Conventional Interventions Research Articles

Clinical value of combining epirubicin with mindfulness intervention in patients with urinary system tumors and depression

BACKGROUND Urinary system tumors often cause negative psychological symptoms, such as depression and dysphoria which significantly impact immune function and indirectly affect cancer prognosis. While epirubicin (EPI) is recommended by the European Association of Urology and can improve prognosis, its long-term use can cause toxic side effects, reduce treatment compliance, and increase psychological burden. Therefore, an appropriate intervention mode is necessary. AIM To explore the clinical value of EPI combined with mindfulness intervention in patients with urinary system tumors and depression. METHODS This was a retrospective study including 110 patients with urinary system tumors and depression admitted to Zhumadian Central Hospital between March 2021 and July 2023. Patients were divided into conventional (n = 55) and joint intervention (n = 55) groups. The conventional group received mitomycin and routine nursing, while the joint intervention group received EPI and mindfulness intervention. Both groups underwent three cycles of chemotherapy. Immune function (CD4+ cells, CD8+ cells, CD4+/CD8+ ratio), tumor marker levels [urinary bladder cancer antigen (UBC), bladder tumor antigen (BTA) and nuclear matrix protein 22 (NMP22)], quality of life questionnaire-core 30 (QLQ-C30), 17-item Hamilton depression scale (HAMD-17), and cancer-related fatigue [cancer fatigue scale (CFS)] were assessed. Adverse reactions and nursing satisfaction were recorded and evaluated. RESULTS Post-intervention, CD4+, CD8+, and CD4+/CD8+ levels increased in both groups, with the joint intervention group showing more significant improvement (P < 0.05). Tumor marker levels (NMP22, BTA, and UBC) were lower in the joint intervention group compared to the conventional group (P < 0.05). The joint intervention group also showed a greater reduction in HAMD-17 scores (9.38 ± 3.12 vs 15.45 ± 4.86, P < 0.05), higher QLQ-C30 scores, and lower CFS scores (both P < 0.05). Additionally, the joint intervention group had a lower incidence of adverse reactions and higher nursing satisfaction (P < 0.05). CONCLUSION EPI combined with mindfulness intervention significantly improved clinical outcomes in patients with urinary system tumors and depression and is worthy of clinical application.

Synergy-based motor therapy for post-stroke hemiparetic subjects: A randomized controlled trial

Objectives: Motor recovery is inclusively based on the severity of abnormal coupling or the abnormal synergistic actions among the post-stroke hemiparetic subjects. The normal synergistic pattern shall be incorporated to inhibit the abnormal synergistic behavior to attain motor control. Materials and Methods: A randomized controlled double blinded (assessor and subjects) trial was conducted in a rehabilitation institute. One hundred and thirty-six post-stroke (mean duration, 12.73 ± 9.52 months) hemiparetic subjects were conveniently selected and randomly allocated in two groups (experimental, 68 and control, 68). The experimental group received synergistic-based motor therapy (SBMT) protocol and the control group of the subjects received the conventional occupational therapy intervention. Both of the groups received dose-matched intervention for the period of 3 months, 48 sessions (4/week). Normal synergistic linkage was being exploited to encounter the abnormal synergistic patterns. The main outcome measures were Fugl-Meyer Assessment – upper extremity (FMA-UE), arm (FMA-A), wrist-hand (FMA-WH) for the motor recovery and Finger Breadth Palpation method (FBP) for the shoulder subluxation. Results: In comparison to the control group, the experimental group exhibited highly significant results. The mean score of FMA-UE was changed to 41.32 ± 11.50 from the pre-intervention score of 25.76 ± 15.26 (P < 0.001). Post-intervention, the mean score of FMA-A was increased to 26.89 ± 0.93 from 17.36 ± 1.21 (P < 0.001). The pre-assessment score of FMA-WH was 8.29 ± 0.96 and post-intervention, it was increased to 14.13 ± 0.88 (P < 0.001). The experimental group of subjects was recorded to have a reduction in the shoulder subluxation. The grade of FBP reduced to 0.39 ± 0.11 from the pre-intervention score of 1.23 ± 0.13 (P < 0.001). Conclusion: SBMT was concluded to be superior and highly significant than the conventional intervention for enhancing upper limb motor recovery among post-stroke hemiparetic subjects. Further, the grade of shoulder subluxation was also found to be significantly reduced among the SBMT group participants in comparison to the control subjects.

