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Insulinoma is one of the most prevalent form of functional neuroendocrine tumor of the pancreas (PNET) that often manifests with debilitating symptomatic hypoglycemia. When conventional imaging fails to detect the lesion, endoscopic ultrasound (EUS) have proven to be of value to determine the preoperative localisation as well as with biochemical sampling via fine needle aspiration of the suspected lesion. Surgical resection has been the standard care for these pancreatic neuroendocrine tumors. However, with recent advancements, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has emerged as a promising and less invasive therapeutic approach that carries a favourable outcome and a low risk of complications. We report eda patient with symptomatic pancreatic insulinoma who was treated with EUS-RFA. [ABSTRACT FROM AUTHOR]

Caffeic acid, a naturally occurring organic compound, possesses antioxidant and anti-inflammatory properties, along with its derivatives. This systematic review aimed to evaluate the effect of caffeic acid and its derivatives on oxidative stress and inflammatory response in cutaneous wound healing. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Searches were performed in PubMed, Scopus, and Ovid MEDLINE. Articles published between 2000 and June 2022, with seven articles meeting the inclusion criteria were retrieved. The articles constituted in-vivo studies that utilised caffeic acid phenethyl ester (CAPE) as the therapeutic agent in three types of cutaneous wound including full-thickness burn injury (n=4), two incisional wounds, and one pressure ulcer. CAPE scavenged reactive oxidative species and reduced lipid peroxidation, superoxide dismutase, nitrotyrosine, malondialdehyde, catalase, xanthine oxidase, and nitric oxide levels. The treated injured area revealed enhanced granulation tissue formation, vascularisation, and collagenisation as well as long-term effects of CAPE as evidenced by reduced myofibroblast amount, CD68-positive macrophages, and increased collagen deposition. The systematic review emphasised how antioxidant and anti-inflammatory effects of CAPE could improve the process of wound healing, suggesting its substantial potential for clinical applications in this domain. [ABSTRACT FROM AUTHOR]

The emerging field of photonic topological insulators offers promising platforms for high-performance optical communication, computing, and sensing. However, conventional photonic topological insulator designs typically operate within the diffraction limit due to their dielectric nature. This limitation imposes constraints on device miniaturization, reduces light–matter interaction, and decreases overall device sensitivity. Introducing a new valley-Hall hybrid plasmonic topological insulator, we overcome this limitation by exploiting the coupling of surface plasmon oscillations with the optical modes of a dielectric photonic crystal, allowing for sub-diffraction vertical confinement of light. Deep-subwavelength chiral edge states can, therefore, be generated and robustly guided along disordered Z-shaped topological boundaries with much lower propagation loss compared to purely plasmonic platforms. Such extreme manipulation of light on an integrated chip platform maximizes light–matter interaction and opens the door for truly compact and efficient optical modulators, molecular sensors, and next-generation nanophotonic and quantum devices.

Background: The utilization of vitamins and dietary supplements (DSs) among consumers in Malaysia has seen a notable increase. However, there is limited research available on how pharmacists in Eastern countries manage the provision of these products. Objective: This study aims to assess the knowledge, attitudes, and practices of community pharmacists in Malaysia regarding the provision of counselling services on vitamins and DSs. The findings will inform education strategies in this area. Methods: A cross-sectional quantitative study was conducted from February to April 2022 using a validated online-based questionnaire. The survey was distributed to community pharmacists across Malaysia through social media channels. t-test and ANOVA test were used for data analysis. Results: Among the 260 participants, 73.5% were categorized as having average product knowledge. Key concerns included a lack of knowledge about the indications of new products and when to discontinue their use. Regarding dosing in specific patient groups, 33.5% of pharmacists only occasionally consulted references and primarily relied on product labels. Furthermore, 29% of pharmacists believed it was unnecessary to refer patients to doctors when they experienced ongoing symptoms while taking vitamins or DSs. Interestingly, 44.6% of pharmacists believed there was a correlation between the efficacy of vitamins and their price, often recommending more expensive brands despite similar content. Conclusion: There is an opportunity to enhance the knowledge of pharmacists in Malaysia regarding vitamins and DSs. Education interventions should focus on areas such as dosing for specific patient groups, when to discontinue products, understanding new products, evidence-based efficacy of products for specific conditions, and providing a framework for appropriate referral to support pharmacists in their practice.

