2-week Intervals Research Articles

Mathematics Worked Examples with Tracing Gesture Makes Learning Last

The immediate measurement of tracing effect in the previous studies have shown that the use of tracing gesture in the visuospatial-based worked examples instruction may enhance the learning of mathematical concepts, specifically the geometrical principles. The present study further explored whether the use of tracing gesture in the visuospatial-based worked examples during the acquisition phase results in better memory retention on the learning over time. To investigate the robustness of tracing effect, a 4-weeks interval delayed post-test was conducted after the participants (mean age = 12.37, SD = 0.27) were asked to study worked examples on angles relationships involving parallel lines either without tracing instruction or with tracing instruction. The results showed that the tracing group (N = 30) outperformed the non-tracing group (N = 30) in the delayed post-test and reported lower levels of test difficulty, suggesting that tracing gesture may help to retain the knowledge gained during instruction and consolidated the learning during the intervening period.

ЭКСПЕРИМЕНТАЛЬНЫЕ МЕТОДЫ МОДЕЛИРОВАНИЯ ПРЕЖДЕВРЕМЕННОЙ НЕДОСТАТОЧНОСТИ ЯИЧНИКОВ: ПРЕИМУЩЕСТВА И НЕДОСТАТКИ

Premature ovarian insufficiency (POI) is a disorder of ovarian function in women under 40 years of age accompanied by amenorrhea or oligomenorrhea for more than 4-6 months with biochemical confirmation of follicle-stimulating hormone (FSH) levels >25 IU/L when assessed twice at 4-week intervals. There are four main types of mouse models of PND: the "chemotherapy" model, the "autoimmune" model, the "psychological stress" model, and the "natural aging" model. The most commonly used is the chemotherapeutic model of NPT induced by cyclophosphamide. Also, such a model can be obtained by induction with trypterigium glycosides (TG), busulfan (BF), DOX, etc. An autoimmune model is developed using ZP3 glycoproteins, a stress mouse model of PNJ is obtained using CUMS, MS, etc. methods. By subcutaneous injection of D-Gal, a natural aging model is generated. Each has its own advantages and disadvantages, relative to ideal criteria mouse models of premature ovarian failure. Based on such considerations, chemotherapeutic models are leading so far, but this mode of induction has a number of side effects such as myelosuppression and bleeding. The aim of this review is to analyze the current data on different murine models of PND, their advantages disadvantages, as well as subtypes and modes of induction.

Effects of adaptive scaffolding on performance, cognitive load and engagement in game-based learning: a randomized controlled trial

BackgroundWhile game-based learning has demonstrated positive outcomes for some learners, its efficacy remains variable. Adaptive scaffolding may improve performance and self-regulation during training by optimizing cognitive load. Informed by cognitive load theory, this study investigates whether adaptive scaffolding based on interaction trace data influences learning performance, self-regulation, cognitive load, test performance, and engagement in a medical emergency game.MethodsSixty-two medical students from three Dutch universities played six game scenarios. They received either adaptive or nonadaptive scaffolding in a randomized double-blinded matched pairs yoked control design. During gameplay, we measured learning performance (accuracy, speed, systematicity), self-regulation (self-monitoring, help-seeking), and cognitive load. Test performance was assessed in a live scenario assessment at 2- and 6–12-week intervals. Engagement was measured after completing all game scenarios.ResultsSurprisingly, the results unveiled no discernible differences between the groups experiencing adaptive and nonadaptive scaffolding. This finding is attributed to the unexpected alignment between the nonadaptive scaffolding and the needs of the participants in 64.9% of the scenarios, resulting in coincidentally tailored scaffolding. Exploratory analyses suggest that, compared to nontailored scaffolding, tailored scaffolding improved speed, reduced self-regulation, and lowered cognitive load. No differences in test performance or engagement were found.DiscussionOur results suggest adaptive scaffolding may enhance learning by optimizing cognitive load. These findings underscore the potential of adaptive scaffolding within GBL environments, cultivating a more tailored and effective learning experience. To leverage this potential effectively, researchers, educators, and developers are recommended to collaborate from the outset of designing adaptive GBL or computer-based simulation experiences. This collaborative approach facilitates the establishment of reliable performance indicators and enables the design of suitable, preferably real-time, scaffolding interventions. Future research should confirm the effects of adaptive scaffolding on self-regulation and learning, taking care to avoid unintended tailored scaffolding in the research design.Trial registrationThis study was preregistered with the Center for Open Science prior to data collection. The registry may be found at https://osf.io/7ztws/.