Early Intervention for Children With Developmental Disabilities and Their Families via Telehealth: Systematic Review.

Early intervention during the first 3 years of life is crucial for children with developmental disabilities to optimize developmental outcomes. However, access to such services is often limited by geographical distance and resource constraints. Telehealth can be part of a solution for overcoming these barriers, enabling the delivery of early intervention services. However, a comprehensive understanding of the efficacy and implementation of telehealth in early interventions remains elusive, particularly for children aged 0-3 years. This systematic review aims to synthesize existing research on the effectiveness and implementation of telehealth interventions in infants and toddlers (aged 0-3 years) who are at risk of or diagnosed with developmental disabilities. The primary objective of the study is to evaluate the ways that telehealth compares to conventional in-person interventions in improving developmental outcomes for children and supporting family well-being. A systematic search was conducted of 4 electronic databases (PubMed, Embase, CINAHL, and Web of Science), focusing on studies published between 2010 and 2024. The inclusion criteria were studies involving telehealth interventions for children aged 0-3 years who were at high risk or had developmental disabilities, which involved active interactions between the providers and the families. Study quality was assessed using the mixed methods appraisal tool, and a narrative synthesis was used to analyze the data. Eighteen studies met the inclusion criteria: 12 single-case designs, 4 randomized controlled trials, and 2 nonequivalent control group designs. All studies involved caregiver-child dyads, with child ages ranging from 5 to 37 months and having or at risk of autistic spectrum disorder (n=10, 56%), cerebral palsy (n=4, 22%), and other conditions (n=4, 22%). Synchronous videoconferencing was the primary modality for caregiver training and coaching (n=17, 94%) while 1 intervention used an Internet of Things system. Outcomes were identified in child communication (n=9, 50%), physical (n=6, 33%), social or emotional (n=6, 33%), and adaptive behavior (n=4, 22%), as well as caregiver implementation (n=12, 66%). Telehealth demonstrated comparable or superior effectiveness to traditional in-person methods in 2 studies. However, the focus on specific conditions and limited research on cognitive development were notable gaps. Telehealth can be a viable alternative to traditional in-person early interventions for young children who have developmental disabilities and their families. It enhances accessibility and interactions between families and providers at a distance while promoting family-centered care. Challenges exist, including those of technological literacy, and the lack of research on cognitive outcomes must be addressed. Future work should explore more comprehensive interventions, including multidisciplinary approaches and expanded family outcomes, to solidify the role that telehealth plays in early intervention. PROSPERO CRD42024551286; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=551286.

Current Concepts and Clinical Applications in Cartilage Tissue Engineering.

Cartilage injuries are extremely common in the general population, and conventional interventions have failed to produce optimal results. Tissue engineering (TE) technology has been developed to produce neocartilage for use in a variety of cartilage-related conditions. However, progress in the field of cartilage TE has historically been difficult due to the high functional demand and avascular nature of the tissue. Recent advancements in cell sourcing, biostimulation, and scaffold technology have revolutionized the field and made the clinical application of this technology a reality. Cartilage engineering technology will continue to expand its horizons to fully integrate three-dimensional printing, gene editing, and optimal cell sourcing in the future. This review focuses on the recent advancements in the field of cartilage TE and the landscape of clinical treatments for a variety of cartilage-related conditions.

