4th Week Research Articles

Prior Trichinella spiralis infection protects against Schistosoma mansoni induced hepatic fibrosis.

Schistosomiasis affects approximately 250 million people worldwide, with 200,000 deaths annually. It has been documented that the granulomatous response to Schistosoma mansoni (S. mansoni) oviposition is the root cause of progressive liver fibrosis in chronic infection, in 20% of the patients, and can lead to liver cirrhosis and/or liver cancer. The influence of helminths coinfection on schistosomiasis-induced liver pathological alterations remains poorly understood. Therefore, in this study, we investigated the effect of Trichinella spiralis (T. spiralis) infection on S. mansoni-induced hepatic fibrosis. Thirty adult male Balb-c mice were divided into three groups. Group 1 was left uninfected; group 2 was infected with S. mansoni cercariae and group 3 was orally infected with T. spiralis larvae, then 28 days later, this group was infected with S. mansoni cercariae. All groups were sacrificed at the end of the 8th week post infection with S. mansoni to evaluate the effect of pre-infection with T. spiralis on S. mansoni induced liver fibrosis was evaluated parasitologically (worm burden and egg count in tissues), biochemically (levels of alanine aminotransferase and aspartate aminotransferase), histopathologically (H&E and MT staining, and immunohistochemical staining for the expression of α-SMA, IL-6, IL-1β, IL-17, IL-23, TNF-α, and TGF-β). The results in the present study demonstrated marked protective effect of T. spiralis against S. mansoni induced liver pathology. We demonstrated that pre-infection with T. spirais caused marked reduction in the number of S. mansoni adult worms (3.17 ± 0.98 vs. 18 ± 2.16, P = 0.114) and egg count in both the intestine (207.2 ± 64.3 vs. 8,619.43 ± 727.52, P = 0.009) and liver tissues (279 ± 87.2 vs. 7,916.86 ± 771.34; P = 0.014). Consistently, we found significant reductions in both number (3.4 ± 1.1 vs. 11.8.3 ± 1.22; P = 0.007) and size (84 ± 11 vs. 294.3 ± 16.22; P = 0.001) of the hepatic granulomas in mice pre-infected with T. spiralis larvae compared to those infected with only S. mansoni. Furthermore, pre- infection with T. spiralis markedly reduced S. mansoni- induced hepatic fibrosis, as evidenced by decreased collagen deposition, low expression of α-SMA, and significantly reduced levels of IL-17, IL-1B, IL-6, TGF-B, IL-23, and TNF-α compared to mice infected with S. mansoni only. Our data show that pre-infection with T. spiralis effectively protected mice from severe schistosomiasis and liver fibrosis. We believe that our findings support the potential utility of helminths for the preventing and ameliorating severe pathological alterations induced by schistosomiasis.

Study protocol of a breathing and relaxation intervention included in antenatal education: A randomised controlled trial (BreLax study).

Antenatal education is part of antenatal care in many countries. Physical and mental preparation for childbirth and information on pain management are considered key elements of antenatal education classes. Evidence suggests that women who participate in antenatal education classes appear to benefit in terms of self-efficacy and childbirth experience. In particular, women with increased fear of childbirth benefit from trained breathing and relaxation techniques in antenatal education. However, little is known about the effect of breathing and relaxation techniques on the outcomes of healthy pregnant women without fear of childbirth or who do not have medical or obstetric risks, or on neonatal outcomes. The aim of this study is to test whether including a breathing and relaxation technique in an antenatal education class will improve self-efficacy towards birth compared to a standard antenatal education class. The study will be a two-armed randomised controlled trial (RCT). Healthy pregnant women between the 12th and 30th week of gestation with singleton low-risk pregnancies and who are receiving routine antenatal care will be recruited in a hospital in Switzerland. All women included will attend an 8-hour antenatal education class. The intervention group will additionally practise a breathing and relaxation technique, receive a handbook to guide their exercise practice at home, and be provided with access to an online brochure with video and audio recordings for guidance. Data on maternal and neonatal outcomes will be collected after recruitment, in the 37th week of pregnancy, and two to four weeks postpartum. The effectiveness of including a breathing and relaxation technique in antenatal education classes on women's self-efficacy is discussed as a means to improving women's pregnancy and childbirth outcomes. NCT06003946, SNCTP000005672.

