Favorable Changes Research Articles

Feasibility of a Cardiac Magnetic Resonance Protocol for "off-on" Cardiac Resynchronization Therapy Evaluation.

Cardiac resynchronization therapy (CRT) is a standard treatment for patients with heart failure and electrical dyssynchrony. Cardiac magnetic resonance (CMR) is the gold standard for assessing left ventricular (LV) function. However, the feasibility of using CMR with active CRT is still uncertain. To assess the feasibility of a CRT "off-on" protocol during CMR and measure the acute effects of CRT interruption on LV function. Patients underwent CMR before (pre-CRT) and 6 months after (post-CRT) an MR-conditional CRT defibrillator implantation. The post-CRT scan included two complete sets of cine images, one with inactive (post-CRTOFF) and one with active CRT (post-CRTON), maintaining a continuous connection between device and programmer. Out of 29 enrolled patients, 8 (28%) had complete and analyzable post-CRT data. Unsuccessful procedures were attributed to connection problems between the CRT device and the programmer (n = 10), poor image quality (n = 7), and lack of patient cooperation (n = 4). LV ejection fraction significantly increased between pre-CRT scan (28.1%) and both post-CRTOFF (37.9%; p = 0.046) and post-CRTON CMR (35.0%; p = 0.037), with a nonstatistically significant trend toward decreased LV volumes. No adverse events or significant changes in device electrical parameters (including battery level) were detected during the post-CMR scan period. A CRT "off-on" protocol during CMR studies can be safely executed in patients with an MR-conditional CRT defibrillator. However, technical improvements are needed to facilitate high-quality scans during active CRT. Favorable changes in LV function induced by CRT remodeling were not acutely reversed with the interruption of electrical therapy.

Tyrosine modifications of insulin-degrading enzyme enable favorable control of substrate specificity for both Alzheimer’s disease and type-2 diabetes mellitus

Insulin-degrading enzyme (IDE) cleaves amyloid beta (Aβ), insulin, and other bioactive peptides. Because Aβ and insulin are closely related to Alzheimer’s disease (AD) and type-2 diabetes mellitus (T2DM), respectively, IDE is a candidate drug target for treating both AD and T2DM. However, the activity of IDE has opposing effects, including decreasing AD risk by degrading Aβ and increasing T2DM risk by degrading insulin. The opposed substrate specificity is associated with the exo- and active sites containing Tyr314 and Tyr831 residues, the plausible modification targets for controlling substrate specificity. In this study, we used a tyrosine-specific modification regent, Cookson reagent (4-phenyl-1,2,4-triazoline-3,5-dione, PTAD), for IDE and examined the degradation activities on Aβ40 and insulin. Fifteen tyrosine residues, including Tyr314 and Tyr831, were modified by PTAD. After incubation with PTAD-modified IDE for 3 days, insulin remained intact, whereas Aβ40 was completely degraded. This favorable change of substrate specificity was also observed in the mixture of Aβ40 and insulin, suggesting that tyrosine modification of IDE might be a therapeutic strategy for AD and T2DM.

The Effectiveness of Remineralization with Compound Silver Nanoparticles and Fluoride Varnish in Carious Lesions in Primary Teeth: A Randomized Split-Mouth Clinical Trial.

Background: Anti-cariogenic properties of silver nanoparticles and fluorides have been probed mainly in vitro and with the objetive to evaluate the remineralizing effects of an applied silver nanoparticle compound plus fluoride varnish, a randomized split-mouth clinical trial was conducted in children aged 6 to 7 years. Methods: The project was approved by the ethics committee of the faculty. Primary molars were randomly distributed into two groups, as follows: Group A was treated with a compound based on silver nanoparticles plus fluoride varnish (SNP-FV), and Group B was treated with a silver diamine fluoride compound (SDF-KI), which is the current standard treatment. Laser fluorescence with a DIAGNOdent pen was used for the evaluation, with follow-up examinations at 15 days, 6 months, and 12 months. ANOVA test was used to compare the groups. The results showed a decrease in demineralization was observed after treatment with SNP-FV; similar results were observed after treatment with SDF-KI. Within each group, there were favorable changes. In the SDF-KI group, the differences in demineralization were 25.63 at 15 days, 29.37 at 6 months, and 30.6 at one year (p < 0.05). Meanwhile, in the SNP-FV group, the decreases were 22.7 at 15 days, 28.78 at 6 months, and 31.11 at one year (p < 0.05). Conclusions: The SNP-FV combined treatment represents an alternative remineralizing treatment for the management of carious lesions in the dentin of primary molars.

