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Abstract Centella asiatica (L.) Urb an is distributed widely in South America and Asia and is known as a therapeutic agent in folk medicine, capable of improving memory and treating [...]

Aim: To systematically and critically summarize the state of the evidence about the Synergy Model and its utilization in nursing practice. Background: The Synergy Model emphasizes the importance of alignment between patient needs and nurse competencies in achieving adequate patient‐ and nurse‐related outcomes. It is a relatively new patient‐centred care model developed at the end of the 1990s. Introduction: Despite the Synergy Model's potential to support patient‐centred care, its practical application is still mainly limited. Thus far, literature about the Synergy Model has not yet been synthesized, undermining its broader utilization globally. Methods: A systematic search was performed on the following databases: PubMed, CINAHL and Scopus. The authors used the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) statement and checklist to guide the systematic search; 26 papers were included in this study. A critical interpretative synthesis was adopted to summarize the data extracted from the included papers. Results: Five interpretative themes emerged: conceptualization, experiences from the field, nursing education, patient‐related outcomes and system‐related outcomes. Synergy Model shows a precise theoretical definition, and it was implemented in multiple clinical settings, mainly in critical care contexts. It seems to have a positive influence on patient‐related, nurse‐related and system‐related outcomes. Discussion: Synergy Model seems to be positively associated with specific susceptible outcomes, such as patient satisfaction, reduction of patient's complications, staff satisfaction, empowerment, and engagement of patients and healthcare providers. However, the level of evidence is still limited. Conclusion: Future international research should demonstrate the feasibility of implementing the Synergy Model at an international level. More empirical research is needed to demonstrate the effectiveness of the model on susceptible outcomes. Implications for nursing and health policy: This systematic review could support further development of international programmes based on the Synergy Model. The Synergy Model's implementation has the potential to optimize nursing competencies, patient‐ and nurse‐related outcomes. [ABSTRACT FROM AUTHOR]

Aim: The aim of this systematic review was to provide a critical synthesis of the factors that historically shaped the advancements of nursing regulators worldwide. Background: An in‐depth examination of the different factors that moulded regulatory changes over time is pivotal to comprehend current issues in nursing. Introduction: In the light of global health scenarios, the researchers explored the factors that historically influenced the socio‐contextual circumstances upon which governments made regulatory changes. Methods: A systematic search was performed on the following databases: PubMed, CINAHL, Scopus, OpenGrey and ScienceDirect. The review included papers from January 2000 to October 2016 published in English. The authors used the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) and an inductive thematic approach for synthesis. Results: Two main themes were identified: factors underpinning current challenges and historical and contextual triggers of regulation. The first theme was composed of three aspects: education, migration and internationalization, and policy and regulation; the second theme consisted of four attributes: demographics, economics, history of registration and wars, and historical changes in nursing practice. Discussion: Factors that shaped nursing regulation were linked to changing demographics and economics, education, history of nursing registration, shifting patterns of migration and internationalization, nursing practice, policy and regulation and significant societal turns often prompted by wars. Conclusion: A deeper understanding of the developments of the nursing regulatory institutions provides the foundation for portable standards that can be applied across an array of jurisdictions to guarantee a better public safety. Implication for nursing and health policy: Understanding factors that socially, legislatively and politically have influenced the development of regulatory bodies over time helps to mould local, national and international policies that have a stronger impact on health worldwide. To achieve this, there must be effective cooperation among systems of nursing regulations globally. [ABSTRACT FROM AUTHOR]

Abstract: Centella asiatica (L.) Urb an is distributed widely in South America and Asia and is known as a therapeutic agent in folk medicine, capable of improving memory and treating several neurological disorders. Asiaticoside is one of the compounds found in C. asiatica leaves that is suggested to be responsible for its pharmacological potential. Phospholipase A2 (PLA2) is a group of enzymes that has abnormal activity in the central nervous system in some neuropsychiatric diseases. In this work, the asiaticoside present in C. asiatica water extract was quantified by HPLC analysis. We also evaluated the activity of subtypes of PLA2 in cerebellar samples from rats after C. asiatica water extract treatment using a radioenzymatic assay. Asiaticoside was the major compound (84%) found in Centella water extract. We found a dose-dependent inhibitory effect of C. asiatica water extract on the activity of Ca2+-independent PLA2 (iPLA2) and cytosolic PLA2 (cPLA2). The inhibition of these enzymes in the brain suggests that C. asiatica may be useful to treat conditions associated with increased PLA2 activity in the brain, such as epilepsy, stroke, multiple sclerosis and other neuropsychiatric disorders. [Copyright &y& Elsevier]