Comparative study on productivity of Hybrid Napier CO3 and CO4 with the application of organic and inorganic fertilizers

The present study aimed to assess the growth parameters, herbage yield and chemical composition of CO3 and CO4 (Pennisetum perpureum X Pennisetum americarnum) at the Livestock farm Eastern University, Sri Lanka from July to September 2018. Four different treatments; inorganic fertilizer 100%, Organic fertilizer 100%, Control and Inorganic+Organic fertilizer 1:1 (weight basis). Plant height, leaf length, number of tillers per clump, leaf area, yield and total ash content were measured at two-week intervals from the 4th week up to the 8th week and data were subjected to Analysis of Variance (ANOVA). The means were separated using Duncan’s multiple range test at 0.05 significance level. Results indicated that the productivity of CO3 is superior to CO4 in terms of growth and yield under (T4) CO3 with 1:1 mixture of inorganic and organic fertilizer. The highest (p<0.05) fresh matter yield of 18.07 t/ha, with a dry matter yield of 3.83 t/ha was recorded in the sole application of inorganic fertilizer. A similar yield was obtained in CO3 with the 1:1 inorganic and organic fertilizer mixture. CO3 showed the highest total ash content (18.44%) on dry matter basis. Hence, farmers can save half of the cost of inorganic fertilizer by using farmyard manure along with half of the recommended dose of inorganic fertilizer for fodder cultivation

A case study on the management of Prathishyaya (Chronic Allergic Rhinitis) using Bharangi Arka Nasal Spray

The omnipresence of Prathishyaya among school-aged groups is overlooked until the complications like kasa, swasa and rajayakshma come into being. Pratishyaya if taken heed of in the initial stage, helps to frustrate the looming effects of its complications. Bharangi Arka is cited as an effectual remedy for Prathishyaya in the Arka Prakasha of Ravana. Prescribing medications for children is usually challenging as they often resist taking them and so, Ayurveda formulations when transmuted into more palatable forms can have salutary impacts on children than classical forms. This case study was carried out on an 8 ½ years old male child with sneezing, runny nose and chronic symptoms including nasal itching and obstruction in particular. Prathishyaya was diagnosed after a proper clinical evaluation. Bharangi Arka in the form of nasal spray was opted as the sole drug in the treatment. Assessment of symptoms was done using Total Nasal Symptom score on the 7th, 14th, 21st and 28th days of the first month of the treatment and at the end of the following two months. Subsidence of all the symptoms was observed in the patient almost in the 4th week. This corroborates the stupendous action of Bharangi Arka nasal spray on Pratishyaya and it could usher in a way for further research to be carried out on the potency of nasal sprays in Ayurveda.

The effect of online motivational interviewing on pregnant women's smoking cessation behaviour: A randomized controlled trial.

This study aims to examine the effect of online individual motivational interviewing based on the transtheoretical model on pregnant women's smoking cessation behaviour. Sixty-two pregnant women who did not complete the 16th gestational week and who smoked were randomly assigned to intervention (n = 31) and control (n = 31) groups. While the intervention group was administered model-based motivational individual counselling interventions, the control group was administered no interventions. The results showed that 58.1% of the pregnant women in the intervention group and 22.6% of the pregnant women in the control group ceased smoking. Online motivational interviewing based on the transtheoretical model was found to be effective in pregnant women's smoking cessation.

Evaluation of the effectiveness of topical use of sertaconazole in dermatophytosis