Evaluation of a multicomponent positive psychology program to prevent gaming disorder and enhance mental wellness in primary pupils: A randomized controlled trial.

Gaming disorder (GD) is a prevalent and complex issue that has recently been recognized as a condition that impairs mental health, underscoring the urgent need for early prevention measures. This evaluation study examined the effectiveness of the Digital Netizen Alliance (D.N.A.) program, a new multicomponent positive psychology program for preventing GD and bolstering mental wellness among Chinese children. Drawing on gamification and positive psychology principles, the program builds four key positive skills collectively referred to as the P-A-G-E framework: psychological resilience, active coping, growth mindset, and emotion regulation. A randomized controlled trial was conducted with 264 primary school pupils attending fourth, fifth, or sixth grade in Hong Kong (63% female; mean age = 10.83, SD = 1.18). The findings revealed that participation in the program effectively promoted active coping, a growth mindset, and emotion regulation. Moreover, program participation alleviated GD symptoms and reduced negative affect. These desirable changes were fullyexplained by the P-A-G-E framework. The new D.N.A. program, which cultivates the positive psychology skills specified in the P-A-G-E framework, facilitates favorable psychological changes among children. These results emphasize the importance of using multicomponent frameworks for interventions targeting GD prevention.

Efficacy and safety of an ultra-low-dose 0.005 % estriol vaginal gel in the prevention of urinary tract infections in postmenopausal women with genitourinary syndrome of menopause: A randomized double-blind placebo-controlled trial

ObjectivesThis study evaluated the efficacy of an ultra-low-dose 0.005 % estriol vaginal gel in the prevention of urinary tract infections in postmenopausal women with genitourinary syndrome of menopause. Study designRandomized, double-blind, placebo-controlled, multicenter clinical trial conducted across 28 Spanish sites involving specialists in gynecology, urology, and primary care. A total of 108 postmenopausal women were randomly assigned in a 1:1 ratio to receive 1 g of vaginal gel with 50 micrograms of estriol or an identical moisturizing vaginal gel without estriol. Main outcome measuresThe primary outcome was the number of episodes of urinary tract infection by the end of the 24-week treatment. Secondary measures encompassed percentage of patients without recurrence, time to first recurrence, use of antibiotic treatment, vaginal pH, safety, and tolerability, among others. ResultsThe incidence rate of urinary tract infections (new cases per 100 women-year) was 26 % lower in the group that received estriol vs. the group that received placebo (32.34 vs. 43.76 (RR = 0.74) p < 0.001). The frequency of urinary tract infections fell during treatment in all patients in the estriol group. Favorable pH changes from baseline were observed in the estriol arm at all follow-up visits. ConclusionsUltra-low-dose 0.005 % estriol vaginal gel is safe and effective in preventing recurrent urinary tract infections in postmenopausal women with genitourinary syndrome of menopause, reducing the incidence and potentially decreasing the susceptibility to urogenital infections by improving vaginal pH.Study registration N°: 2018-001481-42. Date of registration: 09-04-2018.

Preliminary Metabolomics Study Suggests Favorable Metabolic Changes in the Plasma of Breast Cancer Patients after Surgery and Adjuvant Treatment.

Background/Objectives: The management of early breast cancer (BC) includes surgery, followed by adjuvant radiotherapy, chemotherapy, hormone therapy, or immunotherapy. However, the influence of these interventions in metabolic reprogramming remains unknown. This study explored alterations in the plasma metabolome of BC patients following distinct treatments to deepen our understanding of BC pathophysiology, outcomes, and the identification of potential biomarkers. Methods: We included 52 women diagnosed with BC and candidates for surgery as primary oncological treatment. Blood samples were collected at diagnosis, two weeks post-surgery, and one month post-radiotherapy. Plasma samples from 49 healthy women served as controls. Targeted metabolomics assessed 74 metabolites spanning carbohydrates, amino acids, lipids, nucleotide pathways, energy metabolism, and xenobiotic biodegradation. Results: Before treatment, the BC patients exhibited notable changes in carbohydrate, nucleotide, lipid, and amino acid metabolism. We noticed a gradual restoration of specific metabolite levels (hypoxanthine, 3-phosphoglyceric acid, xylonic acid, and maltose) throughout different treatments, suggesting a normalization of the nucleotide and carbohydrate metabolic pathways. Moreover, we observed increased dodecanoic acid concentrations, a metabolite associated with cancer protection. These variations distinguished patients from controls with high specificity and sensitivity. Conclusions: Our preliminary study suggests that oncological treatments modify the metabolism of patients towards a favorable profile with a decrease in the pathways that favor cell proliferation and an increase in the levels of anticancer molecules. These findings emphasize the pivotal role of metabolomics in recognizing the biological pathways influenced by each cancer treatment and the resulting metabolic consequences. Furthermore, it aids in identifying potential biomarkers for disease onset and progression.