Aim: This study aimed to describe the levels of self-care behaviors and self-care self-efficacy in patients with Marfan syndrome and to identify the individual-level determinants of self-care behaviors., Background: The behaviors aimed at maintaining health stability (self-care maintenance), monitoring signs and symptoms (self-care monitoring), and taking action when signs and symptoms occur (self-care management) are key aspects of the care for addressing the complexity of care of patients with Marfan syndrome. However, the description of self-care behaviors and their determinants in patients with Marfan syndrome are highly under-described., Methods: The adopted design was descriptive observational with a cross-sectional data collection on 111 patients with MFS in a single Italian specialized and reference center for this disease between 2020 and 2021., Results: Performing healthy activities and managing illness, therapies, and follow-ups to maintain health over time (self-care maintenance) was almost adequate (mean score = 67.87 ± 13.17), as well as the ability to recognize signs and symptoms promptly (self-care monitoring, mean score = 67.95 ± 26.70). The ability to respond to symptoms when they occur (self-care management, mean score = 54.17 ± 19.94) was sub-optimal. The stronger positive predictor of each self-care behavior was self-care self-efficacy., Conclusions: This study suggested prioritizing educational activities focused on enhancing self-care management in patients with Marfan syndrome and strengthening their self-care self-efficacy. Researchers should develop and validate evidence-based educational approaches to enhance self-care in patients with Marfan syndrome, and clinical nurses should strengthen their focused educational activities to improve the self-care management of these patients., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Lung cancer is the leading cause of cancer-related mortality worldwide, largely due to the limited efficacy of anticancer drugs, which is primarily attributed to insufficient doses reaching the lungs. Additionally, patients undergoing treatment experience severe systemic adverse effects due to the distribution of anticancer drugs to non-targeted sites. In light of these challenges, there has been a growing interest in pulmonary administration of drugs for the treatment of lung cancer. This route allows drugs to be delivered directly to the lungs, resulting in high local concentrations that can enhance antitumor efficacy while mitigating systemic toxic effects. However, pulmonary administration poses the challenge of overcoming the mechanical, chemical, and immunological defenses of the respiratory tract that prevent the inhaled drug from properly penetrating the lungs. To overcome these drawbacks, the use of nanoparticles in inhaler formulations may be a promising strategy. Nanoparticles can assist in minimizing drug clearance, increasing penetration into the lung epithelium, and enhancing cellular uptake. They can also facilitate increased drug stability, promote controlled drug release, and delivery to target sites, such as the tumor environment. Among them, chitosan-based nanoparticles demonstrate advantages over other polymeric nanocarriers due to their unique biological properties, including antitumor activity and mucoadhesive capacity. These properties have the potential to enhance the efficacy of the drug when administered via the pulmonary route. In view of the above, this paper provides an overview of the research conducted on the delivery of anticancer drug-loaded chitosan-based nanoparticles incorporated into inhaled drug delivery devices for the treatment of lung cancer. Furthermore, the article addresses the use of emerging technologies, such as siRNA (small interfering RNA), in the context of lung cancer therapy. Particularly, recent studies employing chitosan-based nanoparticles for siRNA delivery via the pulmonary route are described.