Investigation of the expression of Cis P-tau and Pin1 proteins following air pollution induction in the brain tissue of C57BL/6 mice.

Alzheimer's disease (AD) is a multifactorial disease in which environmental factors play a role. Among environmental factors, air pollution is a vital issue in modern life. Despite extensive considerations, it remains uncertain how pollution mediates neurodegeneration in AD. Beta-amyloids and hyperphosphorylated tau proteins are the two main pathological markers that have been studied in AD so far. Tau protein is basically a phosphoprotein whose functions are controlled by phosphorylation. The function of tau protein is to be located on the surface of microtubules and stabilize them. Studies have shown that phosphorylated tau protein (p-tau) exists in cis and trans conformations at Thr231, among which cis is highly neurotoxic. The Pin1 enzyme performs the conversion of cis to trans or vice versa. In this study, an experimental mouse model was designed to investigate the formation of cis p-tau by inducing air pollution. In this way, mice were randomly exposed to pollution at 2-week, 1-month, and 2-month intervals. We investigated the formation of phosphorylated cis tau form during air pollution on mouse brains using Western blots and immunofluorescence. The fluorescent imaging results and Western blotting analysis of mouse brains revealed a significant accumulation of cis p-tau in pollution-treated mice models compared to the healthy control mice. According to Western blot results, air pollution induction caused a significant decrease in Pin1 protein. The results clearly show that the tauopathy observed during air pollution is mediated through the formation of cis tau. Our findings unravel tauopathy mysteries upon pollution and would help find a possible therapeutic target to fight the devastating disorder caused by modern life.

Defining the glenohumeral range of motion required for overhead shoulder mobility: an observational study.

Recovery of overhead mobility after shoulder surgery is time-consuming and important for patient satisfaction. Overhead stretching and mobilization of the scapulothoracic and glenohumeral (GH) joints are common treatment interventions. The isolated GH range of motion (ROM) of flexion, abduction, and external rotation required to move above 120° of global shoulder flexion in the clinical setting remains unclear. This study clarified the GH ROM needed for overhead mobility. The timely development of shoulder ROM in patients after shoulder surgery was analyzed. Passive global shoulder flexion, GH flexion, abduction, and external rotation ROM were measured using goniometry and visually at 2-week intervals starting 6-week postsurgery until the end of treatment. Receiver operating characteristic curves were used to identify the GH ROM cutoff values allowing overhead mobility. A total of 21 patients (mean age 49 years; 76% men) after rotator cuff repair (71%), Latarjet shoulder stabilization (19%), and arthroscopic biceps tenotomy (10%) were included. The ROM cutoff value that accurately allowed overhead mobility was 83° for GH flexion and abduction with the area under the curve (AUC) ranging from 0.90 to 0.93 (p < 0.001). The cutoff value for GH external rotation was 53% of the amount of movement on the opposite side (AUC 0.87, p < 0.001). Global shoulder flexion above 120° needs almost full GH flexion and abduction to be executable. External rotation ROM seems less important as long as it reaches over 53% of the opposite side.

Evaluating the Reliability and Model Fit of the 13-Item and 10-Item Big Five Inventory (Malay Version) among Malaysian Firefighters.

Lengthy instruments for assessing personality traits may not be applicable in certain research settings. In situations where time is scarce, a briefer measurement is preferable. However, the reliability of a briefer measurement of the Big Five Inventory (BFI) among firefighters in Malaysia has not been reported. This study aimed to investigate the reliability and model fit of the Malay version of the BFI with 13 items (BFI-13) and 10 items (BFI-10) among Malaysian firefighters. A cross-sectional study using cluster sampling was conducted in a state in Malaysia. Each respondent completed BFI-10 and BFI-13 using an online survey with a 1-month interval between each response. Reliability testing was evaluated using internal consistency and a 2-week interval test-retest. The model fit of these two BFI questionnaires was evaluated via confirmatory factor analysis (CFA). A total of 124 firefighters participated in the study, with a zero-dropout rate. The Malay version of BFI-13 exhibited higher reliability by displaying good internal consistency with Cronbach's alpha of 0.919, 0.838, 0.871 and 0.896 for the domains conscientiousness, neuroticism, agreeableness and extraversion, respectively, and acceptable test-retest reliability with moderate to good intraclass correlation (0.588-0.806). The CFA model also indicated that BFI-13 has a better model fit (comparative fit index [CFI] = 0.993; Tucker-Lewis index [TLI] = 0.991; standardised root mean squared residual [SRMR] = 0.029; root mean square error of approximation [RMSEA] = 0.035). The Malay version of BFI-13 is reliable and applicable enough to be supplementarily used in surveys among Malaysian firefighters. By using a brief personality assessment, it will reduce the cognitive and emotional burden on respondents.