Low-Intensity Online Intervention for Mental Distress Among Help-Seeking Young People in Hong Kong

Mental health issues among young people are increasingly concerning. Conventional psychological interventions face challenges, including limited staffing, time commitment, and low completion rates. To evaluate the effect of a low-intensity online intervention on young people in Hong Kong experiencing moderate or greater mental distress. This randomized clinical trial was conducted from May 12, 2022, to September 22, 2023, in Hong Kong. Participants (aged 12-30 years) were recruited from a community project, self-reported moderate to severe distress (Kessler Psychological Distress Scale score ≥5), and were randomized 1:1 to receive the low-intensity online intervention or self-help tips (waitlist group). The low-intensity online intervention group received 4 weekly 1-on-1 online sessions on stress management, sleep, or problem-solving delivered by trained psychological well-being practitioners. The waitlist group received weekly mental health tips via text messaging. Primary outcomes were changes in Kessler Psychological Distress Scale scores and depression and anxiety subscale scores of the Depression, Anxiety, and Stress Scale. Secondary outcomes included general stress, overall negative emotions, quality of life, sleep quality, resilience, and self-efficacy. The primary outcome analysis was based on intention to treat with the last observation carried forward approach. Sensitivity analyses were conducted using per-protocol and multiple imputation methods. Of 332 screened participants, 120 (mean [SD] age, 22.4 [3.4] years; 87 [72.5%] female) were randomized. From baseline to 4 weeks, the low-intensity online intervention group and the control group both saw reductions in scores for depression (mean [SD] difference, 6.0 [7.7] and 4.8 [7.9]; P = .17; ηp2 = 0.02), anxiety (mean [SD] difference, 6.0 [7.7] and 3.5 [7.7]; P = .07; ηp2 = 0.03), and psychological distress (mean [SD] difference, 3.8 [3.8] and 2.9 [3.8]; P = .24; ηp2 = 0.01), but none of these differences were statistically significant. However, the intervention group showed greater reductions in general stress (mean [SD] difference, 7.5 [7.2] vs 4.4 [7.2]; P = .02; ηp2 = 0.05), negative emotion (mean [SD] difference, 20.3 [19.2] vs 12.7 [19.2]; P = .03; ηp2 = 0.04), and increased resilience (mean [SD] difference, 0.5 [0.6] vs 0.2 [0.6]; P = .01; ηp2 = 0.05) compared with the waitlist group. Younger participants and those with lower initial distress experienced greater improvements. The findings were supported by the per-protocol analysis but not by multiple imputation analysis. A low-intensity online intervention did not significantly improve distress, depressive, or anxiety symptoms but showed some potential in reducing general stress and negative emotions and improving resilience. These findings are encouraging but not definitive, and caution is needed due to missing data. These data suggest that a low-intensity online intervention may offer a scalable option for youth mental health. ClinicalTrials.gov Identifier: NCT05510453.

Mindfulness-based interventions for improvement of lifestyle behaviors and body mass index in children with overweight or obesity: a systematic review and meta-analysis.

Mindfulness-based interventions are generally acceptable and show potential for improving lifestyle behaviors. However, their impact on BMI remains inconsistent in children with overweight or obesity. Comprehensive behavioral interventions that combine mindfulness practices with conventional approaches may enhance effectiveness. Given the limited evidence, these findings should be interpreted with caution.PROSPERO registration number: CRD42023411790. • Childhood obesity is a significant public health concern, and conventional interventions have achieved limited success. • Mindfulness-based interventions offer a promising alternative to conventional approaches. A systematic review is urgently needed to evaluate their acceptability and effectiveness in improving lifestyle behaviors and body mass index (BMI) in children with overweight or obesity. • Mindfulness-based interventions are generally acceptable to children with overweight or obesity. • Mindfulness-based interventions show potential for improving lifestyle behaviors, but their effectiveness in reducing BMI remains inconsistent.