Background: Androgenetic alopecia (AGA) is a prevalent genetic condition that can affect both male and female, and is considered the most frequent form of hair loss. Traditional scales and methods of classifying AGA are basically qualitative., Objective: This work aims to propose a quantitative scale to classify AGA in order to assist hair transplantation surgery., Methods: Based on whole hairless and thinning areas that needs to receive follicular units in a hair transplantation procedure, basic equations to support the scale are proposed. Additionally, the study involves simulations that apply the classification system and compare its results with those of qualitative methods., Results: The PRECISE scale utilizes a range of 0-10, using 30 cm 2 as the measured standard of a bald area. For hair transplantation, 1500 follicular units (FU) are recommended for each score in the PRECISE scale. Technological and manual methods to measure the hairless and thinning areas are presented and discussed. This new quantitative classification, combined with different and complementary methods of measurement of hairless and thinning areas endorse the understanding of the clinical condition by the patient and the planning of a surgery procedure., Conclusion: The developed PRECISE scale brings a different way of classifying Androgenetic alopecia (AGA), through an essentially quantitative evaluation. It can be used to elaborate the best strategy for the hair transplantation surgery and to improve the outcomes., Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2023. The Author(s).)

Introduction: The fruit oil from Acrocomia aculeata (Macauba or Bocaiuva) is highly rich in antioxidants and other bioactive compounds, emerging as a natural source of high potential for the modulation of chronic non-communicable diseases (NCDs), like diabetes. Its effects on chronic NCDs are poorly studied yet. This review aimed to evaluate the therapeutic results of pharmaceutical preparations containing Acrocomia aculeata pulp oil that are used for chronic NCDs., Method: A search was performed using PICO acronyms in English, Portuguese, and Spanish languages in the MEDLINE®, PubMed, EMBASE, Scopus, LILACs, and CENTRAL Cochrane Library databases. The degree of agreement for selection and eligibility was significant (Kappa= 0.992; 95% CI: 0.988-0.996). The difference between the intervention and control groups for blood glucose reduction was 63.5 ± 69.5 mg/dL (p<0.0001)., Result: Overall, an improvement percentage of 55.1 ± 0.1 was observed for the variables associated with chronic NCDs, which represented 89.96% of the relative risk reduction (efficacy)., Conclusion: The Acrocomia aculeate pulp oil exhibited promising results in experimental studies for glycemic control and reduction of a specific tumor, indicating a good potential to be explored for chronic NCDs treatment., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Aims: To develop and validate the Digital and Technological Self-Efficacy Scale (Digitech-S) for healthcare workers among nurses and nursing students., Background: Digital and technological solutions (DTS) significantly impact working life in healthcare and educational settings. DTS-related self-efficacy might be defined the individual's confidence in proficiently performing digital and technological tasks, even when faced with challenges. Its assessment might guide educators in orienting focused interventions to enhance the self-efficacy of nurses and nursing students. Thus far, the assessment of DTS-related self-efficacy is currently undermined by the lack of valid and reliable measurements., Design: A stepwise methodological approach was employed in two main phases. Phase one focused on tasks guided by literature for generating items reflecting DTS. Phase two encompassed three steps: A content validity step, a first cross-sectional data collection for Mokken scaling analysis (MSA) performed to reduce the number of items toward a unidimensional structure and with a hierarchical approach, and a confirmatory factor analysis including the group (nurses vs. nursing students) as a covariate (MIMIC) to cross-validate the unidimensional structure and assess the measurement invariance using a second cross-sectional data collection round. A Multi-Group Confirmatory Factor Analysis (MG-CFA) was also conducted to test for configural, metric, scalar, and strict invariance across the two groups., Results: Phase one resulted in 36 items derived from a literature review, which was reduced to 33 after the content validity process. 660 responders (nurses = 388; nursing students = 272) were included in the sample analyzed with MSA, and 13 items were hierarchically selected for the subsequent data collection (Rho reliability = 0.95; H s = 0.67; H i ranging from 0.55 to 0.72). MIMIC models were performed on 421 responders (nurses = 268; nursing students = 153), and three items that caused non-invariance between nurses and nursing students were identified and removed from the final version (Cronbach's alpha = 0.928). The MG-CFA demonstrated configural and metric invariance, suggesting a consistent factor structure and factor loadings across both groups, but scalar and strict invariance were not fully achieved., Conclusions: The Digitech-S is a 10-item scale showing a unidimensional and stable structure, which could be used for educational and research purposes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The evolution of respiratory diseases represents a considerable public health challenge, as they are among the leading causes of death worldwide. In this sense, in addition to the high prevalence of diseases such as asthma, chronic obstructive pulmonary disease, pneumonia, cystic fibrosis, and lung cancer, emerging respiratory diseases, particularly those caused by members of the coronavirus family, have contributed to a significant number of deaths on a global scale over the last two decades. Therefore, several studies have been conducted to optimize the efficacy of treatments against these diseases, focusing on pulmonary drug delivery using nanomedicine. Thus, the development of nanocarriers has emerged as a promising alternative to overcome the limitations of conventional therapy, by increasing drug bioavailability at the target site and reducing unwanted side effects. In this context, nanoparticles composed of chitosan (CS) show advantages over other nanocarriers because chitosan possesses intrinsic biological properties, such as anti-inflammatory, antimicrobial, and mucoadhesive capacity. Moreover, CS nanoparticles have the potential to enhance drug stability, prolong the duration of action, improve drug targeting, control drug release, optimize dissolution of poorly soluble drugs, and increase cell membrane permeability of hydrophobic drugs. These properties could optimize the performance of the drug after its pulmonary administration. Therefore, this review aims to discuss the potential of chitosan nanoparticles for pulmonary drug delivery, highlighting how their biological properties can improve the treatment of pulmonary diseases, including their synergistic action with the encapsulated drug.

