Common Route Research Articles

Impact of In-Feed versus In-Water Chlortetracycline and Tiamulin Administrations on Fecal Prevalence and Antimicrobial Susceptibilities of Campylobacter in a Population of Nursery Pigs.

Antimicrobial resistance (AMR) in bacteria is a major public health concern in the US and around the world. Campylobacter is an important foodborne pathogen that resides in the gut of pigs and is shed in feces, with the potential to be transmitted to humans. In pigs, the oral route, either in-feed or in-water, is by far the most common route of administration of antimicrobials. Because the distribution of the antibiotic in the gut and the dosages are different, the impact of in-feed vs. in-water administration of antibiotics on the development of AMR is likely to be different. Therefore, a study was conducted to compare in-feed vs. in-water administrations of chlortetracycline (CTC) and/or tiamulin on fecal prevalence and AMR profiles of Campylobacter among weaned nursery piglets. A total of 1,296 weaned piglets, allocated into 48 pens (27 piglets per pen), were assigned randomly to six treatment groups: Control (no antibiotic), in-feed CTC, in-water CTC, in-feed tiamulin, in-water tiamulin, or in-feed CTC and tiamulin. Fecal samples were collected randomly from 5 piglets from each pen during the pre-treatment (days 0, 7), treatment (days 14, 21), and post-treatment (days 28, 35) phases. Bacterial isolations and species identifications were conducted by culture and PCR, respectively. The microbroth dilution method with SensititreTM plates was used to determine the antimicrobial susceptibility and resistance of Campylobacter isolates. The results on resistance were interpreted based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) epidemiological cutoff values for Campylobacter. The overall prevalence of Campylobacter was 18.2% (262/1440). Speciation of Campylobacter isolates by PCR indicated the prevalence of only two species: Campylobacter hyointestinalis (17.9%; 258/1440) and C. coli (0.3%; 4/1440). Campylobacter isolates were resistant to tetracycline (98.5%), ciprofloxacin (89.3%), and nalidixic acid (60.3%). Neither the antibiotic nor the route of administration had an effect (p > 0.05) on the prevalence of AMR Campylobacter in the feces of piglets.

Serum Hormone Concentrations in Transgender Youth Receiving Estradiol

ObjectiveThis study aimed to evaluate the serum estradiol levels in gender-diverse youth to compare the efficacy of different estradiol routes in achieving therapeutic blood levels and suppressing serum testosterone levels. MethodsThis was a retrospective chart review of patients who initiated estradiol at an adolescent gender clinic between 2010 and 2019. Data on the route of estradiol administration and antiandrogen use (spironolactone or gonadotropin-releasing hormone agonist) were collected, and laboratory data were analyzed. Scatterplots were used to visualize the relationship between the estradiol dose and testosterone and estradiol laboratory values. ResultsA total of 118 patients were included, with a mean (standard deviation [SD]) age of 17.2 (1.6) years. The most common route of estradiol administration was oral only (62.7%), followed by transdermal only (23.7%), multiple routes excluding subcutaneous (8.5%), and any subcutaneous (5.1%). Notable variability was observed in the serum estradiol levels, with means (SDs) of 131.9 (120.4) pg/mL for those on oral estrogen 6 to 8 mg per day, 62.6 (40.3) pg/mL for those on transdermal estrogen 0.1 to 0.15 mg every 24 hours, and 53.6 (42.4) pg/mL for those on subcutaneous estradiol. In patients who received spironolactone, transdermal estradiol was associated with lower testosterone levels than estradiol administered orally or subcutaneously. ConclusionOral, transdermal, and subcutaneous administrations of estrogen all lead to increased serum estradiol levels and are effective for use in gender-affirming care for youth. Patients on transdermal estrogen tended to have lower serum estradiol levels but also had more suppression of serum testosterone levels.

Inhaled Litsea glaucescens K. (Lauraceae) leaves’ essential oil has anxiolytic and antidepressant-like activity in mice by BDNF pathway activation.