. Serum Neuroprotection , nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and superoxide dismutase (SOD) Levels in Neonates with Hypoxic-ischemic Encephalopathy

Abstract: Neonatal hypoxic-ischemic encephalopathy (HIE) is one of the main causes of brain injury and death in infants. This article aimed to investigate the effects of mild hypothermia therapy on neuroprotection and cytokine levels in neonates with HIE. 132 children with HIE in the Northwest Women's and Children's Hospital between January 2022 and April 2023 were enrolled as the study subjects, and they were grouped by the method of random number table, controls using conventional treatment intervention, mild hypothermia group adopting mild hypothermia therapy based on conventional treatment. The levels of cytokines and neonatal behavioral neurological assessment (NBNA) were compared before and following remedy. As against controls, in mild hypothermia therapy-treated subjects, the levels of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and superoxide dismutase (SOD) were clearly raised; the levels of malondialdehyde (MDA), interleukin (IL-18), and Caspase-3 were clearly decreased, and the NBNA score of mild hypothermia therapy-treated subjects was clearly raised; the recovery time of neurological function was clearly shortened (all P <0.05). Mild hypothermia therapy has an obvious neuroprotective outcome on neonates with HIE, possibly by regulating the levels of cytokines.

EFFECTIVENESS OF HERBAL AND CONVENTIONAL MANAGEMENT INTERVENTIONS OF HEPATITIS B VIRUS.

Liver inflammation caused by the Hepatitis B virus (HBV) could become chronic and unresolved if untreated. Prevention and management of the disease are through vaccination and other conventional interventions. This study evaluated the cost-effectiveness of herbal management (HM) and conventional pharmaceutical management (PM) interventions in treating HBV. A purposive sampling technique was used to administer questionnaires at the University College Hospital (UCH) and Total Healthcare Diagnostic Centre (THDC). Data collection was according to a EuroQol (EQ -5D), while descriptive and inferential analyses were performed. Findings revealed a high prevalence of HBV among females from ages 26 to 50. The majority discovered their health status through free HBV tests. Other than cost-effective interventions, about 73% of cases adopted HM to manage the disease. A significant difference (P<0.00) was observed in the correlation analysis of the current health status of respondents and the intervention management adopted. correlation analysis of the current health status of respondents was significantly different (P<0.01) against the intervention management adopted (P<0.00). The minister of health should emphasize HBV regular screening, subsidized viral load test and free vaccination in both public and private healthcare centres.

Curing cryptoglandular anal fistulas-Is it possible without surgery?

Empirical reviews suggested that cryptoglandular anal fistulas require surgical resolution. However, some reports have indicated the possibility of nonsurgical and conservative treatment, which is discussed in this review. This review explores the potential of nonsurgical approaches for curing anal fistulas through bacterial inhibition and immunomodulation. The longstanding cryptoglandular theory has been a subject of controversy, prompting the reevaluation of conventional surgical interventions for anal fistulas. The review was conducted through database searches, including Medline, EMBASE, PubMed, and the Cochrane Library. Emerging evidence suggests that targeting the anaerobic environments present in anal fistulas and perianal abscesses and eradicating bacteria and their by-products may be critical for successful treatment. Immunomodulatory strategies show promise as a potential avenue for the nonsurgical management of anal fistulas. Ongoing developments in pharmacological research offer opportunities for alternative treatment options, shedding light on the prospects of noninvasive anal fistula management.

Effects of high intensity interval training on mobility and fitness outcomes in stroke

Background: Stroke causes severe impairments in mobility, balance, and quality of life, making it the leading cause of disability globally. New research indicates that high-intensity interval training (HIIT) may benefit stroke patients more. Objective: To determine the effects of high-intensity interval training on mobility and fitness outcomes in stroke. Methods: A single-blinded, randomized controlled study was carried out on n=44 ambulatory stroke survivors between the ages of 45 and 65 years. The participants were randomly assigned to group A (n=22) received conventional physiotherapy (CPT). While Group B received HIIT in addition to conventional physiotherapy. The Berg Balance Scale (BBS), Heart Rate Recovery (HRR), Functional Ambulation Categories (FAC), Stroke-Specific Quality of Life (SS-QOL), Timed Up and Go (TUG) test, and the 6-Minute Walk Test (6MWT) were the outcome measures. At baseline, six weeks, and twelve weeks, assessments were carried out. Results: The HIIT group had significantly improved mobility, balance, and cardiovascular fitness. In the 6MWT (p&lt;0.001), BBS (p&lt;0.001), FAC (p=0.002,), insignificant p-value in HRR (p=0.93, ηp²=0.00), SS-QOL (p=0.01, ηp²=0.16), and TUG tests (p=0.01, ηp²=0.16), and hence was better (p &lt; 0.05) in all variables except FAC (0.48). Conclusion: High-intensity interval Training significantly improves walking capacity, balance, cardiovascular recovery, and quality of life in stroke survivors when combined with conventional standard physiotherapy interventions, as compared to conventional physiotherapy alone. Keywords: Fitness, FAC, HR reserved, High-Intensity Interval Training (HIIT), Ischemic, Mobility, Stroke Rehabilitation, 6-Minute Walk Test (6MWT)