The emergence of SARS-CoV-2 variants can affect their detection via RT-qPCR. The Omicron variant has a greater affinity for the upper respiratory system and causes clinical conditions similar to bronchitis, as opposed to the pneumonitis-like conditions caused by other SARS-CoV-2 variants. This characteristic increases the viscosity of clinical samples collected for diagnosis. Coinciding with the arrival of the Omicron variant, we observed a failure in control gene expression in our laboratory. In this report, we have optimized a rapid nucleic acid extraction step to restore gene expression and detect the presence of the SARS-CoV-2 virus. We reevaluated 3000 samples, compared variant types occurring in different time periods, and confirmed that the presence of the Omicron variant was responsible for changes observed in the characteristics of these clinical samples. For samples with large amounts of mucus, such as those containing the Omicron variant, a modification to the nucleic acid extraction step was sufficient to restore the quality of RT-qPCR results.

Objective: Assessing nursing self-efficacy could be strategic to sustain nursing competence. This study aimed to develop and validate the nursing self-efficacy scale for managing cancer treatment-induced cardiotoxicity (NSS-CTC)., Data Sources: An exploratory mixed-method study was performed by including two main phases. The first comprised the developmental tasks to generate the initial pool of items, including a literature review and a consensus meeting based on a nominal group technique. The second phase initially involved an external panel of experts in assessing the content validity of the novel scale, followed by a cross-sectional data collection to perform exploratory factor analysis by employing a multicenter and convenience sampling approach. The most plausible psychometric structure derived from the exploratory factor analysis was tested with a confirmatory factor analysis using a second data collection round on another sample enrolled with a multicenter and convenience sampling approach. Internal consistency was assessed using Cronbach's alfa., Conclusion: The NSS-CTS is a novel 15-item self-report measure for assessing nurse self-efficacy in dealing with cancer treatment-related cardiotoxicity. Its two plausible domains were labeled knowledge-related self-efficacy (Cronbach's α = 0.924) and practice-related self-efficacy (Cronbach's α = 0.937); the factor analyses in both samples showed adequate fit to sample statistics. Future studies are necessary to corroborate its construct validity and assess its measurement invariance across various country contexts., Implications for Nursing Practice: Assessing nursing self-efficacy for managing cancer treatment-induced cardiotoxicity is a promising approach for identifying educational gaps and promoting nursing competency in this particular area of cancer care., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Breast cancer is the type of cancer with the highest incidence in women around the world. Noteworthy, the triple-negative subtype affects 20% of the patients while presenting the highest death rate among subtypes. This is due to its aggressive phenotype and the capability of invading other tissues. In general, tumor-associated macrophages (TAM) and other immune cells, are responsible for maintaining a favorable tumor microenvironment for inflammation and metastasis by secreting several mediators such as pro-inflammatory cytokines IL-1β, IL-6, and TNF-α, chemokines like CCL2, and other proteins, as metalloproteinases of matrix (MMP). On the other hand, immunomodulatory agents can interfere in the immune response of TAM and change the disease prognosis. In this work, we prepared nanostructured lipid carriers containing kaurenoic acid (NLC-KA) to evaluate the effect on cytokine production in vitro of bone marrow-derived macrophages (BMDM) and the migratory process of 4 T1 breast cancer cells. NLC-KA prepared from a blend of natural lipids was shown to have approximately 90 nm in diameter with low polydispersity index. To test the effect on cytokine production in vitro in NLC-KA treated BMDM, ELISA assay was performed and pro-inflammatory cytokines IL-1β, IL-6, and TNF-α were quantified. The formulation reduced the secretion of IL-1β and TNF-α cytokines while presenting no hemolytic activity. Noteworthy, an anti-migratory effect in 4 T1 breast cancer cells treated with NLC-KA was observed in scratch assays. Further, MMP9 and CCL2 gene expressions in both BMDM and 4 T1 treated cells confirmed that the mechanism of inhibition of migration is related to the blockade of this pathway by KA. Finally, cell invasion assays