Ethnopharmacological relevanceLitsea glaucescens K. (Lauraceae) is a small tree from the Mexican and Central American temperate forests, named as “Laurel”. Its aromatic leaves are ordinarily consumed as condiments, but also are important in Mexican Traditional Medicine, and among the most important non wood forest products in this area. The leaves are currently used in a decoction for the relief of sadness by the Mazahua ethnic group. Interestingly, “Laurel” has a long history. It was named as “Ehecapahtli” (wind medicine) in pre-Columbian times and applied to heal maladies correlated to the Central Nervous System, among them depression, according to botanical texts written in the American Continent almost five centuries ago. Aim of the studyDepression is the first cause of incapacity in the world, and society demands alternative treatments, including aromatherapy. We have previously demonstrated the antidepressant-like activity of L. glaucescens leaves’ essential oil (LEO), as well as their monoterpenes linalool, and beta-pinene by intraperitoneal route in a mice behavioral model. Here we now examined if LEO and linalool exhibit this property and anxiolytic activity when administered to mice by inhalation. We also investigated if these effects occur by BDNF pathway activation in the brain. Materials and methodsThe LEO was prepared by distillation with water steam and analyzed by gas chromatography-mass spectrometry (GC-MS). The monoterpenes linalool, eucalyptol and β-pinene were identified and quantified. Antidepressant type properties were determined with the Forced Swim Test (FST) on mice previously exposed to LEO or linalool in an inhalation chamber. The spontaneous locomotor activity and the sedative effect were assessed with the Open Field Test (OFT), and the Exploratory Cylinder (EC), respectively. The anxiolytic properties were investigated with the Elevated Plus Maze Apparatus (EPM) and the Hole Board Test (HBT). All experiments were video documented. The mice were subjected to euthanasia, and the brain hippocampus and prefrontal cortex were dissected. ResultsThe L. glaucescens essential oil (LEO) contains 31 compounds according to GC/MS, including eucalyptol, linalool and beta-pinene. The LEO has anxiolytic effect by inhalation in mice, as well as linalool, and β-pinene, as indicated by OFT and EC tests. The LEO and imipramine have antidepressant like activity in mice as revealed by the FST; however, linalool and ketamine treatments didn't modify the time of immobility. The BDNF was increased in FST in mice treated with LEO in both areas of the brain as revealed by Western blot; but did not decrease the level of corticosterone in plasma. The OFT indicated that LEO and imipramine didn't reduce the spontaneous motor activity, while linalool and ketamine caused a significant decrease. ConclusionHere we report by the first time that L. glaucescens leaves essential oil has anxiolytic effect by inhalation in mice, as well as linalool, and β-pinene. This oil also maintains its antidepressant-like activity by this administration way, similarly to the previously determined intraperitoneally. Since inhalation is a common administration route for humans, our results suggest L. glaucescens essential oil deserve future investigation due to its potential application in aromatherapy.

Ethnobotanical study of traditional medicinal plants in Kebridehar and Shekosh districts, Korahi zone, Somali Region, Ethiopia

This study was conducted in Kebridehar and Shekosh districts, Ethiopia, to investigate an ethnobotanical study on traditional medicinal plants. Systematic random sampling techniques were used for data collection. Preference ranking, paired comparison, informant consensus factor, direct matrix ranking, and jaccard comparison were used for data analysis. A total of 44 medicinal plant species from 34 genera and 23 families have been documented as being used to treat 38 human, 5 livestock, and 1 both human and livestock ailment. The shrub category was the dominant growth form in the study area. The study showed that the most frequently used plant parts for the preparation of traditional medicine were roots (45.45 %), followed by leaves, glue, and liquid (11.36 % each). The most common route of administration was oral (30.77 %), followed by dermal (20.51 %). Jaccard's Coefficient of Similarity for Kebridehar and Shekosh for the reported traditional medicinal plants were 0.21, indicating some trend towards using common plants. Methanol extracts were more effective than ethanol extracts. The results of this study provide an insight into the anti-bacterial properties of the extracts of Aloe megalacantha, Ephorbiarobecchi, and Oppiliacampestris. This in vitro study demonstrated that these three folklore medicinal plants have good potential. In conclusion, the main threat to medicinal plants in the study area was drought. Therefore, it is recommended that the cultivation of medicinal plants be encouraged in home gardens.

Using molten-salts as a thermal processing medium for cobalt-free lithium-rich cathode material

Lithium-rich nickel manganese oxide cathode materials are well known to have limited rate capabilities. In this investigation we demonstrate that modifying a common sol-gel synthetic route by adding simple salts to the precursors during firing can create a molten-salt environment for the synthesis of the material that may results in improved materials and performance attributes. After screening multiple salt species, our findings indicate that the use of NaCl can provide a cost-effective and facile method for increasing the rate capability of these materials.