Objective — to evaluate the effectiveness of a cream containing sertaconazole nitrate 2 % (Onabet 2 % cream) in patients with various forms of dermatophytosis. Materials and methods. 32 patients aged 21—50 were under outpatient observation. The duration of dermatophytosis varied from several weeks to 3 months. Tinea corporis was diagnosed in 25.0 % of patients, foot mycosis in 43.8 %, and axillary mycosis in 31.2 %. The diagnosis was based on the clinical manifestations of the disease and the results of microscopic examination with potassium hydroxide (PH). The clinical picture was evaluated based on the presence of subjective and objective signs (itching, erythema, scaling, vesicles/maceration, pustules) and their intensity according to the scale: 0 points — absence, 1 point — mild, 2 points — moderate, 3 points — severe. The area of skin damage was determined using the «rule of the palm» in patients. The final score of clinical manifestations was calculated by adding the individual scores of each symptom and the value of the area of the affected skin. Onabet 2 % cream was applied by patients twice a day to the affected area of the skin for 4 weeks. Results and discussion. As a result of topical treatment, positive dynamics regarding the clinical manifestations of dermatophytosis were noted in all patients. The regression of inflammatory symptoms (itching, erythema, wetting in 65.5, 40.6 and 71.4 % of patients, respectively) by the end of the 1st week of treatment serves as evidence of anti-fungal, anti-inflammatory and anti-pruritic effects. The terms of regression of clinical manifestations of dermatophytosis depended on the clinical form of the infection. Clinical remission by the end of the 1st week of therapy in 34.4 % of patients, clinical remission and mycological negativity by the end of the 2nd week in 81.3 % of patients testify to the rapid effect of the drug. At the end of the 6th week, clinical success was achieved in 93.7 %, mycological (pathogen eradication) in 100.0 % of patients. Remote observation results within 3 months showed no disease recurrence in all patients. Side effects during treatment were not registered. Conclusions. Onabet cream 2 % is a modern topical antimycotic with a wide spectrum of action; its use twice a day for 1 month allows for achieving clinical cure in 93.7 %, etiological cure in 100 % of patients with dermatophytes (tinea corporis, tinea pedis, and tinea cruris). The high effectiveness and safety of Onabet cream in treating dermatophytosis allow us to recommend this topical agent for treating patients with dermatophytosis.

Simple Sitting Baduanjin mind-body exercise: randomized controlled trial protocol for advanced cancer patients with the fatigue-sleep disturbance symptom cluster

BackgroundAdvanced cancer patients commonly suffer from a fatigue-sleep disturbance symptom cluster. Baduanjin is considered a promising mind-body exercise for relieving the fatigue-sleep disturbance symptom cluster. However, few studies have investigated a tailored Baduanjin for advanced cancer patients. The proposed study will create an optimized Baduanjin exercise program to adapt to advanced cancer patients and evaluate the effect of a Simple Sitting Baduanjin (SSBDJ) mind-body exercise on the fatigue-sleep disturbance symptom cluster among advanced cancer patients.MethodsThe study will be a prospective, assessor-blinded, two-arm, randomized controlled trial, involving a 12-week intervention and 4-week follow-up. A total of 108 advanced cancer patients experiencing the fatigue-sleep disturbance symptom cluster will be recruited from two tertiary general hospitals in China. Participants will be randomized to an experimental group (n = 54) or a control group (n = 54). The experimental group will receive a 12-week SSBDJ intervention plus the usual care, and the control group will receive only the usual care. Outcomes including fatigue-sleep disturbance symptom cluster, fatigue, sleep disturbance, and quality of life will be measured before the intervention, at the 4th, 8th, and 12th weeks of the intervention, and 4 weeks after the intervention. The intention-to-treat principle and a generalized estimating equation will be used to analyze data.DiscussionThis study may produce a new Baduanjin exercise prescription that is user-friendly, simple to execute, more targeted, and adaptable. If proven effective, this approach may be integrated into routine cancer care to manage the fatigue-sleep disturbance symptom cluster and improve QOL in advanced cancer patients.Trial registrationChinese Clinical Trial Registry, ChiCTR-2,300,072,331. Registered on 9 June 2023.

Increased Runx-2 Expression In The Y-TZP Biomaterial Osteointegration Process With hADMSC Seeding