confirmed that NLC-KA treatment resulted in less invasiveness of 4 T1 cells than control, and it is independent of CCL2 stimulus or BMDM direct stimulus. Ultimately, NLC-KA was able to regulate the cytokine production in vitro and reduce the migration of 4 T1 breast cancer cells by decreasing MMP9 gene expression., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background and Aim: recent studies regarding COVID-19 experiences of nursing students highlighted the effect of the transition from face-to-face to online education, rather than the complexity of the overall quality of educational life. This study aim investigating of how the students perceive the quality of educational life in the forced online training, searching for any shift of meanings concerning the students learning experience, from the first phase of the sudden transition to online and the online stabilization phase., Methods: a longitudinal qualitative study, carried during two moments of the online teaching activity forced by COVID-19, the first one in May-June 2020 and the second six months later in January -February 2021. A convenience sample of 24 students attending post-graduate courses for health professions recruited at University of Parma, answered in-depth interviews, videotaped, verbatim transcribed and analyzed using the Braun and Clarke model., Results: five themes emerged from meaning shift of data collection: reactions to change in educational life; factors favoring a new quality of educational life; factors hindering the perception of the quality of educational life; adaptation strategies to the new educational life; tools and strategies to facilitate communication and the absence of the classroom., Conclusions: participants perceive advantages of online teaching, on quality of their educational life. The issue of how to create opportunities for internship period remains open. Further research to understand online internship and exploring what extent it is essential to propose it in face-to-face modality.

The demand for care services in the healthcare system has changed and is triggering a smooth transition from in-hospital to primary care. In this regard, patient-centered-care models of care delivery might provide a framework to follow patients' journeys throughout their transition between different levels of care. Accordingly, an Italian research group at a cardiac hospital in Northern Italy implemented the Synergy Model in a Cardiac Surgery Unit, a patient-centered-care model, and is using the framework of the model to guide a smooth transition of patients towards rehabilitation and primary care after their hospitalization. This discursive paper is focused on the experience, perspectives, and future implications of adopting the Synergy Model to facilitate the transition from in-hospital to primary care. The presented experience and discussion might be helpful to the international debate regarding the strategies to boost a smooth transition from in-hospital to primary care.

Background: The unprecedented changes in daily-life caused by Covid-19 restrictions had many psycho-logical and adverse effects, not only in sufferers but also in the general population, including university students. To date, little is known about Post-Traumatic Stress Disorder symptoms experienced by university students during the peak of Covid-19 in Italy. Thus, the study describes Post-Traumatic Stress Disorders related to the Covid-19 outbreak among Italian university students and identifies the psychological distress risk and protective factors., Study Design: A multicentre observational cross-sectional study., Methods: Data collection was involved in a self-reported web questionnaire, using the on-line platform Qualtrics®, in March and April 2020, involving convenience and consecutive sampling of Italians university students in different Italy regions., Results: A sample of 720 Italian university students was enrolled. Data analysis highlighted the leading role of sex, health concerns, and health engagement as negative or positive determinants of Post-Traumatic Stress Disorders in Italian university students during the Covid-19 outbreak. In particular, it is very insightful having discovered that health engagement is a protective factor of students' mental health., Conclusions: This is the first study identifying sex, health issues and health commitment as positive or negative determinants of Post-Traumatic Stress Disorders symptoms in Italian university students during the Covid-19 epidemic. Accordingly, this new achievement could be the starting point for the development of awareness campaigns for the psychological health of Italian university students.