Effects of Alpha-Tocopherol (Vitamin E) Treatment on Cardiovascular Biomarkers: A Comprehensive Review

This comprehensive review explores that subjoining of alpha-tocopherol (vitamin E) have improved effect on cardiovascular biomarkers in the human subjects, focusing on its potential role in addressing cardiovascular diseases (CVDs), which are major global health challenges exacerbated by risk factors such as dyslipidaemia and hypertension. Systematic analysis of various randomized controlled trials, evaluates alpha-tocopherol's effects on LDL cholesterol, HDL cholesterol, systolic blood pressure, triglycerides, total cholesterol levels etc. The synthesis of current literature consistently indicates that alpha-tocopherol treatment leads to significant reductions in systolic blood pressure compared to control groups. Furthermore, substantial evidence supports alpha-tocopherol's ability to increase HDL-cholesterol levels and decrease LDL-cholesterol concentrations, suggesting beneficial impacts on lipid profiles. The review also discusses alphatocopherol's influence on additional cardiovascular biomarkers such as Troponin I, B-type Natriuretic Peptide (BNP), Nterminal pro-BNP, Troponin T, C-reactive Protein (CRP), Lipoproteins, Creatine Kinase-MB (CK-MB), Myoglobin, and Fibrinogen, highlighting its potential broader effects on cardiovascular health indicators. Overall, this review underscores alpha-tocopherol's potential as an adjunctive therapy for managing cardiovascular risk factors, particularly hypertension and dyslipidemia. The findings suggest that alpha-tocopherol supplementation may induce favourable changes in cardiovascular biomarkers, offering insights into its therapeutic potential and calling for further investigation in clinical settings.

Antibacterial and Healing Efficacy of Mangiferin-Loaded Silver Nanoparticle and Chitosan-Alginate Membrane Dressings

Mangiferin, a bioactive constituent of Mangifera indica (family Anacardiaceae), has an impressive therapeutic profile, having antioxidant, anti-inflammatory, analgesic, antibacterial, and immunomodulatory properties capable of possessing wound healing potential. Our investigation aims to isolate and characterize mangiferin, green synthesis of silver nanoparticles (Ag-NPs) and production of chitosan alginate (Cs/Alg) film dressing loaded with mangiferin Ag-NPs and assess antibacterial and wound-healing properties against infected excision and burn wounds. The isolated mangiferin was authenticated by estimating melting point, thin layer chromatography (TLC), fourier-transform infrared spectroscopy (FTIR), and high-performance liquid chromatography (HPLC). Ag-NPs were green synthesized and characterized by UV-visible, particle size, zeta potential (ZP), entrapment efficiency (%EE), scanning electron microscope (SEM), transmission electron microscope (TEM), and stability study. Chitosan alginate membrane dressing was prepared by incorporating mangiferin Ag-NPs, and film thickness, pH, film weight, water intake capacity, and in-vitro drug release parameters were estimated. Among the four mangiferin Ag-NP batches, MN3 formed stable polydispersity spherical Ag-NPs with smaller particle size and high %EE. Mangiferin-loaded Cs/Alg film MN-CM4 showed significantly higher (p &lt; 0.001) drug content, wettability, release profile, and favorable pH changes. The mangiferin Ag-NPs embedded Cs/Alg film dressing showed a significantly high antimicrobial effect against the gram-positive bacterial strain of S. aureus, commonly found in wounds. MN3 and MN-CM4 treatment showed the shortest epithelialization period and enhanced wound closure. The hydroxyproline content has significantly (p &lt; 0.001) increased, and myeloperoxidase content was reduced by MN3 and MN-CM4 treatment. MN-CM4 treatment showed complete re-epithelialization reduced inflammatory cells with thicker and denser collagen fiber deposition. The effectiveness of the Cs/Alg film of mangiferin Ag-NPs dressing has a synergistic effect on promoting speedy wound healing. The Cs/Alg film of mangiferin Ag-NPs showed rapid wound healing against infected and burned wounds, enhanced collagen synthesis, and anti-inflammatory and antibacterial efficacy.