Introduction:. Peri-implantitis, overload, and poor prosthetic construction result in dental implant failure. The success factor of the implant is osteointegration, the formation of tissue between the implant surface and the bone without fibrous tissue. Human Mesenchymal bone marrow (hBMSC) is difficult and risky. Biomarkers associated with increased osteogenesis for osseointegration of biomaterials. This research was conducted to analyze biomarkers that can occur osteogenesis, to increase osteointegration of biomaterials that have high biocompatibility using mesenchymal stem cells. Methods: The research carried out is a true experimental study on Wistar rat test animals totaling 6 treatment groups consisting of 3 groups at the 1st week and 8th week. Each tissue sample was made into a slice preparation with a thickness of 4um, then detected by immunohistochemical examination for Runx2 expression and data in analysis. Results: An increase in Runx-2 expression occurred significantly at week 8 in the Y-TZP biomaterial treatment group seeded with hADMSC (P4). Disscusion: Through increased expression of Runx-2 is a biomarker as a marker on hADMSC which can increase osteogenesis and osteointegration of Y-TZP biomaterial. The use of Y-TZP biomaterial in tissue engineering can be used in other fields of medicine, due to its good biocompatibility as an implant biomaterial so that implant failure can be prevented. Conclusion: Dental implant failure prevented by hADMSC seeding in Y-TZP via increased Runx-2 extrusion. Runx-2 in osteogenesis and fibroblast migration are influenced by various genes in the bone healing process. The benefits of this research can reduce the stiffness of dental implants.

Study of postoperative changes in ocular alignment in surgically corrected esotropia

Background Esotropia (ET) represents an ocular alignment disorder characterized by the eyes’ inward deviation. Aim This work aimed to compare changes in postoperative ocular alignment at 6 weeks as well as 6 months following the surgical procedure among cases, who were initially surgically adequately corrected for ET, and to determine if preoperative characteristics are correlated with these changes in ocular alignment. Patients and methods Our prospective clinical trial study involved 30 patients aged between 1 and 40 years, who developed comitant ET and had not undergone any strabismus surgery before. Results A positive weak association (r=0.406) was documented between the age of ET onset and the 6th month postoperative alignment. The age of onset of ET in both groups (infantile and partially accommodative ET) showed a significant difference (P=0.001). The differences in alignment between 1st week and 6th week and between 1st week and 6th month were significant (P<0.001). Mean change in alignment at 6th week postoperatively was significantly different between amblyopic cases and nonamblyopic cases (P=0.012). The age of onset of ET and the degree of preoperative ET less than 50 prism diopters (PD) showed a significant difference between the successful versus unsuccessful cases at the 6th month postoperative (P=0.002 and 0.031, respectively). Conclusion The higher age of ET onset (nearly above 2.5 years) and the lower preoperative angle of deviation (below 40 prism diopter) are associated with a slightly better surgical outcome at the 6th month postoperatively.

Critical windows for exposure to chemical composition of ambient particulate matter and human semen quality decline

BackgroundCritical windows for exposure to chemical components of particulate matter (PM <2.5 μm in diameter [PM2.5]) associated with the human semen quality decline remain unclear. ObjectivesTo address this gap, we developed a new analytical framework by integrating a Linear Mixed Model (LMM) with subject- and center-specific intercepts and a Distributed Lag Model (DLM) to fully account for correlations between finely vulnerable exposure windows based on complete profile of the spermatogenesis cycle. MethodsWe constructed a multicenter cohort involving 33,234 sperm donors with 78,952 semen samples covering 6 representative regions across China from 2014 to 2020 to investigate the week-scale critical windows for the exposure. Daily exposure to PM2.5 chemical components of donors was derived from grid data based on 1-km spatial resolution surface measurements. ResultsDecreased sperm count was significantly associated with NO3− and SO42− at 9–10 weeks (e.g., β: -0.05 %, 95%CI: [−0.10 %, −0.00 %] at the 9th week) and 0–2 weeks (e.g., β: -0.66 %, 95%CI: [−1.24 %, −0.07 %] at the 1st week), respectively. Critical windows of progressive motility decline were 0–10 weeks for BC (e.g., β: -0.07 %, 95%CI: [−0.11 %, −0.03 %] at the 5th week), Cl− at 1–4 weeks (e.g., β: -2.21 %, 95%CI: [−3.77 %, −0.66 %] at the 2nd week), 0–6 weeks and 9–10 weeks for NO3− (e.g., β: -0.05 %, 95%CI: [−0.09 %, −0.01 %] at the 4th week), 1–3 weeks and the 8th week for NH4+ (e.g., β: -0.06 %, 95%CI: [−0.11 %, −0.01 %] at the 2nd week). Total motility is significantly negatively associated with BC at entire windows, Cl− at 0–3 weeks, the 5th week and 9–10 weeks. ConclusionsThere are week-scale vulnerable windows of exposure to PM2.5 chemical components for human semen quality. This highlights the need for more targeted pollution control strategies addressing PM2.5 and its chemical components.