Since 2020, humanity has been facing the COVID-19 pandemic, a respiratory disease caused by the SARS-CoV-2. The world's response to pandemic went through the development of diagnostics, vaccines and medicines. Regarding diagnostics, an enormous challenge was faced due to shortage of materials to collect and process the samples, and to perform reliable mass diagnosis by RT-qPCR. In particular, time-consuming and high cost of nucleic acid extraction procedures have hampered the diagnosis; moreover, several steps in the routine for the preparation of the material makes the extracted sample susceptible to contamination. Here two rapid nucleic acid extraction reagents were compared as extraction procedures for SARS-CoV-2 detection in clinical samples by singleplex and multiplex RT-qPCR analysis, using different transport media, samples with high and low viral load, and different PCR machines. As observed, rapid nucleic acid extraction procedures can be applied for reliable diagnosis using a TaqMan-based assay, over multiple platforms. Ultimately, prompt RNA extraction may reduce costs with reagents and plastics, the chances of contamination, and the overall time to diagnosis by RT-qPCR.

This study aimed to systematically synthesize evidence regarding burnout and post-traumatic stress disorder (PTSD) among nurses engaged in the frontline during the COVID-19 pandemic, highlighting their risk and protective factors. The specific literature on nurses' mental health outcomes still remains not synthesized. A systematic review was performed (PROSPERO: CRD42021227939), searching literature published in 2020 on Pubmed, Scopus, CINAHL, and PsycInfo. We quantitatively pooled means of included studies measuring burnout and PTSD with the same tools. Twenty-five studies were included in this review. Seven (3766 nurses) were included in the meta-analysis for estimating means of depersonalization and emotional exhaustion assessed using the Maslach Burnout Inventory, respectively: 7,40 (95%CI=6,00-8,80) and 22,82 (95%CI=19,24-26,41). Likely, 12 studies were used to estimate two pooled means for PTSD, one for six studies adopting the Impact of Event Scale-Revised (1551 nurses), and six adopting the PTSD Scale for DSM-5 (8547 nurses). The main risk and protective factors of both outcomes were female sex and younger age, work-related variables, and physical and mental factors, such as concerns, skin lesions from wearing personal protective equipment. This systematic review portrayed the situation described in literature during 2020 on nurses' burnout and PTSD during the COVID-19 pandemic. Although the outcomes' levels described in the included studies are diverse, the broad situation appears alarming, and supportive multi-level strategies, considering individual and system-level, should be planned to decrease the described worsening scenario within the clinical settings avoid middle and long-term negative consequences.

The main function of the skin is to protect the body from the external environment. However, the skin can undergo inflammatory processes, due to genetic, hormonal, or environmental factors. When the defense system is overloaded, there is an increase in pro-inflammatory mediators and reactive oxygen species (ROS), which results in skin disorders. Among the substances used to treat these inflammatory processes, many natural substances with anti-inflammatory and antioxidant properties are being studied: nature is yet an abundant source to obtain diverse pharmacological actives. The treatment of skin diseases is usually focused on topical application, as it reduces the risk of systemic side effects and prevents drug degradation by first-pass metabolism. Thus, the properties of drug delivery vehicles can facilitate or inhibit its permeation. Due to the hydrophobic nature of the skin, a promising strategy to improve dermal drug penetration is the use of lipid-based nanoparticles, such as nanostructured lipid carriers (NLC). Therefore, in this review, we present NLC as a tool to improve dermal administration of natural substances with anti-inflammatory properties.