Safety and Tolerability of ADR-001 Therapy for Immunoglobulin A Nephropathy.

Immunoglobulin A nephropathy often requires kidney replacement therapy because of its refractoriness and because corticosteroids pose infection risks. However, mesenchymal stem cells offer clinical benefits because of their regenerative and immunomodulatory properties. This prospective clinical trial assessed the safety and tolerability of adipose-derived mesenchymal stem cell therapy and evaluated its therapeutic efficacy. This phase 1 study included adult patients with refractory immunoglobulin A nephropathy that was difficult to treat with traditional therapies. Adipose-derived mesenchymal stem cell therapy comprising one intravenous dose of 1 × 108 cells was administered to three to six patients in cohort 1. The same intravenous dose was administered twice with a 2-week interval to six patients in cohort 2. Heparin was administered simultaneously. This study continued for 52 weeks, and the primary endpoints were safety and tolerability during the 6-week period after treatment administration. Secondary endpoints included adverse events and efficacy measures such as clinical remission, partial remission, urine protein remission, hematuria remission, time to remission, changes in the urine protein and hematuria levels, and changes in the estimated glomerular filtration rate. The three patients in cohort 1 and six patients in cohort 2 who received adipose-derived mesenchymal stem cell therapy achieved the primary endpoints. No severe adverse clinical events were observed. Therefore, the safety and tolerability of adipose-derived mesenchymal stem cells were confirmed. Improvements such as significantly decreased kidney damage markers and urinary protein levels were observed immediately after adipose-derived mesenchymal stem cell administration. The safety and tolerability of adipose-derived mesenchymal stem cells are acceptable for patients with immunoglobulin A nephropathy. This trial was registered with the Japan Registry of Clinical Trials (jRCT2043200002; registration date: April 14, 2020) and ClinicalTrials.gov (NCT04342325; registration date: April 13, 2020).

Turkish adaptation of the Neonatal Eating Assessment Tool-Bottle-Feeding in preterm infants discharged to home.

Preterm infants often continue to have feeding difficulties after hospital discharge. Parental use of assessment tools and collaboration with health professionals are important for the early diagnosis of postdischarge feeding difficulties. This methodological study examined the validity and reliability of the Turkish version of the Neonatal Eating Assessment Tool (NeoEAT)-Bottle-feeding in postdischarge preterm infants in Türkiye. A Turkish version of the NeoEAT-Bottle-feeding was developed and applied to 321 mothers of preterm infants younger than 7 months of corrected age between August 2021 and December 2022. Cronbach's alpha, exploratory factor, confirmatory factor, item-total correlation, test-retest, and known-groups validity analyses were performed. The Turkish NeoEAT-Bottle-feeding has 60 items in five factors explaining 55.785% of the total variance. Exploratory factor analysis indicated that the item factor loading ranged from 0.320 to 0.792. The known-group validity analysis confirmed that preterm infants with diagnosed feeding problems had higher total and subscale scores than those without (p = 0.001). The Cronbach's alpha (α) of the entire scale was 0.96. The item-total correlation coefficients were between 0.31 and 0.77 (p = 0.001). There was excellent agreement between test values and retest values obtained after a 2-week interval (intraclass correlation coefficient: 0.930-1.000). The Turkish NeoEAT-Bottle-feeding was shown to be a reliable and valid parent-reported assessment tool for oral feeding skills and difficulties after neonatal intensive care unit discharge in bottle-fed preterm infants younger than 7 months of corrected age. Healthcare professionals can use this assessment tool during the initial evaluation of risk factors contributing to problematic feeding and to determine the effectiveness of planned interventions in preterm infants.