Effects of diluted seawater in drinking water on physiological responses, feeding, drinking patterns, and water balance in crossbred dairy goats

Background and Aim: In tropical regions, the intrusion of saline from seawater (SW) due to global warming and sea level rise in recent years is an important natural factor influencing goat well-being. This study aimed to determine the effects of diluted SW in drinking water on the physiological responses and eating and drinking patterns of crossbred dairy goats under tropical conditions. Materials and Methods: Twenty dairy goats were divided into four groups (five animals each) based on body weight and milk yield. Animals received either fresh drinking water (SW0.0, control) or diluted SW at concentrations of 0.5% (SW0.5, low salinity), 1% (SW1.0, moderate salinity), and 1.5% (SW1.5, high salinity). The experiment was performed for 49 days (1st–7th week). Throughout this period, daily food and water intake were measured every day. In addition, blood collection was performed on day 25. Total urine and feces were collected from days 25 to 29. Meal and drinking patterns were determined on days 31 and 32. Results: Salinity did not influence dry matter intake throughout the experiment (p &gt; 0.05). However, SW had a significant effect on eating patterns. The effect of SW on water intake (WI) was pronounced from the 2nd to 7th weeks of this experiment (p &lt; 0.05). The water balance decreased and plasma antidiuretic hormone levels increased from SW1.5 to SW2.5 compared to the other treatments. Rectal temperature and respiration rate increased from 15:00 to 17:00 in SW1.5 patients. The concentrations of plasma electrolyte, creatinine, and heat shock protein 70 did not differ between treatments (p &gt; 0.05). The urinary excretion of Na+ from SW1.5 and K+ and Cl- from SW1.0 was higher than that from SW0.0 and SW0.5 (p &lt; 0.01). Conclusion: Lactating crossbred goats adapted to low and moderate SW by increasing urine volume and urinary electrolyte excretion (Uex), whereas animals responded to high SW by either increasing Uex or altering drinking patterns to minimize salt stress. Keywords: antidiuretic hormone, dairy goat, kidney, saline water, water balance.

Paternal HLA-Derived Epitopes and Live Birth in SecondaryRecurrent Pregnancy Loss: New Insights FromaClinical Trial.

Recurrent pregnancy loss (RPL), defined as two or more pregnancy losses before the 24th week of gestation, affects 1%-3% of women worldwide. Approximately, 40% of RPL cases are secondary RPL (sRPL), where women have given birth before facing pregnancy losses. The underlying causes of RPL remain unclear, but immune-related factors may play a role. Previously, a randomised controlled trial using immunoglobulin (IVIG) in sRPL women with a history of four pregnancy losses performed in our RPL unit did not show significant effects of IVIG treatment overall. Yet, some evidence suggests potential benefits for a subset of sRPL patients. In the cohort used for the randomised controlled trial, we examined the role of maternal HLA class II-presented fetal HLA-derived epitopes in sRPL using the predicted indirectly recognisable HLA epitopes (PIRCHE-II) algorithm. In the placebo group, sRPL mothers with an anti-HLA antibody response had higher PIRCHE-II scores when having a live birth compared with sRPL women who experienced another pregnancy loss. This difference was not observed in the IVIG-treated group. Furthermore, as a proxy for T-cell memory, the number of overlapping peptides between the two paternal haplotypes in couples having live births without treatment displayed a larger number of overlapping peptides. This effect was primarily driven by class II-derived peptides. These results suggest that specific combinations of sRPL mothers and fathers, particularly those with an anti-HLA antibody response, may generate higher PIRCHE-II scores, which could contribute to successful live births. Understanding these immune interactions may provide insights for personalised diagnostic and therapeutic strategies in sRPL.