Background: The use of RNA interference (iRNA) therapy has proved to be an interesting target therapy for the cancer treatment; however, siRNAs are unstable and quickly eliminated from the bloodstream. To face these barriers, the use of biocompatible and efficient nanocarriers emerges as an alternative to improve the success application of iRNA to the cancer, including breast cancer., Results: A hybrid nanocarrier composed of calcium phosphate as the inorganic phase and a block copolymer containing polyanions as organic phase, named HNPs, was developed to deliver VEGF siRNA into metastatic breast cancer in mice. The particles presented a rounded shape by TEM images with average size measured by DLS suitable and biocompatible for biomedical applications. The XPS and EDS spectra confirmed the hybrid composition of the nanoparticles. Moreover, after intravenous administration, the particles accumulated mainly in the tumor site and kidneys, which demonstrates the tumor targeting accumulation through the Enhanced Permeability and Retention Effect (EPR). A significant decrease in size of the tumors treated with the nanoparticles containing siVEGF (HNPs-siVEGF) was observed and the reduction was related to enhanced tumor accumulation of siRNA as well as in vivo VEGF silencing at gene and protein levels., Conclusion: The hybrid system prepared was successful in promoting the RNAi effect in vivo with very low toxicity., General Significance: This study shows the valuable development of a hybrid nanoparticle carrying VEGF siRNA, as well as their tumor targeting, accumulation and reduction in mice triple-negative breast cancer., (Copyright © 2021. Published by Elsevier B.V.)

Introduction: Several studies described burnout levels of healthcare workers (HCWs) during the COVID-19 pandemic; however, sex-related differences remain poorly investigated., Objective: To describe sex-related differences in burnout and its determinants among HCWs during the first pandemic wave of the COVID-19 in Italy., Methods: A cross-sectional study was performed between April and May 2020. The framework given by the Job Demands Resources (JD-R) model was used to assess burnout determinants (risk and protective factors)., Results: Male HCWs (n=133) had higher levels of depersonalization than female HCWs (P=0,017) and female HCWs (n=399) reported greater emotional exhaustion rates (P=0,005). Female nurses were the most exposed to burnout (OR=2,47; 95%CI=1,33-4,60; P=0,004), emotional exhaustion (OR=1,89; 95% CI=1,03-3,48; P=0,041), and depersonalization (OR=1,91; 95% CI=1,03-3,53; P=0,039). Determinants of burnout differed between sexes, and some paradoxical associations were detected: the score of job demands was a protective factor in females for burnout, emotional exhaustion, and depersonalization, resilience was a risk factor for males., Conclusions: This study reveals that the stressors in male and female HCWs tended to be associated with burnout differently. Both sexes showed alarming burnout levels, even if the weights of emotional exhaustion and depersonalization acted in different ways between the sexes. The revealed paradoxical effects in this study could reflect the study's cross-sectional nature, highlighting that more resilient and empathic individuals were more consciously overwhelmed by the challenges related to the COVID-19 pandemic, thus reporting higher scores of emotional exhaustion and burnout. Future in-depth and longitudinal analyses are recommended to further explore sex-related differences in burnout among HCWs.

Aim: To isolate licochalcone A (LicoA) from licorice, prepare LicoA-loaded solid lipid nanoparticles (L-SLNs) and evaluate the L-SLNs in vitro and in vivo against Schistosoma mansoni . Materials & methods: LicoA was obtained by chromatographic fractionation and encapsulated in SLNs by a modified high shear homogenization method. Results: L-SLNs showed high encapsulation efficiency, with satisfactory particle size, polydispersity index and Zeta potential. Transmission electron microscopy revealed that L-SLNs were rounded and homogenously distributed. Toxicity studies revealed that SLNs decreased the hemolytic and cytotoxic properties of LicoA. Treatment with L-SLNs showed in vivo efficacy against S. mansoni . Conclusion: L-SLNs are efficient in reducing worm burden and SLNs may be a promising delivery system for LicoA to treat S. mansoni infections.

This study aimed to describe the impact of mutuality, anxiety, and depression on quality of life (QoL) in patients with heart failure (HF) using cross-sectional, convenient, and consecutive sampling. A total of 97 patients were recruited. Socio-demographic and clinical variables and self-report measures of anxiety, depression, mutuality, and QoL were collected. The results highlighted the pivotal role of mutuality (specifically the domain of shared values between patients and their caregivers) in determining perceptions of physical health. Conversely, depression was a negative determinant of perceptions of both physical and mental health. Future research is needed to describe in-depth and longitudinally the associations between mutuality and QoL in patients with HF., (© Copyright 2021 Creative Health Care Management.)