Abstract Background To address the hospital bed demand for Delta and Omicron surges in Singapore, the National University Health System (NUHS) developed a COVID Virtual Ward to relieve bed pressures on its three acute hospitals—National University Hospital, Ng Teng Fong General Hospital, Alexandra Hospital. To serve a multilingual population, the COVID Virtual Ward featuring protocolized teleconsultation of high-risk patients, use of a vital signs chatbot, supplemented by home visits where necessary. This study aims to evaluate the safety, outcomes and utilisation of the Virtual Ward as a scalable response to COVID-19 surges. Methods This is a retrospective cohort study of all patients admitted to the COVID Virtual Ward between 23 September to 9 November 2021. Patients were defined as “early discharge” if they were referred from inpatient COVID-19 wards and “admission avoidance” if they were referred directly from primary care or emergency services. Patient demographics, utilisation measures and clinical outcomes were extracted from the electronic health record system. The primary outcomes were escalation to hospital and mortality. Use of the vital signs chatbot was evaluated by examining compliance levels, need for automated reminders and alerts triggered. Patient experience was evaluated using data extracted from a quality improvement feedback form. Results 238 patients were admitted to the COVID Virtual Ward from 23 September to 9 November, of whom 42% were male, 67.6% of Chinese ethnicity. 43.7% were over the age of 70, 20.5% were immunocompromised, and 36.6% were not fully vaccinated. 17.2% of patients were escalated to hospital and 2.1% of patients died. Patients who were escalated to hospital were more likely to be immunocompromised or to have a higher ISARIC 4C-Mortality Score. There were no missed deteriorations. All patients received teleconsults (median of 5 teleconsults per patient, IQR 3–7). 21.4% of patients received home visits. 77.7% of patients engaged with the vital signs chatbot, with a compliance rate of 84%. All patients would recommend the programme to others in their situation. Conclusions Virtual Wards are a scalable, safe and patient-centered strategy to care for high risk COVID-19 patients at home. Trial Registration NA.

The ability to control and steer optical beams is critical for emerging technologies. Among these are light detection and ranging (LiDAR), laser display, free space communication, and single pixel imaging. Improvements in these areas promise enhanced 3D data collection capabilities, orders of magnitude increase in wireless data rate, less expensive cameras, and ever more immersive virtual/augmented reality (VR/AR) consumer electronics. Bulk mechanical or liquid crystal devices are conventionally utilized platforms that achieve optical beam steering, but they are bulky and limited in speed and reliability. Instead, chip-scale photonic platforms offer faster and more elegant mechanisms to manipulate light, capable of minimizing device size, weight, and power. Additionally, a critical device metric is its far field resolution, which influences fine feature detection in imaging applications, laser display quality, and signal power and fidelity of free space communication links. Strong light matter interaction achieved with nanophotonic approaches generally makes devices smaller and more efficient, yet ultimately these effects must be scaled to suitable aperture sizes to maintain good resolution. Recent years have seen rapid development in these performance characteristics, spurred by research on active metasurfaces, slow light waveguides, and waveguide phased arrays, with different architectures encountering unique tradeoffs between device complexity, resolution, and speed, in attempting to achieve groundbreaking values for all three. We review these diverse emerging nanophotonic approaches that aspire to achieve high-performance optical beam steering.

Research background. Antioxidants are important compounds present at low concentrations that inhibit oxidation processes. Due to the side effects of synthetic antioxidants, research interest has increased considerably towards finding natural sources of antioxidants that can replace the synthetic ones. The emergence and spread of antibiotic resistance require the development of new drugs or some potential sources of novel medicine. This work aims to extract the secondary metabolites of Saccharomyces cerevisiae using ethyl acetate as a solvent and to determine the antioxidant and antimicrobial activities of these extracted metabolites. Experimental approach. The antioxidant activity of the secondary metabolites of S. cerevisiae were determined using DPPH, ABTS and FRAP assays. Furthermore, the antimicrobial potential of the ethyl acetate extract of S. cerevisiae against Cutibacterium acnes, Staphylococcus aureus and Staphylococcus epidermidis was assessed. Results and conclusion. Five out of 13 of the extracted secondary metabolites were identified as antioxidants. The antioxidant activity of the S. cerevisiae extract exhibited relatively high IC50 of 455.26 and 294.51 μg/mL for DPPH and ABTS respectively, while the obtained FRAP value, expressed as ascorbic acid equivalents, was 44.40 μg/mL. Moreover, the extract had a significant antibacterial activity (p

A thermal plasma process for the synthesis of nanoparticles and their immediate assembly into nanostructured films is discussed. In this process, known as hypersonic plasma particle deposition, a thermal plasma with injected precursors is expanded through a nozzle to nucleate nanoparticles, which are then inertially deposited onto a cooled substrate in vacuum. A lightly consolidated nanostructured film results. Particle and film diagnostics along with images of the plasma flow are used to explain the formation of nanostructured silicon carbide films by this process.