The dose effectiveness of extracorporeal shockwave on plantar flexor spasticity of ankle in stroke patients: a randomized controlled trial

BackgroundExtracorporeal shockwave therapy (ESWT) has been proven beneficial for post-stroke spasticity (PSS) of ankle plantar flexor muscles. This study aims to investigate the dose-response effectiveness of focused-ESWT and the duration of its effect on the treatment of ankle PSS in stroke patients.MethodsIn this double-blinded randomized controlled trial, stroke patients diagnosed with PSS in the ankle plantar flexor muscles were randomly assigned to two groups. The experimental group received double-dose ESWT (4000 pulses per session) targeting spastic calf muscles, while the control group received half the dose (2000 pulses per session). Both groups underwent four sessions over two weeks. The outcomes, including modified Ashworth Scale (MAS), modified Tardieu Scale (MTS), passive range of motion (PROM) of the ankle, Timed Up and Go (TUG) Test, Barthel index and strain elastography were evaluated at baseline, 1st, 4th, 12th, and 24th week after ESWT.ResultsWithin-group analysis revealed significant improvements in MAS, PROM, TUG Test, and Barthel index for the double-dose ESWT group and improvements in Barthel index for the control group. Between-group analysis revealed greater improvements in TUG Test, Barthel Index and strain elastography for the double-dose ESWT group. Generalized estimating equations analysis indicated that the double-dose ESWT group achieved superior outcomes in the TUG Test, Barthel Index, and strain elastography across various time points and groups.ConclusionsDouble-dose ESWT showed better functional improvement and elastography compared to the control group. ESWT demonstrated dose-response effectiveness for PSS of ankle-equinus.Trial registrationNCT05878223.

Laparoscopic Cornuostomy: A Conservative Surgical Approach to Interstitial Pregnancy — A Case Report

Interstitial pregnancy accounts for only 2%–4% of all ectopic pregnancies, however, it is associated with higher mortality rates as compared to other ectopic pregnancies, due to the associated risk of uterine rupture, and hemorrhage. A 35-year-old gravida 4 abortion 3 woman reported at the 8th week of gestation for antenatal care with comorbidity of protein C and protein S deficiency and recurrent pregnancy loss with for routine care. She was diagnosed as a case of interstitial pregnancy by transvaginal sonography and magnetic resonance imaging. She was subsequently managed by laparoscopic cornuostomy. Prompt recognition and definitive management are crucial in averting life-threatening hemorrhage due to this rare condition.

Home treatment protocol for dentin hypersensitivity with hydroxyapatite-based biodynamic toothpaste and lactoferrin: a pilot study.

In recent years, there has been a gradual increase in cases of dentin hypersensitivity, often related to gingival recession, enamel abrasion from brushing, and wear of root cementum. This condition can affect patients of all ages but is more common between 20 and 40 years of age, especially in females and individuals with periodontal disease. The study aimed to evaluate and compare the efficacy over time of a product for at-home treatment of dentin hypersensitivity. One hundred five patients aged between 28 and 65 years were recruited, each with at least two hypersensitive teeth due to erosions, abrasions, gingival recessions, and/or periodontal diseases. Participants were selected through the Schiff Test and anamnestic evaluations, with compilation of periodontal records. Patients are instructed to use the product three times a day, to be applied with a soft-bristled toothbrush and/or topically as a gel on teeth with strong sensitivity and deep cervical lesions and gingival recessions. There were no statistically significant differences between measurements at baseline and after scaling. However, significant differences were observed in follow-ups from the 1st to the 8th week, with a progressive decrease in values. The average trend of product efficacy increases over time according to the Schiff Test, with a significant improvement observed at follow-ups conducted after four and eight weeks. The results indicate that the product enriched with biomimetic hydroxyapatite and lactoferrin is effective in reducing the painful symptoms of dentin hypersensitivity and in counteracting the inflammatory state of the supporting tissues.