A cavernous sinus dural arteriovenous fistula treated by direct puncture of the superior ophthalmic vein with craniotomy: illustrative case.

The authors report a case of symptomatic cavernous sinus (CS) dural arteriovenous fistula (dAVF) that was successfully treated using direct puncture of the superior ophthalmic vein (SOV) with craniotomy. CS dAVF is commonly treated using transvenous embolization (TVE), with the most common access route via the inferior petrosal sinus (IPS). However, this route is sometimes unavailable because of an occluded, hypoplastic, aplastic, or tortuous IPS. The SOV is an alternative, albeit tortuous and long, route to the CS; therefore, direct SOV puncture is occasionally performed. Direct SOV puncture is mostly percutaneous; however, in this case, it was difficult because of subcutaneous SOV narrowing. As the patient experienced increased intraocular pressure, decreased vision, and eye movement disorders, CS embolization was performed via direct puncture with a craniotomy because of other access difficulties. Several reports have described CS dAVF in patients receiving endovascular treatment via direct SOV puncture using a transorbital approach. However, to the best of the authors' knowledge, this is the first reported case of a CS dAVF treated using TVE with craniotomy. This approach is useful when the SOV cannot be reached intravenously and its distance from the epidermis is long.

Design Considerations and Performance Evaluation of Gossip Routing in LoRa-Based Linear Networks

Linear networks (sometimes called chain-type networks) occur frequently in Internet of Things (IoT) applications, where sensors or actuators are deployed along pipelines, roads, railways, mines, and international borders. LoRa, short for Long Range, is an increasingly important technology for the IoT with great potential for linear networking. Despite its potential, limited research has explored LoRa’s implementation in such networks. In this paper, we addressed two important issues related to LoRa linear networks. The first is contention, when multiple nodes attempt to access a shared channel. Although originally designed to deal with interference, LoRa’s technique of synchronisation with a transmission node permits a novel approach to contention, which we explored. The second issue revolves around routing, where linear networks permit simpler strategies, in contrast to the common routing complexities of mesh networks. We present gossip routing as a very lightweight approach to routing. All our evaluations were carried out using real equipment by developing real networks. We constructed networks of up to three hops in length and up to three nodes in width. We carried out experiments looking at contention and routing. We demonstrate using the novel approach that we could achieve up to 98% throughput. We compared its performance considering collocated scenarios that achieved 84% and 89% throughputby using relay widths of two and three at each hop, respectively. Lastly, we demonstrate the effectiveness of gossip routing by using various transmission probabilities. We noticed high performance up to 98% throughputat Tprob = 0.90 and Tprob = 0.80 by employing two and three active relay nodes, respectively. The experimental result showed that, at Tprob = 0.40, it achieved an average performance of 62.8% and 73.77% by using two and three active relay nodes, respectively. We concluded that LoRa is an excellent technology for Internet of Things applications where sensors and actuators are deployed in an approximately linear fashion.

Differential impact of comorbidities and sex on pathophysiological pathways leading to heart failure with preserved ejection fraction

Abstract Background Heart failure (HF) with preserved ejection fraction (HFpEF) is a major public health problem worldwide, especially among the elderly. It is a complex syndrome characterised by multiple underlying comorbidities whose specific contribution is virtually impossible to disentangle in humans. As a result, treatment for HFpEF is still largely based on a "one-size-fits-all" approach, ignoring the specific pathophysiological substrate in each patient. Purpose we sought to identify the specific contribution of each HFpEF comorbidity to the development of this complex syndrome and to identify its earliest determinants and underlying mechanisms. Methods We used mouse models of ageing, obesity, hypertension, sleep apnoea, and hyperglycaemia to study the natural course of the syndrome and investigate the main determinants of HFpEF in each group separately and collectively. We followed the mice for up to 2.5 years and generated 100,000 individual data points (without omics), including echocardiography, vascular echography, lung ultrasound, histology and gene expression analyses in right and left ventricle, lung, liver and kidney. We developed new ad hoc statistical models to analyse all the longitudinal data. To identify the parameters that best determine the risk of HFpEF we used two complementary approaches: we first investigated features that could discriminate between mice with and without HFpEF and next, we investigated the changes associated with increased risk of HFpEF (time-to-HFpEF) among those animals that developed the syndrome. In addition, we used mass spectrometry proteomics to identify changes in protein expression and post-translational modification associated to HFpEF in each comorbidity. Results Age was the major contributor to HFpEF. Animals with HFpEF showed an increase in proteins involved in glycolysis, glycogen catabolism, and glutathione metabolism compared to those that did not develop HF, suggesting a change in metabolic substrate. The main parameters associated with HFpEF at old age started changing already at middle age. All comorbidities contributed to HFpEF through routes that were partially common but that were also characterised by distinct features. Changes in the right ventricle and in large vessels were strongly associated with the development of HFpEF in some comorbidities. Neither myocardial inflammation nor fibrosis were associated with HFpEF. Female mice followed a rather common route to HFpEF, including an association with kidney fibrosis and myocardial hypertrophy, while the development of the syndrome in mice was more comorbidity-determined. Conclusions Mice with different comorbidities follow at least partially different routes to HFpEF that are further affected by sex-dependent differences. Our results suggest that patients would benefit from a more tailored approach depending on their specific underlying pathology and gender.Main changes associated with HFpEF