Comparison of platelet-rich plasma efficacy with and without photoactivation in melasma: A randomized double-blind study.

Photoactivation has been suggested to enhance the efficacy of platelet-rich plasma (PRP) in conditions other than dermatological diseases. To evaluate the efficacy of photoactivated PRP (P-PRP) treatment for melasma by comparing it with non-photoactivated, classical PRP (C-PRP). The study consisted of 38 female patients diagnosed with melasma between April 2022 and May 2023. The patients were randomized into the P-PRP and C-PRP groups. Three sessions of P-PRP or C-PRP were applied to the patients at 2-week intervals. The Melasma Area and Severity Index (MASI) and Melasma Quality of Life Index (MELASQoL) scores were compared before and 2 weeks after treatment. The median age was 38 years, and the median disease duration was 60 months. Clinically, 94.7% of the cases were centrofacial and 5.3% were malar. According to Wood's lamp examination, 55.3% of the cases were epidermal, 13.2% were dermal, and 31.6% were mixed-type. The median pre- and post-treatment scores were 14.5 and 9, respectively, for MASI and 36.5 and 17, respectively, for MELASQoL. The post-treatment MASI and MELASQoL scores of both groups significantly decreased (p < 0.001 for both). However, the intergroup difference was not significant. When all patients were evaluated together a moderate, positive, and significant relationship was detected between PRP and the pre- and post-treatment MASI and MELASQoL scores (r = 0.494 and p = 0.002). No side effects associated with PRP were observed. PRP is an effective and safe treatment method for melasma. Further studies are needed to evaluate the contribution of photoactivation to PRP treatment in melasma.

Efficacy and safety of non-cross-linked hyaluronic acid compound in the treatment of keratosis pilaris: A split-body randomized clinical trial.

Keratosis pilaris (KP) is a prevalent benign dermatological condition characterized by small bumps at the hair follicles alongside surrounding redness, significantly impacting both aesthetics and mental well-being. This study investigated the potential benefits of a non-cross-linked hyaluronic acid (HA) compound for treating KP. A split-body, investigator-blinded, randomized, intraindividual comparative clinical trial was conducted. The non-cross-linked HA compound was injected into KP-affected regions on both upper arms. The treatment was delivered across four sessions scheduled at 4-week intervals. Blinded physicians and patients assessed differences in erythema, skin roughness, and overall scores between treated and control areas at the final follow-up visit. At the 12th and 24th weeks post-treatment, a four-point scale was utilized to assess subjects' perceived treatment efficacy. Additionally, dermoscopic images, histological alterations, and adverse events were monitored. Physician assessments revealed a significant reduction in roughness and overall scores for treated areas compared to controls. Patient self-assessments also reflected improvements in roughness, redness, and overall scores for treated sides at the final visit, with 35.71% of patients demonstrating sustained improvement in redness and 71.43% reporting persistent improvements in roughness at 24th weeks post-treatment. The dermatoscopic examinations revealed a notable enhancement in both the quantity of follicular plugs and the extent of erythema among the subjects in the treatment group. Histopathological outcomes also demonstrated improvement. This study suggests that the non-cross-linked HA compound effectively improves skin roughness and promotes hair shaft growth in KP treatment, demonstrating a favorable safety profile. These findings position it as a potentially viable alternative therapy in clinical practice.

Camembert-Type Cheese with Sweet Buttermilk: The Determination of Quality Properties and Microstructure.

Camembert is a type of surface-mold-ripened soft cheese traditionally produced from cow's milk. Buttermilk, a by-product of butter production with beneficial nutritional and technological properties, is increasingly being used in various applications, including cheesemaking. Therefore, this study aimed to use sweet buttermilk (BM) in combination with milk at concentrations of 10% (w/w) (BM10) and 20% (w/w) (BM20) for the production of Camembert-type cheese. A control cheese made entirely from milk was also produced. The cheese samples underwent a 28-day ripening process during which their composition, acidity, water activity, color, and sensory properties were examined at 1-week intervals. The microstructure of the matured Camembert-type cheese samples was analyzed using scanning electron microscopy (SEM), and their texture was evaluated. The production yield of BM20 cheese (18.03 ± 0.29 kg/100 kg) was lower (p < 0.05) than that of the control (19.92 ± 0.23 kg/100 kg), with BM10 showing the distinctly lowest yield (14.74 ± 0.35 kg/100 kg). The total solid and fat content of BM Camembert-type cheese samples was lower than the control. However, the total protein content in cheese BM20 at the end of the ripening period was the same as that of the control. The changes in acidity in all samples were typical for Camembert cheese, and water activity was high (above 0.92). The sensory properties of all samples were characteristic of the cheese type, while the color of BM cheese samples differed from the control. The microstructure of BM10 and BM20 cheese variants was similar, namely homogenous and less porous compared to the control. In terms of texture, the BM samples had significantly lower hardness, adhesiveness, and gumminess. This study indicates that sweet BM, particularly at a concentration of 20%, may be effectively used in the production of Camembert-type cheese.