A Protocol Investigation Comparing Transcatheter Repair with the Standard Surgical Procedure for Secondary Mitral Regurgitation.

Background: Secondary mitral regurgitation (SMR) is characterized by a pathological process impacting the left ventricle (LV) as opposed to the mitral valve (MV). In the absence of structural alterations to the MV, the expansion of the LV or impairment of the papillary muscles (PMs) may ensue. A number of technical procedures are accessible for the purpose of determining the optimal resolution for MR. Nevertheless, there is a dearth of rigorous data to facilitate a comparative analysis of MV replacement, MV repair (including subvalvular repair), and transcatheter mitral valve interventions (TMV-Is). The objective of this investigation is to evaluate and compare the efficacy and clinical outcomes of transcatheter mitral valve repair (TMV-r) utilizing the edge-to-edge mitral valve repair (TEER) procedure in comparison to conventional surgical mitral valve interventions (S-SMVis) in patients with secondary mitral regurgitation. Methods and analysis: A consortium of five cardiac surgery institutions from four European states and Japan have joined forces to establish a multicenter observational registry, designated TEERMISO. Patients who underwent technical procedures for SMR between January 2007 and December 2023 will be enrolled consecutively into the TEERMISO registry. The investigation team evaluated the comparative efficacy of replacement and repair techniques, utilizing both the standard surgical methodology and the transcatheter intervention. The primary clinical outcome will be the degree of left ventricular remodeling, as assessed by the left ventricular end-diastolic volume index, at 10 years. The forthcoming research will assess a variety of secondary endpoints, among which all-cause mortality will be the primary endpoint. Subsequent assessments will be made in the following order: functional status, hospitalization, neurocognition, physiological measures (echocardiographic assessment), occurrence of adverse clinical incidents, and reoperation. Ethics and dissemination: The multicenter design of the database is anticipated to reduce the potential for bias associated with institutional caseload and surgical experience. All participating centers possess an established mitral valve protocol that facilitates comprehensive follow-up and management of any delayed mitral complications following replacement surgery or surgical repair of the secondary mitral regurgitation. The data collected will provide insights into the impact of diverse surgical approaches on standard mitral valve surgery and TEER. This will facilitate the evaluation of LV remodeling over the course of long-term post-procedural follow-up. Trial Registration: ClinicalTrials.gov ID: NCT05090540; IRB ID: 202201143.

IUPHAR themed review: The gut microbiome in schizophrenia.

Gut microbial dysbiosis or altered gut microbial consortium, in schizophrenia suggests a pathogenic role through the gut-brain axis, influencing neuroinflammatory and neurotransmitter pathways critical to psychotic, affective, and cognitive symptoms. Paradoxically, conventional psychotropic interventions may exacerbate this dysbiosis, with antipsychotics, particularly olanzapine, demonstrating profound effects on microbial architecture through disruption of bacterial phyla ratios, diminished taxonomic diversity, and attenuated short-chain fatty acid synthesis. To address these challenges, novel therapeutic strategies targeting the gut microbiome, encompassing probiotic supplementation, prebiotic compounds, faecal microbiota transplantation, and rationalised co-pharmacotherapy, show promise in attenuating antipsychotic-induced metabolic disruptions while enhancing therapeutic efficacy. Harnessing such insights, precision medicine approaches promise to transform antipsychotic prescribing practices by identifying patients at risk of metabolic side effects based on their microbial profiles. This IUPHAR review collates the current literature landscape of the gut-brain axis and its intricate relationship with schizophrenia while advocating for integrating microbiome assessments and therapeutic management. Such a fundamental shift in proposing microbiome-informed psychotropic prescriptions to optimise therapeutic efficacy and reduce adverse metabolic impacts would align antipsychotic treatments with microbiome safety, prioritising 'gut-neutral' or gut-favourable drugs to safeguard long-term patient outcomes in schizophrenia therapy.