Prevalence of polypharmacy and pharmacotherapy complexity in elderly people living with HIV in Spain. POINT study

ObjectiveTo determine the prevalence of polypharmacy in persons living with HIV of at least 65 years of age receiving antiretroviral treatment. A characterization of antiretroviral treatment, as well as a determination of the prevalence of comorbidities; of the most common types of concomitant medication; of adherence rates; of the pharmacotherapeutic complexity; and of drug-drug interactions were also among the goals of the study. MethodTh is was a multi-center, cross-sectional observational study that included persons living with HIV aged 65 years or more who were on active antiretroviral treatment. Demographic, clinical (viral load, CD4 count and comorbidities) and pharmacotherapeutic (type of antiretroviral treatment: single tablet regimen, polypharmacy [six active ingredients or more] and major polypharmacy [11 active ingredients or more] variables were considered). Adherence to antiretroviral treatment was measured by dispensation records and the Simplified Medication Adherence Questionnaire, while adherence to concomitant medication was measured using dispensation records and the Morisky-Green questionnaire. The Medication Regimen Complexity Index was calculated. Drug-drug interactions were analyzed using the Liverpool and Lexicomp databases. ResultsSeventy-four patients (86.5% male) were included, with a median age of 69 years (66.7-72.0). The sexual route was the most common route of transmission of the disease (67.6%). The virus was undetectable in 89.2% of patients; the CD4 count was over 200/mL in 94.6% of the sample. The median number of comorbidities was 3.5 (2.0-5.0), 52.7% of them being cardiovascular; 50.0% related to the central nervous system; 176% hepatic; and 8.1% consisting in chronic pulmonary disease. A total of 81.1% of patients received triple therapy and 48.6% single tablet regimen. The median number of concomitant drugs administered was 5.0 (2.0-70), polypharmacy was observed in 71.6% of cases and major polypharmacy in 25.7%. Antihypertensive and cardiovascular drugs were prescribed to 56.8% of patients, lipid-lowering drugs to 50.0%, antiulcer agents to 33.8% and psychoactive drugs to 32.4%. According to dispensation records, adherence to antiretroviral treatment was 85.1% and to concomitant medication 62.8%. The median Medication Regimen Complexity Index for the whole treatment was 13.0 (8.0-176). Potential drug-drug interactions were observed in 55.4% of patients and contraindicated interactions in 12.2%. ConclusionsElderly persons living with HIV exhibit a high prevalence of polypharmacy, pharmacotherapeutic complexity, poor adherence and drug-drug interactions. For that reason, pharmacotherapeutic optimization must be a priority in these patients.

Trans-Arterial Embolization of Anterior Cranial Fossa Dural Arteriovenous Fistulas via the Sphenopalatine Artery: A Technique Report