Nutrient Dynamics and Resource-Use Efficiency in Greenhouse Strawberries: Effects of Control Variables in Closed-Loop Hydroponics

The importance of implementing recirculating drainage for greenhouse strawberries is often overlooked because of the low electrical conductivity (EC) of drainage and transpiration despite the large area of cultivation in Korea. In this study, we analyzed the growth of strawberry crops and their water and individual nutrient use efficiency when using closed-loop hydroponics in greenhouses. The study consisted of two parts: Experiment (Exp) 1 and Exp 2, each of which employed a different closed-loop hydroponic control method. In Exp 1, the system was controlled solely based on the EC of the drainage mixed with raw water. In Exp 2, the nutrient solution (NS) was corrected according to the ion concentrations in the drainage, with correction intervals of 2 weeks, 4 weeks, and no correction, while the control treatment was open-loop. In Exp 1, a prolonged increase in drainage EC resulted in an imbalance in NS ion composition and reduced fruit yield. In Exp 2, the NS composition was stabilized through periodic nutrient correction, and the fruit yield of the closed-loop treatments did not differ from the open-loop treatment. However, the closed-loop with 2- and 4-week correction in Exp 2 showed 94% and 88% higher nutrient use efficiency (NUE), respectively, than an open-loop system. Among the closed-loop treatments, the 2- and 4-week correction intervals had 36% and 32% higher NUE than the no-correction treatment. Furthermore, the 2-week correction interval showed a 3% improvement in NUE compared to the 4-week interval. These findings highlight the importance of considering a shorter ion correction interval for optimal NUE and normal plant growth in recirculating hydroponic systems of strawberry cultivation.

Pain perception, aqueous humour cytokines, and miosis response following first and second eye femtosecond laser-assisted cataract surgery: A randomised, prospective, intraindividual study.

To compare pain perception, pupil behaviours, and cytokine levels during first-eye and second-eye femtosecond laser-assisted cataract surgery (FLACS) and determine which is better regarding a short or long interval for bilateral FLACS. Notably, 96 eyes of 48 patients with bilateral cataracts underwent the first surgeries in the left or right eye, according to a random sequence. They were further randomised into 2- and 6-week subgroups based on surgery intervals. Pupil size was measured from captured images, and pain perception was assessed using a visual analog scale (VAS). Aqueous humour prostaglandin E2 (PGE2), monocyte chemoattractant protein-1 (MCP-1), interleukin (IL)-6, and IL-8 levels were also quantitatively analysed. All patients were followed for 1 week to evaluate changes in endothelial cell density (ECD), central corneal thickness (CCT), and macular central subfield thickness (CST). Ocular pain was significantly higher in patients who underwent second-eye FLACS. First tear break-up time was negatively correlated with VAS score. MCP-1 levels were significantly higher in patients who underwent second-eye FLACS, and VAS scores were positively correlated with MCP-1 levels across all patients. There were no differences between sequential FLACS in miosis, PGE2, IL-6, IL-8 levels and changes in postoperative ECD, CCT, and CST. Patients who underwent second-eye FLACS after 6 weeks showed more CCT, CST, and MCP-1 changes than baseline. Second-eye FLACS causes more pain and upregulated MCP-1. There was no difference between sequential FLACS in PGE2 levels, miosis, and postoperative inflammation. Furthermore, first-eye FLACS triggered a sympathetic irritation, particularly after a 6-week interval.

Evaluation of Peri-Implantitis Bone Defect Healing: Comparing the Efficacy of Small-Particle Dentin and Bio-Oss in Bone Density Attenuation.