The Effect of Nursing Intervention Application in Patients with Diabetes Mellitus and Urinary Tract Infection

Objective: To analyze the effect of using a comprehensive nursing intervention model for patients with diabetes mellitus and urinary tract infections. Methods: 60 patients with diabetes mellitus combined with urinary tract infection who were admitted to the hospital from November 2021 to November 2023 were randomly divided into the observation group and the control group, and were treated with conventional nursing interventions and comprehensive nursing interventions respectively. The nursing status of the two groups was compared and analyzed. Results: After the intervention, the observation group showed lower levels of fasting blood glucose and other indicators, and lower anxiety and depression scores, P &lt; 0.05. After the intervention, the observation group’s blood creatinine and other biochemical indicators improved significantly, P &lt; 0.05. Conclusion: For the treatment of patients with both diabetes mellitus and urinary tract infections, nursing staff should pay attention to the development of nursing interventions to enhance the level of patients’ glucose control, improve the patients’ bad moods, and improve patients’ therapeutic efficacy.

A Decade of Prostate Intervention Robots: Systematic Review

Abstract: The image-guided prostate intervention robot can assist surgeons in performing minimally invasive intervention procedures. It has the advantage of overcoming the disadvantages of a traditional surgeon's hand tremor and dependence on the need for an experienced surgeon, improving the intervention precision, and reducing the hazards caused by normal soft tissues due to surgical precision errors compared to traditional intervention procedures. In the design of prostate intervention robots, structural design, materials, actuators, and compatibility issues should be considered. Based on the above considerations, a representative literature of the last decade was selected for review. Patents and articles on image-guided prostate intervention robots published in the last 10 years (2013-2023)were searched in several electronic databases, focusing on keywords (structural design, puncture accuracy, image compatibility, actuator) for screening. We retrieved a total of 26 prostate intervention robots guided by different images, classified them by US, MRI, MRI-US and CT, selected representative robots guided by different image modalities for review and tabulated them for comparison, and finally boldly predicted that the future direction will be prostate robots guided by MRI-US images. Image-guided prostate intervention robots can improve the deficiencies of conventional intervention procedures. In the future how to improve the intervention accuracy will be the primary problem of all intervention robots, through structural design, materials, actuators, and image compatibility issues have been improved.

Role of microRNA in Diabetic Osteoporosis.

Diabetic osteoporosis (DOP), a complication associated with diabetes mellitus (DM), is a metabolic bone disorder characterized by a reduction in bone mass per unit volume, impaired bone tissue microarchitecture, heightened bone fragility, and increased susceptibility to fractures. Individuals with diabetes exhibit a significantly greater incidence of osteoporosis and related fractures than those without diabetes. These fractures present a significant challenge in terms of the healing process and can result in severe consequences, including fatalities. MicroRNAs (miRNAs), a class of noncoding RNAs, play a pivotal role in numerous human diseases and are implicated in the pathogenesis of DOP. This review initially elucidates the essential role of miRNAs in the pathogenesis of DOP. Next, we emphasize the potential significance of miRNAs as valuable biomarkers for diagnosing DOP and predicting DOP-related fractures. Furthermore, we explore the involvement of miRNAs in managing DOP through various pathways, including conventional pharmaceutical interventions and exercise therapy. Importantly, miRNAs exhibit potential as targeted therapeutic agents for effectively treating DOP. Finally, we highlight the use of novel materials and exosomes for miRNA delivery, which has significant advantages in the treatment of DOP and overcomes the limitations associated with miRNA delivery.