BackgroundTrans-arterial embolization (TAE) via the ophthalmic artery and middle meningeal arterial are the common arterial routes for anterior cranial fossa (ACF) dural arteriovenous fistulas (DAVFs). However, TAE via the sphenopalatine artery (SPA) to treat ACF DAVFs is rarely reported. Here, we describe 14 cases of ACF DAVFs that were either treated solely or in conjunction with other arterial routes via the SPA. A total of 15 embolization attempts were performed via the SPA. Method14 patients were treated with TAE via the SPA over a 20-year period. There were 13 males and 1 female in total, with a mean age of 57.4 (57.4±6.0) years. The clinical presentation, angiographic features, treatment strategy, and clinical outcomes were all documented. Results14 patients with ACF DAVFs underwent TAE via the SPA. Complete immediate angiographic occlusion was achieved in 78.6% of the fistulas (11/14). Complete embolization via the SPA alone was achieved in 63.6% (7/11) of the fistulas. A total of 15 embolization attempts were performed via the SPA, with a 46.7% (7/15) success rate. After TAE via the SPA, no complications were found. 42.9% (6/14) of the patients had DSA or MRA follow-up. There was no recurrence of the fistulas. ConclusionsThe SPA may be as an alternative arterial route if other appropriate arterial routes are unavailable. However, its safety and efficiency need to be confirmed further.

Epidemiology, clinical characteristics, and outcomes of nontuberculous mycobacterial skin, soft tissue, and bone infections from a single center over a 10-year period

IntroductionNon-tuberculous mycobacteria (NTM) cause a wide variety of clinical syndromes. Data guiding diagnosis and treatment of NTM skin and soft tissue infections (SSTI) and bone infections are limited. We sought to better understand SSTI and bone infections caused by NTM. MethodsAll NTM clinical isolates recovered at Brooke Army Medical Center from 2012 to 2022 were screened; SSTI and bone isolates were included. Electronic health records were reviewed for epidemiologic, microbiologic, and clinical data. Infections were defined as recovery of one or more NTM isolate from skin, soft tissue, or bone cultures with a corresponding clinical syndrome. ResultsForty isolates of skin, soft tissue, or bone origin from 29 patients were analyzed. Twenty (69 %) patients, majority female (14/20, 70 %), had infecting isolates, most commonly secondary to surgery (35 %) or trauma (35 %). Six of 20 (30 %) had bone infections. Time from symptom onset to isolate recovery was a median 61 days (IQR 43–95). Eight (40 %) had combined medical/surgical therapy, 8 (40 %) had surgery alone, and 4 (20 %) had medical therapy alone. M. abscessus was more frequently isolated from patients with true infections. ConclusionsData supporting diagnosis and treatment decisions in NTM SSTI/bone infections is sparse.In this study the majority of NTM isolated were true infections. We confirm that surgery and trauma are the most common routes of exposure. The delay between symptom onset and directed therapy and the wide variety of treatment regimens highlight a need for additional studies delineating criteria for diagnosis and treatment.

Pain Treatment in Polish Emergency Medical Teams—Is the Pain Management Entitlement Being Used?—A Retrospective Study

Introduction: Pain has been identified as the most common reason for emergency medical service (EMS) calls. Despite many years of pain research, it is still true that oligoanalgesia is an ongoing phenomenon. This demonstrates the need for the implementation of new solutions and for further analyses on the causes of inadequate pain treatment. The study was undertaken to analyze analgesic treatment implemented in specialist “S” and basic “P” Emergency Medical Teams (EMTs). Methods: This retrospective study was based on the analysis of medical records using the emergency medical service card. A total of 1333 medical files were analyzed, of which 539 cases were qualified for the study according to the inclusion and exclusion criteria. Results: The analysis has shown that the majority of interventions were undertaken by basic emergency medical teams and that acute pain was the most common reason for contacting the EMS. However, only 62.52% of patients received analgesia. It was shown that the frequency of administering paracetamol, metamizole, and ketoprofen was proportional to the increase in pain intensity. Similar correlations were identified in the cases of morphine, fentanyl, and drotaverine, which were most often administered to patients with the most severe pain. Conclusions: The nature and location of pain, as well as its intensity, affected the choice of analgesia. Opioids were administered more frequently with more extensive injuries and at greater pain intensity. Significant differences were found in the frequency at which acetylsalicylic acid was administered more often in “S” EMTs and drotaverine more often in “P” EMTs. The intravenous route was found to be the most common route of analgesia administration in EMTs.

Subcutaneous deuterated substrate administration in mice: An alternative to tail vein infusion.