Introduction: Peri-implantitis is a serious complication in dental implantology that, if left untreated, may lead to implant loss and systemic diseases. Effective regeneration of bone defects resulting from peri-implantitis is crucial to maintaining the functionality of dental implants. Purpose of the Study: The study aimed to compare the effectiveness of fine-particle dentin and Bio-Oss in the reconstruction of bone defects caused by peri-implantitis. Materials and Methods: The study included a comprehensive radiological assessment of changes in bone density over time. Bone density was assessed using Hounsfield Units (HUs) as a measure of bone attenuation, with radiological assessments performed at 8- and 12-week intervals during the healing process. The study included participants ranging in age from 30 to 65 years. Fifty-seven patients were divided into three groups: 22 patients received small-particle dentin, 15 received Bio-Oss, and 20 controls without bone substitute material. Results: The fine-dentin group showed a 20% increase in bone density after 8 weeks (p < 0.05), while the Bio-Oss group showed a 15% increase after 12 weeks (p < 0.05). The control group showed minimal changes in bone density (5% after 12 weeks), which was not statistically significant. Clinical evaluations showed 95% successful integration in the fine dentin group, 85% in the Bio-Oss group, and 70% in the control group. The fine-dentin group showed a 20% increase in bone density after 8 weeks (p < 0.05), while the Bio-Oss group showed a 15% increase after 12 weeks (p < 0.05). The control group showed minimal changes in bone density (5% after 12 weeks), which was not statistically significant. Clinical evaluations showed 95% successful integration in the fine-dentin group, 85% in the Bio-Oss group, and 70% in the control group. Conclusions: Both fine-particle dentin and Bio-Oss significantly improved bone density compared to the control group. Fine-particle dentin is suitable for immediate bone regeneration due to its rapid initial regeneration, while Bio-Oss provides long-term support, ideal for maintaining implant stability over a longer period of time. The results highlight the importance of selecting appropriate bone replacement materials depending on the clinical scenario to improve patient outcomes after dental implant placement.

Evaluation of oral silymarin formulation efficacy in prevention of doxorubicin induced hepatotoxicity in patients with non-metastatic breast cancer.

Chemotherapy-induced hepatotoxicity is a common complication in breast cancer patients, especially with doxorubicin-containing regimens. Liver enzyme abnormality is reported in 34.8% of patients undergoing AC-T regimen and fatty liver is reported in 30% to 50% of cases. Antioxidant and anti-inflammatory properties of silymarin, a polyphenolic flavonoid extract derived from Silybum marianum, may be useful in preventing chemotherapy-induced hepatotoxicity. This study evaluated the effect of oral silymarin for preventing doxorubicin induced hepatotoxicity in non-metastatic breast cancer patients. In this triple-blind, placebo-controlled clinical trial, 50 patients with non-metastatic breast cancer were assigned to receive either 140 mg silymarin tablets or the placebo three times daily for 63 days and were evaluated for liver function test before the study and at the end of each chemotherapy cycle (every 3 weeks) for 4 cycles. In addition, an ultrasonography assessment was performed upon entry and the end of the study. Based on ultrasonography, the fatty liver grade was significantly higher in the placebo group at the end of the study. Moreover, the serum levels of aspartate aminotransferase (p = 0.015) and alkaline phosphatase (p = 0.004) at 6-week intervals, and the serum level of alkaline phosphatase (p = 0.002) at 9-week intervals were significantly lower in the silymarin group. Oral formulation of silymarin 420 mg/day for 63 days significantly prevented hepatotoxicity caused by doxorubicin in patients with non-metastatic breast cancer mostly based on liver ultrasonography but not laboratory parameters. Further investigations are suggested on different doses, durations and formulations of silymarin, particularly nano-formulations for increasing its oral bioavailability.

The effects of motivational interviewing on sexual quality of life and sexual self-efficacy in postmenopausal women with sexual dysfunction.