Comparison of the Effects of Microfracture, Soft Callus Implantation, and Matrix-Supported Chondrocyte Implantation in an Experimental Osteochondral Defect Model in Rats

Background: The treatment of cartilage defects remains challenging due to the avascular nature of cartilage. Aim: This study investigates the therapeutic effect of soft callus in osteochondral defects and explores the ability of multipotent and pluripotent cells within the callus to form fibrous or hyaline cartilage in the defective area. Methods: Twenty-one rats were divided into three equal groups: Group 1 received only microfracture (MF), group 2 received microfracture with autologous chondrocyte implantation (MF+ACI), and group 3 received microfracture with soft callus implantation (MF+SCI). All rats underwent diaphyseal fracture in their left tibias, which was stabilized with a Kirshner wire. One week later, osteochondral defects were created in the right knees of all rats. For group 1, microfracture alone was applied to initiate healing in the defects. In group 2, heterologous chondrocytes, previously harvested from the lateral condyle of a rat’s left femur and cultivated in a laboratory environment, were implanted into the microfracture site. In group 3, soft callus tissue obtained from the left tibial fracture was compressed and implanted into the defective area. All groups were sacrificed at the 6th week, and the healing status of the osteochondral defect areas was histopathologically evaluated. Results: Macroscopic examination at the end of the study revealed comparable ICRS-1 scores for MF+ACI (group 2) (11.28 ± 1.25) and MF+SCI (group 3) (11.14 ± 0.37), while MF alone (group 1) (4.28 ± 1.25) showed significantly lower results. Microscopic examination yielded similar outcomes. Regarding histological scores, ICRS-2 scores for MF (group 1) (35.30 ± 1.13), MF+ACI (group 2) (47.09 ± 1.63), and MF+SCI (group 3) (43.97 ± 1.49) were statistically significantly lower. Conclusion: Defects treated with soft callus implantation demonstrated comparable outcomes to the widely used and gold-standard autologous chondrocyte implantation. When compared to microfracture alone, better macroscopic and microscopic results were achieved with soft callus implantation.

Absence of Survival Impact from Hepatitis During Immunotherapy in 193 Patients with Advanced Hepatocellular Carcinoma - An Observational Study from Taiwan.

Hepatitis often occurs after initiating immune checkpoint inhibitor (ICI) treatment. The time and grade of hepatitis after ICI starts and the prognostic role of immune-related hepatitis in patients with advanced hepatocellular carcinoma (aHCC) remain unclear. In this real-world analysis, we enrolled aHCC patients receiving ICIs, documented the highest level of liver enzymes during/after ICIs, and analyzed the survival impact of different hepatitis patterns. One hundred and ninety-three aHCC patients receiving ICIs were recruited. During ICIs, 88.6% of patients experienced aspartate transaminase (AST) elevations (Grade III/IV: 7.8%). For alanine transaminase (ALT), 81.3% had elevated levels (Grade III/IV: 3.6%), and 41.5% of patients had elevated bilirubin levels (Grade 3/4: 6.7%). The median AST, ALT, and total bilirubin values significantly increased after ICI treatment initiated (all p < 0.001) and, similarly, after excluding progressive disease (p = 0.014, p = 0.002, p < 0.001). The median time of hepatitis occurrence is from the 4.0th to 15.9th weeks. Multivariable analysis showed that patterns of liver enzyme change of AST and total bilirubin in patients receiving ICIs significantly correlate to overall survival (OS, p = 0.009 and 0.001, respectively). After ICI termination, patients with elevated bilirubin (p = 0.003) and AST (p = 0.005) would indicate poor survival, with adjustment of viral hepatitis and ICI responses. Hepatitis emerges between the 4th and 20th weeks post-ICI initiation. Changes in liver enzymes during ICI therapy do not directly affect OS, implying the safety of ICI use when corticosteroids are promptly administered if clinically indicated.

Significance of Physical Exercise in Pregnancy: Comparison of Short and Long Exercise Programs.