Tail-vein catheterization and subsequent in-magnet infusion is a common route of administration of deuterium (2 H)-labeled substrates in small-animal deuterium (D) MR studies. With mice, because of the tail vein's small diameter, this procedure is challenging. It requires considerable personnel training and practice, is prone to failure, and may preclude serial studies. Motivated by the need for an alternative, the time courses for common small-molecule deuterated substrates and downstream metabolites in brain following subcutaneous infusion were determined in mice and are presented herein. Three 2 H-labeled substrates-[6,6-2 H2 ]glucose, [2 H3 ]acetate, and [3,4,4,4-2 H4 ]beta-hydroxybutyrate-and 2 H2 O were administered to mice in-magnet via subcutaneous catheter. Brain time courses of the substrates and downstream metabolites (and semi-heavy water) were determined via single-voxel DMRS. Subcutaneous catheter placement and substrate administration was readily accomplished with limited personnel training. Substrates reached pseudo-steady state in brain within ∼30-40 min of bolus infusion. Time constants characterizing the appearance in brain of deuterated substrates or semi-heavy water following 2 H2 O administration were similar (∼15 min). Administration of deuterated substrates via subcutaneous catheter for in vivo DMRS experiments with mice is robust, requires limited personnel training, and enables substantial dosing. It is suitable for metabolic studies where pseudo-steady state substrate administration/accumulation is sufficient. It is particularly advantageous for serial longitudinal studies over an extended period because it avoids inevitable damage to the tail vein following multiple catheterizations.

Patient access to first contact practitioner physiotherapists in the UK: A national survey.

First Contact Practice Physiotherapists (FCPPs) offer expert care for patients with musculoskeletal (MSK) conditions in Primary Care, usually within GP practices. This is a rapidly expanding area of practice endorsed by NHS England, the Chartered Society of Physiotherapy (CSP) and the British Medical Association (BMA). Efficient and appropriate access is important for optimising FCPP practice, but there is little published information about how patients currently access FCPP appointments. To investigate how patients access FCPP appointments in General Practice. Cross-sectional online survey of FCPPs in the UK. FCPPs were surveyed about patient access to appointments. The survey instrument was designed using Jisc Online Surveys, piloted, and then distributed via social media and professional groups to FCPPs nationwide. Descriptive statistics were used to analyse demographic and multiple-choice questions, and free text responses were analysed using quantitative content analysis. 193 participants completed the survey. Booking via GP Reception (n=179) was reported as the most common route into an FCPP appointment, closely followed by booking after seeing another clinician for the problem (n=172). This research has provided clarity regarding how patients access the rapidly growing speciality of FCPP within GP practices in the UK. The role of GP Reception staff in facilitating access to FCPPs, the application of triage and the use of digital or online systems were highlighted as important elements for enabling efficient access to FCPPs by patients with MSK conditions.

Monitoring and reporting of adverse effects of testosterone prescribing for gender affirmation at general practice clinics - Data from the PUSH! Audit

Introduction Prescribing testosterone for gender affirming hormone therapy (GAHT) has been increasing in Australia with much of this practice done by general practitioners (GPs) and there are current AusPATH guidelines on how this can be done appropriately. There has been limited data collected from GPs about how well these patients are monitored and the adverse effects (AEs) that are experienced by this population of patients. Objectives The primary objective of this study was to collect data about monitoring and adverse effects of GAHT provided in GP settings. Methods The PUSH! Audit was a cross-sectional study that collected data from 9 GP Clinics across 5 Australian cities who provided GAHT with testosterone. Data was also collected about cisgender men who were prescribed testosterone for testosterone deficiency (TD) as a comparison group (n = 209). Results The patients in the GAHT group (n = 277) tended to be younger (29.8 vs 54.9), with significant prevalence of smoking (21.8%) and anxiety/depression (37.2%) although this was not significantly higher that the comparison group. Most of the GAHT group had a testosterone level recorded in their file (90.6%) and the most common route of administration of testosterone was by intra-muscular injection (89.9%). The testosterone levels were mainly in the target range for males (75.7%) with only a small percentage registering levels above the target range (5.6%). Of the measured AEs, whilst there were significant prevalence of liver abnormalities and hypercholesterolemia, this was not significantly different to the TD group. The hypertension prevalence was lower in the GAHT group. Of the reported AEs, acne (10.1%) and balding (4.7%) were the only two AEs that were significantly reported. Conclusion This study shows that GAHT with testosterone can be provided effectively in general practice with high levels of success and very low levels of AEs.

