified by the F3 electrode position and neuronavigation in addition to the 5-cm rule, and these locations were compared. We then performed a correlation analysis of the distance between the sites identified by the 5-cm method and by neuronavigation, as well as changes in scores on the 17-item Hamilton Depression Scale (HAMD-17). Results: The lDLPFC identified by the F3 site and neuronavigation was approximately 3 cm more anterolateral than that identified by the 5-cm method. A significant correlation was found between the distance between the sites identified by the 5-cm method and neuronavigation and the rate of change in HAMD-17 scores. Conclusion: The ideal stimulation site may be approximately 3 cm anterior to the site identified by the 5-cm method, and stimulation of the F3 site may be a valid alternative to the 5-cm method. [ABSTRACT FROM AUTHOR]