Several musculoskeletal changes occur in pregnancy, particularly in the abdominal region. The aim of this study was to search and compare the effects of long (LEP) and short exercise programs (SEP) in terms of the satisfaction of the needs of pregnant women. This study consisted of 2 groups: LEP (n=16) and SEP (n=16). Muscle thickness measurements determined by ultrasound, the 6 minute walk test, Pregnancy Physical Activity Questionnaire, Visual Analogue Scale, Oswestry Disability Index, and Short Form-36 Quality of Life Questionnaire were the study variables. Evaluations were done at the 16th (baseline), 24th, and 32nd gestational weeks. The LEP consisted of 20 and the SEP consisted of 9 exercises, which were applied for 16 weeks until the 32nd gestational week. Emotional role limitation and pain scores of quality of life, 6 minute walk test, and occupational physical activity were found to be better in the LEP group at the 24th gestational week (p=0.043, p=0.049, p=0.049, p=0.026). At the 32nd gestational week, the 6 minute walk test and occupational physical activity were found to be higher in the LEP group (p=0.006, p=0.017). Additionally, rectus abdominis and bilateral diaphragm muscle thicknesses, "moderate intensity and sports physical activity" and "vitality and emotional well-being" were increased over time with the LEP (p+<+0.05 for all). On the other hand, unilateral diaphragm muscle thickness, sports physical activity level, and vitality were improved with the SEP (p+<+0.05 for all). The SEP and LEP both have beneficial effects in pregnant women. However, the LEP increases physical activity level, functional capacity, and quality of life more than the SEP during the later stages of pregnancy.

Deciphering the impact of PROM1 alternative splicing on human photoreceptor development and maturation

Alternative splicing (AS) is a crucial mechanism contributing to proteomic diversity, which is highly regulated in tissue- and development-specific patterns. Retinal tissue exhibits one of the highest levels of AS. In particular, photoreceptors have a distinctive AS pattern involving the inclusion of microexons not found in other cell types. PROM1 whose encoded protein Prominin-1 is located in photoreceptor outer segments (OSs), undergoes exon 4 inclusion from the 12th post-conception week of human development through adulthood. Exon 4 skipping in PROM1 is associated with late-onset mild maculopathy, however its role in photoreceptor maturation and function is unknown. In this study retinal organoids, a valuable model system, were employed in combination with phosphorodiamidate morpholino oligos (PMOs) to assess the role of exon 4 AS in the development of human retina. Retinal organoids were treated with the PMOs for four weeks after which RT-PCR, western blotting and immunofluorescence analysis were performed to assess exon 4 exclusion and its impact on photoreceptors. The transcriptome of treated ROs was studied by bulk RNA-Seq. Our data demonstrate that 55% skipping of PROM1 exon 4 resulted in decreased Prominin-1 expression by 40%, abnormal accumulation of cones in the basal side of the retinal organoids as well as detectable cone photoreceptor cilium defects. Transcriptomic and western blot analyses revealed decreased expression of cone, inner segment and connecting cilium basal body markers, increased expression of genes associated with stress response and the ubiquitin-proteasome system, and downregulation of autophagy. Importantly, the use of retinal organoids provides a valuable platform to study AS and unravel disease mechanisms in a more physiologically relevant context, opening avenues for further research and potential therapeutic interventions. Together our data indicate that cones may be more sensitive to PROM1 exon 4 skipping and/or reduced Prominin-1 expression, corroborating the pathogenesis of late-onset mild maculopathy.

The Effect of Discharge Education and Post-Discharge Telephone Counseling on Quality of Life in Patients Undergoing Radical Prostatectomy: A Randomized Controlled Study

Aim: This study aims to determine the effect of model-based discharge education, and post-discharge telephone counseling on patients who have undergone radical prostatectomy on their quality of life. Methods: This randomized controlled study consisted of patients who underwent radical prostatectomy surgery and completed with a total of 42 patients, 20 of whom were in the experimental and 22 in the control group. The experimental group patients and their relatives were given discharge education and patients were called every two weeks after the operation. The control group received standard care. The patients’ quality of life was evaluated the day before the operation, and at the 6th and 12th weeks after surgery. The data were collected with the “Personal Information Form”, and “Short Form-12 Health Survey (SF-12)”. Results: 55.0% of the patients in the experimental group and 54.5% of the patients in the control group experienced urinary incontinence; 45.0% of the experimental group patients and 50.0% of the control group patients experienced erectile dysfunction three months after surgery. The experimental group had statistically significantly higher SF-12 mental component scores in the 12th week than the control group (p &lt; 0.05). Conclusion: Model-based discharge education and post-discharge telephone counseling for patients who had radical prostatectomy surgery were effective in the mental dimension of the patient's quality of life, but not in the physical dimension. Providing patients with different information channels will support the psychological dimension of their quality of life.