Alpha-synuclein Fibrils Inhibit Activation of the BDNF/ERK Signaling Loop in the mPFC to Induce Parkinson's Disease-like Alterations with Depression.

Depression (Dep) is one of the most common concomitant symptoms of Parkinson's disease (PD), but there is a lack of detailed pathologic evidence for the occurrence of PD-Dep. Currently, the management of symptoms from both conditions using conventional pharmacological interventions remains a formidable task. In this study, we found impaired activation of extracellular signal-related kinase (ERK), reduced levels of transcription and translation, and decreased expression of brain-derived neurotrophic factor (BDNF) in the medial prefrontal cortex (mPFC) of PD-Dep rats. We demonstrated that the abnormal phosphorylation of α-synuclein (pS129) induced tropomyosin-related kinase receptor type B (TrkB) retention at the neuronal cell membrane, leading to BDNF/TrkB signaling dysfunction. We chose SEW2871 as an ameliorator to upregulate ERK phosphorylation. The results showed that PD-Dep rats exhibited improvement in behavioral manifestations of PD and depression. In addition, a reduction in pS129 was accompanied by a restoration of the function of the BDNF/ERK signaling loop in the mPFC of PD-Dep rats.

Effects of E-Cigs on Physiological Pathways and Proposed Therapeutic Intervention with Bixin.

Electronic cigarettes (e-cigs) have increased in popularity and usage over the last few decades. There is rising concern regarding the long-term effects of e-cigs on human health, considering their relatively recent introduction to the market. E-cigs are generally composed of a liquid containing nicotine and various chemicals, a battery, a vaporization chamber, and a coil that serves to heat the liquid upon inhalation of the mouthpiece. While e-cigs were initially introduced as a healthy alternative to cigarette smoking, recent research has demonstrated the cytotoxic effects of nicotinic e-cig devices on multiple cell types, including epithelial and endothelial cells, along with causing dysregulation of inflammatory pathways. This review will discuss the harmful effects of e-cigs on the human body, highlighting the physiological impact of e-cigs on pulmonary, cardiovascular, and cerebrovascular health. Moreover, this review will highlight the potential therapeutic effects of bixin, an apocarotenoid found in the seeds of Bixa orellana, also known as the achiote tree, due to its innate anti-inflammatory, antioxidant, and anti-cancer activities that have been demonstrated in recent research. Nanotechnology has surfaced in the past few decades as a powerful tool for medicinal practice. Specifically, nanoparticles serve as a potential method for treating various conditions and diseases. Bixin nanoparticles show promise as a viable method for treating e-cig-induced damage due to the innate properties of bixin and the advantages of using nanoparticles compared to conventional medicinal interventions.

Avatar Intervention in Virtual Reality for Cannabis Use Disorder in Individuals With Severe Mental Disorders: Results From a 1-Year, Single-Arm Clinical Trial.

The dual diagnosis of cannabis use disorder (CUD) and severe mental disorder (SMD) results in clinically complex individuals. Cannabis use is known to have negative consequences on psychiatric symptoms, medication compliance, and disease prognosis. Moreover, the effectiveness of currently available psychotherapeutic treatments is limited in this population. In this context, our research team developed avatar intervention, an approach using virtual reality as a therapeutic tool to treat CUD in individuals with SMD. This pilot clinical trial aimed to evaluate, until the 1-year follow-up, the efficacy of avatar intervention for CUD among 32 participants with a dual diagnosis of SMD and CUD. Over the course of the 8 intervention sessions, participants were given the opportunity to enter a dialogue in virtual reality with an avatar representing a person with a significant role in their consumption, who was animated in real time by a therapist. The primary outcomes were the quantity of cannabis consumed and the frequency of use. Secondary outcomes included severity of problematic cannabis use, motivation for change, protective strategies for cannabis use, consequences of cannabis use, psychiatric symptoms, and quality of life. Changes in reported outcomes during the assessment periods before the intervention; postintervention; and 3, 6, and 12 months after the end of the intervention were assessed using a linear mixed-effects model. Significant reductions were observed in the quantity of cannabis consumed, and these were maintained until the 12-month follow-up visit (d=0.804; P<.001; confirmed by urine quantification). Frequency of cannabis use showed a small significant reduction at the 3-month follow-up (d=0.384; P=.03). Moreover, improvements were observed in the severity of CUD, cannabis-related negative consequences, the motivation to change cannabis use, and the strategies used to mitigate harms related to cannabis use. Finally, moderate benefits were observed for quality of life and psychiatric symptoms. Overall, this unique intervention shows promising results that seem to be maintained up to 12 months after the end of the intervention. With the aim of overcoming the methodological limitations of a pilot study, a single-blind randomized controlled trial is currently underway to compare the avatar intervention for CUD with a conventional addiction intervention.