This study was conducted to determine the effects of motivational interviewing on sexual quality of life and sexual self-efficacy in postmenopausal women with sexual dysfunction. This randomized controlled study was conducted with 164 postmenopausal women with sexual dysfunction who presented to the gynecology outpatient clinic of a university hospital in Kahramanmaras, Türkiye (82 experimental, 82 control). The data were collected using a personal information form, the Arizona Sexual Experiences Scale-Female Version Questionnaire, the Sexual Quality of Life-Female Questionnaire, and the Sexual Self-Efficacy Scale. Four motivational interview sessions were conducted with the postmenopausal women in the experimental group at 1-week intervals, and those in the control group did not receive any intervention. The data were analyzed using descriptive statistics, Pearson's chi-squared test, and independent samples and paired samples t tests. Both the sexual quality of life and sexual self-efficacy levels of the participants in the experimental and control groups were similar in the pretest stage (P > 0.05). After the motivational interviews with those in the experimental group, the rate of sexual dysfunction was determined as 82.9% in the experimental group and 98.8% in the control group. Additionally, after the motivational interviews, the sexual dysfunction scores of the participants in the experimental group decreased significantly, and their sexual quality of life and sexual self-efficacy levels increased significantly compared to those in the control group (P < 0.001). The results of this study revealed that motivational interviewing decreased sexual dysfunction and increased sexual quality of life and sexual self-efficacy in postmenopausal women with sexual dysfunction.

Extracorporeal shockwave therapy for degenerative meniscal tears results in a decreased T2 relaxation time and pain relief: An exploratory randomized clinical trial.

The optimal management of degenerative meniscal tears remains controversial. Extracorporeal shockwave therapy (ESWT) has been shown to promote tissue repair in both preclinical and clinical studies; however, its effect on degenerative meniscal tears remains unknown. This study aimed to examine whether ESWT improves meniscal degeneration. This randomized trial was conducted between 2020 and 2022 and involved patients with degenerative medial meniscal tears. Patients were allocated to receive either focused ESWT (0.25 mJ/mm2, 2000 impulses, 3 sessions with a 1-week interval) or sham treatment. Patients were evaluated using magnetic resonance imaging (MRI) before treatment and at 12 months after treatment. The primary endpoint was improvement in meniscal degeneration, as assessed by the change in T2 relaxation time from baseline on MRI T2 mapping. Knee pain and clinical outcomes were also examined at the same time. Of 29 randomized patients, 27 patients (mean age 63.9 ± 8.7 years; females 37%; ESWT group 14 patients; control group 13 patients) were included in the final analysis. At 12 months postintervention, patients in the ESWT group showed a greater decrease in the T2 relaxation time (ESWT group -2.9 ± 1.7 ms vs. control group 1.0 ± 1.9 ms; p < 0.001) and had less knee pain (p = 0.04). The clinical outcomes at 12 months post-treatment were not statistically significant. No adverse events were reported. ESWT decreased the T2 relaxation time in the meniscus at 12 months post-treatment. ESWT also provided pain relief, but no differences were observed in clinical outcomes. Level II.

Orally dissolving film as a potential vaccine delivery carrier to prevent influenza virus infection

Orally dissolving films (ODF) are designed to be dissolved on the tongue and absorbed in the mouth. It offers multiple advantages over the commonly used needle-based vaccines, especially in terms of convenience allowing safe, painless, and easy self-administration. As the efficacy of ODF-encapsulated influenza vaccines has not been demonstrated, we assessed the protection elicited by inactivated influenza virus (A/PR/8/34, H1N1) vaccine delivered using ODFs in mice. Trehalose and pullulan components of the ODF ensured that the HA antigens of the inactivated PR8 virus retained their stability while ensuring the rapid release of the vaccines upon exposure to murine saliva. Mice were immunized thrice by placing the PR8-ODF on the tongues of mice at 4-week intervals, and vaccine-induced protection was evaluated upon lethal homologous challenge infection. The PR8-ODF vaccination elicited virus-specific serum IgG and IgA antibody responses, hemagglutinin inhibition (HAI), and viral neutralization. Upon challenge infection, ODF vaccination showed higher levels of IgG and IgA antibody responses in the lungs and antibody-secreting cell (ASC) responses in both lung and spleen compared to unimmunized controls. These results corresponded with the enhanced T cell and germinal center B cell responses in the lungs and spleens. Importantly, ODF vaccination significantly reduced lung virus titers and inflammatory cytokines (IFN-γ, IL-6) production compared to unvaccinated control. ODF vaccination ensured 100% survival and prevented weight loss in mice. These findings suggest that influenza vaccine delivery through ODFs could be a promising approach for oral vaccine development.