Short Communication: Ethnobotanical study of medicinal plants used to treat livestock ailments in Dallo Manna District, Oromia State, Ethiopia

Abstract. Gobana AH, Telila H, Jilo SA. 2023. Short Communication: Ethnobotanical study of medicinal plants used to treat livestock ailments in Dallo Manna District, Oromia State, Ethiopia. Asian J Ethnobiol 6: 127-136. Historical information on the use of medicinal plants is in danger of extinction due to changes in different parts of the world, including Ethiopia. This study aimed at the ethnobotanical analysis of medicinal plants used to treat animal diseases. Data were collected through semi-structured interviews with the selected informant sources. Analysis of ethnobotanical data used the Informant Consensus Factor (ICF), preference ranking, ranking matrix, and calculating the degree of fidelity. Dallo Manna Region was reported to have all 68 medicinal plant species used to treat veterinary diseases. The most common family is Fabaceae (7 spp.), followed by Euphorbiaceae (5 spp.), Asteraceae (5 spp.), and Solanaceae (4 spp.). The local people generally used the root, followed by leaves, seeds, and stems, to prepare drugs for treating livestock diseases. All medicine is made and used immediately; some are boiled and dried. In addition, the most common route of administration for treating animal diseases in the study area is oral, followed by topical application and nasal. The highest consensus criteria (ICF) values were recorded in ophthalmology, followed by dermatology. Most species have been reported for treating gastrointestinal disorders, followed by species for treating skin diseases and fever. Ten participants compared nine herbs used to treat veterinary diseases to determine their rankings. Hagenia abyssinica (Bruce) J.F.Gmel. in the first place, then this was followed by Zingiber officinale Roscoe and Embelia schimperi Vatke in third place, which achieved the highest value among traditional medicinal plants. The main threats to veterinary medicinal plants are overharvesting of available species, agricultural land expansion, and less attention to traditional medicine due to modernization.

Ultrarapid-Acting Microneedles for Immediate Delivery of Biotherapeutics.

Subcutaneous injection is a common administration route for rapid and efficient delivery of biotherapeutics. However, syringe-based injections usually require professional assistance and are associated with pain and potential risks of infections, thus leading to undesired patient compliance and poor life quality. Herein, we present an ultrarapid-acting microneedle (URA-MN) patch for immediate transdermal delivery of therapeutics in a minimally invasive manner. Effervescent agents are incorporated into the tip of URA-MN for rapid generation of CO2 bubbles upon insertion into the skin, immediately powering the biotherapeutics release within a few minutes. The release kinetics of diverse agents including liraglutide, insulin, and heparin from the URA-MN were evaluated in three different mouse models, and the rapid release of biotherapeutics and potent therapeutic effects were achieved with only 5-minute administration. Noteworthily, attributed to the short application duration and negligible residuals of MN matrix remaining in the skin, the URA-MN patch showed desirable biocompatibility after 6-week administration. This article is protected by copyright. All rights reserved.

Awareness and knowledge of physicians and residents on the non-sexual routes of human papilloma virus (HPV) infection and their perspectives on anti-HPV vaccination in Jordan.

Although penetrative sex is the most common route of HPV infection, there is strong evidence of non-sexual modes of transmission. As the first of its kind, this study aimed to investigate the knowledge and awareness of Jordanian physicians on such routes. A questionnaire was conducted among a national Jordanian sample of physicians from Jordanian health sectors. The survey included questions assessing participants' knowledge on HPV, non-sexual routes of infection and HPV vaccines. Physicians' attitudes towards HPV screening and vaccination were covered. Statistical analysis was carried out using SAS 9.4, ANOVA, post-hoc Tukey-Honest test and Kruskal-Wallis test. All significant differences were set at α = 0.05. A total of 412 participants completed the survey. Physicians showed a huge deficit in knowledge on nonsexual routes of HPV transmission. They agreed that the most and least common routes of non-sexual transmission are skin to mucosa (64%) and contaminated water (15%), respectively. Females showed significantly better knowledge in all aspects of HPV transmission and vaccination (p<0.0001) and more positive attitudes towards HPV screening and vaccination compared to males (p = 0.03). Age group ≤ 25 and academic physicians demonstrated higher knowledge on HPV vaccines compared to their counterparts in non-academic places (p = 0.002). Specialty and experience seemed to have no impact on knowledge or attitudes of participants. Higher knowledge physicians had more positive attitude towards vaccination and screening compared to lower knowledge fellows (p<0.001). The noteworthy findings of this study is the extremely low level of knowledge on non-sexual routes of HPV infection among Jordanian physicians. Increasing the level of awareness of physicians and healthcare workers on these routes and their association with cervical and other cancers through university curricula and other reliable sources is strongly recommended.