Effect of Pelvic Control Exercises on Balance in Children with Cerebral Palsy: A Randomized Controlled Trial

Objective: The study’s goal was to find out how children with cerebral palsy’s (CP) balance was affected by exercises for pelvic control. Material and Methods: Forty-two children that participated in this single-blind trial were divided into two groups at random. Group A (n=21) received conventional intervention and pelvic control exercises, while Group B (n=21) received only conventional intervention. For a period of eight weeks, the intervention was carried out; three days a week. The time up and go scale was used for assessment before and after treatment. The paired-t test was used to analyze differences within the group, whereas the independent t-test was utilized to analyze differences between the two groups.Results: Results for pre and post-treatment timed up and go (TUG) scores are presented as means and standard deviations. The values of TUG scores in study group A showed a notable increase (p-value&lt;0.05) after treatment with conventional physiotherapy and pelvic control exercises. Conclusion: The results indicated that pelvic control training was found to be beneficial in improving the balance of children with CP.

Personalized nutrition in type 2 diabetes remission: application of digital twin technology for predictive glycemic control.

Type 2 Diabetes (T2D) is a complex condition marked by insulin resistance and beta-cell dysfunction. Traditional dietary interventions, such as low-calorie or low-carbohydrate diets, typically overlook individual variability in postprandial glycemic responses (PPGRs), which can lead to suboptimal management of the disease. Recent advancements suggest that personalized nutrition, tailored to individual metabolic profiles, may enhance the effectiveness of T2D management. This study aims to present the development and application of a Digital Twin (DT) technology-a machine learning (ML)-powered platform designed to predict and modulate PPGRs in T2D patients. By integrating continuous glucose monitoring (CGM), dietary data, and other physiological inputs, the DT provides individualized dietary recommendations to improve insulin sensitivity, reduce hyperinsulinemia, and support the remission of T2D. We developed a sophisticated DT platform that synthesizes real-time data from CGM, dietary logs, and other biometric inputs to create personalized metabolic models for T2D patients. The intervention is delivered via a mobile application, which dynamically adjusts dietary recommendations based on predicted PPGRs. This methodology is validated through a randomized controlled trial (RCT) assessing its impact on various metabolic markers, including HbA1c, metabolic-associated fatty liver disease (MAFLD), blood pressure, body weight, ASCVD risk, albuminuria, and diabetic retinopathy. Preliminary data from the ongoing RCT and real-world study demonstrate the DT's capacity to generate significant improvements in glycemic control and metabolic health. The DT-driven personalized nutrition plan has been associated with reductions in HbA1c, enhanced beta-cell function, and normalization of hyperinsulinemia, supporting sustained T2D remission. Additionally, the DT's predictions have contributed to improvements in MAFLD markers, blood pressure, and cardiovascular risk factors, highlighting its potential as a comprehensive management tool. The DT technology represents a novel and scalable approach to personalized nutrition in T2D management. By addressing individual variability in PPGRs, this method offers a promising alternative to conventional dietary interventions, with the potential to improve long-term outcomes and reduce the global burden of T2D.