‘Remote inhibition’ of motor cortex in Epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS): A TMS based cortical excitability study

ObjectivesThe study compared real-time motor cortex excitability using transcranial magnetic stimulation (TMS)-derived parameters between children with epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS) and age-matched neurotypical controls. The EE-SWAS group received steroids as standard of care and were longitudinally followed for three months. Materials & MethodsChildren aged 5–12 years with immunotherapy-naive EE-SWAS (spike-wave-index≥50 %) and neurotypical controls were enrolled. Cognitive and behavioral assessments were performed using valid psychometric tools. Real-time motor cortex excitability was assessed by measuring resting motor threshold (RMT), short intra-cortical inhibition (SICI) and long intra-cortical inhibition (LICI) in both groups. In EE-SWAS group, a follow up evaluation with TMS at 4- and 12-week intervals, EEG, and neurobehavioral assessments at 12-weeks were performed to assess the effect of steroids on cortical excitability and to determine electroclinical outcome. ResultsForty-eight children with suspected EE-SWAS and 26 neurotypical controls were screened; 20 were enrolled in each group. Children with EE-SWAS (mean age: 8.05 ± 1.76 years) had cognitive and behavioral problems (20/20), and ongoing seizures (12/20). At baseline, the dominant motor cortex was significantly inhibited in the EE-SWAS group compared to neurotypical children{RMT(%)[86.3 ± 6.96 vs 58.05 ± 4.71(p < 0.0001)]; LICI(%)[55.05 ± 4.39 vs 73.9 ± 3.75(p < 0.0001)]; SICI(%)[39.2 ± 4.36 vs 55.45 ± 4.78(p < 0.0001)]}. Reversal of motor cortex inhibition was sequentially observed in EE-SWAS group at 4- and 12-week follow-ups{(RMT[4, 12 weeks]: 71.45 ± 9.83, 63.45 ± 8.48); (LICI[4, 12 weeks]: 66.00 ± 6.26, 74.50 ± 5.36); (SICI[4, 12 weeks]: 49.35 ± 6.24, 56.05 ± 5.57)}[repeated-measures ANOVA: p < 0.0001]. ConclusionMotor cortex is remotely inhibited in EE-SWAS, which may contribute to neurobehavioral impairment. Steroids can disinhibit/reverse the epilepsy-induced motor cortex inhibition leading to improvement in neurobehavior.

Effects of combined intense pulsed light and cyclosporine 0.05% eyedrops in ocular surface matrix metalloproteinase-9 levels in patients with moderate-to-severe MGD.

To investigate the changes in meibomian gland dysfunction (MGD) and tear matrix metalloproteinase-9 (MMP-9) levels in patients with moderate-to-severe MGD after combined treatment with intense pulsed light (IPL) therapy and cyclosporine 0.05%. Thirty-six patients concurrently treated with IPL and cyclosporine 0.05% ophthalmic drops were retrospectively enrolled. Tear break up time (TBUT), corneal and conjunctival staining scores, Schirmer test, and ocular surface disease index (OSDI) questionnaire responses were recorded. Meibum quality, consistency, and eyelid margin telangiectasia were evaluated. MMP-9 levels were examined by the positivity and signal intensity of red lines (scored 0-4). IPL was performed four times with a vascular filter at 2-week intervals, followed by a 1-month follow-up after treatment cessation. Immediately after each IPL treatment, gentle meibomian gland expression was performed in both the upper and lower eyelids using meibomian gland expressor forceps. TBUT (1.88 ± 1.02s to 3.12 ± 1.08s, p < 0.001), corneal and conjunctival staining (6.19 ± 2.11 to 3.12 ± 1.89, p < 0.001), Oxford staining grade (2.66 ± 0.89 to 1.35 ± 0.76, p < 0.001), and OSDI (52.97 ± 21.86 to 36.36 ± 22.45, p < 0.001) scores significantly improved after the combined treatment. Meibum quality, consistency and lid margin telangiectasia showed significant post-treatment improvement in both the upper and lower eyelids. MMP-9 positivity showed a significant decrease (97-69%, p = 0.026) with a reduction in signal intensity (2.72 ± 0.87 to 2.09 ± 0.95, p = 0.011). The combination of IPL therapy and 0.05% cyclosporine eye drops effectively treats moderate-to-severe MGD by reducing symptoms and signs of MGD and by decreasing ocular surface MMP-9-associated inflammation.