Exploring Molecular Mechanisms of Traditional Persian Medicine-based Herbal Remedies for Depression: A Network-based Study

Background: Major Depressive Disorder (MDD) is a prevalent mental health condition that affects a significant portion of the general population. Despite the availability of pharmacological, psychological, and novel neurological approaches, optimal outcomes are only achieved in roughly 50% of patients. Traditional Persian Medicine (TPM) recommends a holistic approach to cure diseases based on the etiologic cause of malfunctions. This study aimed to explore the potential of integrating TPM and systems pharmacology approaches for the management of MDD. background: Depression is considered one of the most prevalent mental illnesses worldwide. Depression and the effectiveness of antidepressants are both influenced by genetic factors. Various anti-depressant remedies have been listed in Traditional Persian medicine (TPM) manuscripts, which may be useful as adjuvant therapy in the treatment of depression. The use of network-based studies is becoming more and more crucial for comprehending how medications apply their pharmacological actions. The growing fields of systems pharmacology (SP) and bioinformatics make use of computing to comprehend how drugs function at cellular and molecular levels. A common biological route that involves protein-protein (drug-target) interactions can be mechanistically understood using SP. Methods: A network-based investigation was conducted to explore the molecular mechanisms of TPM-based herbal remedies for depression. The study utilized a network pharmacology approach to identify active compounds, targets, and pathways involved in the treatment of depression. The study also conducted a literature review to identify the effectiveness of TPMbased remedies in treating depression. objective: The objective of the current study was to investigate the molecular mechanisms underlying TPM approach in the treatment of depression. Results: The study identified several active compounds, targets, and pathways involved in the treatment of depression by TPM-based herbal remedies. The study also identified several TPMbased remedies with anti-inflammatory properties that may be effective in treating depression. The literature review supported the potential of TPM remedies for the management of MDD. Conclusion: The integration of TPM and systems pharmacology may provide a holistic insight into the management of MDD. The study's findings suggest the potential of TPM-based remedies with anti-depressant properties, and further research is needed to understand the molecular mechanisms underlying their effectiveness. Integrating TPM-based remedies with bioinformatics may provide a complementary therapeutic avenue to MDD management and improve the quality of life for MDD patients. result: According to our study, many phytochemicals found in the plants used to make TPM-based prescriptions may impact various genes linked to depressive disorders. conclusion: The findings of these investigations suggested that many of the identified herbal remedies may have the potential to treat depression by activating a number of different pathways. The current study encourages further study of TPM as a model for creating efficient complementary therapies.

Dual tracer navigation for lymph node dissection in laparoscopic radical gastrectomy (DANCE trial): a protocol for a prospective, randomized clinical trial

BackgroundLymph node (LN) metastasis is the most common metastasis route in gastric cancer. Extensive dissection of LNs can significantly improve the prognosis of patients with gastric cancer. Recently, multiple clinical studies have demonstrated that either indocyanine green (ICG) or carbon nanoparticles (CNs) can assist to promote the dissection of LNs during laparoscopic radical gastrectomy. Considering the pros and cons of the two tracers, this study proposed a novel method of dual tracer (ICG combined with CNs) for lymphatic tracing in laparoscopic gastric cancer surgery.MethodsThis trial is a prospective, randomized controlled trial (RCT) with an estimation of 516 participants that randomize into 4 groups (1:1:1:1), namely control group, ICG group, CNs group, and dual tracer group. The primary outcome is the number of dissected LNs. The secondary outcomes include positive rate, false positive rate, negative rate, false negative rate, number of metastatic LNs, relationship between LN metastasis and tracer stained, operation duration, blood loss, incision length, morbidity and mortality rate, 3-year DFS (disease free survival), PFS (progression-free survival), and OS (overall survival).DiscussionThis study will investigate the efficacy and safety of a novel strategy using dual tracers for laparoscopic gastrectomy. The protocol has been approved by the Ethics Committee of Nanjing Drum Tower Hospital (2021-361-02). The trial findings will be published in peer-reviewed journals.Trial registrationChinese Clinical Trial Registry (ChiCTR2100051309). Registered 18 September 2021, https://www.chictr.org.cn/showproj.html?proj=133764.