Safety and tolerability of a low glycemic load dietary intervention in adults with cystic fibrosis: a pilot study.

To achieve and maintain adequate weight, people with cystic fibrosis (CF) May often consume energy-dense, nutrient-poor foods high in added sugars and refined carbohydrates; however, little is known about the glycemic and metabolic effects of dietary composition in this patient population. The objective of this pilot study was to investigate the safety and tolerability of a low glycemic load (LGL) diet in adults with CF and abnormal glucose tolerance (AGT). Ten adults with CF and AGT completed this prospective, open-label pilot study. Mean age was 27.0 ± 2.1 years, 64% were female, and all had pancreatic insufficiency. Each participant followed his/her typical diet for 2 weeks, then transitioned to a LGL diet via meal delivery service for 8 weeks. The primary outcome was change in weight from baseline to study completion, with safety established if no significant decline was noted. Other key safety outcomes included change in hypoglycemia measured by patient report and continuous glucose monitoring (CGM). Exploratory outcomes included changes in other CGM measures, body composition by dual energy X-ray absorptiometry (DXA), and patient reported outcomes. There were no significant changes in weight or in subjectively-reported or objectively-measured hypoglycemia. Favorable non-significant changes were noted in CGM measures of hyperglycemia and glycemic variability, DXA measures of fat mass, and gastrointestinal symptom surveys. A LGL dietary intervention was safe and well tolerated in adults with CF and AGT. These results lay the groundwork for future trials investigating the impact of low-glycemic dietary interventions on metabolic outcomes in the CF population.

COVID-19-induced changes in the workplace, psychosocial work environment and employee well-being: a longitudinal study.

In many workplaces, the coronavirus disease 2019 pandemic changed work arrangements, but there is scarce longitudinal evidence on whether psychosocial work environment and employee well-being were affected. To examine the psychosocial work environment and employee well-being before, during and after the pandemic in relation to pandemic-induced changes (working from home, change to other tasks and team reorganization). Survey data from a cohort of 20944 public sector employees in Finland were collected before (2016-2018), during (2020) and after the pandemic (2022). Multilevel linear and logistic regression was used to examine group differences between the before-during and during-after periods of the pandemic. Working from home was associated with a small but favourable change in worktime control, organizational justice and social capital (scale 1-5) during the pandemic and after the pandemic (marginal mean difference ranging from 0.02 to 0.09 with 95% confidence intervals [CIs] from 0.01 to 0.10). There was a post-pandemic increase in work time control, even among participants with a transfer into other tasks (0.11, 95% CI 0.07, 0.14) or team reorganization (0.06, 95% CI 0.02, 0.10). The decline in self-rated work ability (scale 0-10) before and during the pandemic was greater in those transferred into other tasks (-0.10, 95% CI -0.13, -0.06) than in those not (-0.05, 95% CI -0.06, -0.04). Working from home during the pandemic was accompanied by small favourable changes in the psychosocial work environment during the pandemic, whereas transition to different tasks was associated with a decline in self-rated work ability.

Research on the Improvement of Endothelial Cell Function and Trophoblast Apoptosis in Rats with Preeclampsia by Tanshinone IIA

Background Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys. Recent studies suggest that endothelial dysfunction and trophoblast apoptosis are involved in the pathogenesis of preeclampsia. Purpose To investigate the effects of tanshinone IIA (TIIA) on clinical symptoms, vascular endothelial function, and placental trophoblast apoptosis in preeclampsia rats. Materials and Methods Twenty-four pregnant Sprague-Dawley rats, between 8 and 10 weeks old, were randomly divided and allocated into three groups: Control, model, and treatment, with each group consisting of 8 rats. The control group received normal saline injections via the tail vein; the model group received NG-nitro-l-arginine methyl ester (l-NAME) to induce preeclampsia, followed by normal saline injections; and the treatment group received TIIA (10 mg/kg) via tail vein injection after preeclampsia induction with l-NAME. Various parameters were measured, including tail artery systolic pressure, 24-hour proteinuria, offspring and placental weight, levels of endothelial nitric oxide synthase (eNOS), endothelin-1 (ET-1), placental growth factor (PLGF), and soluble FMS-like tyrosine kinase 1 (sFlt-1) in serum, and expression of B-cell lymphoma-2 (Bcl-2) and Bcl-2-related X protein (Bax) in placental trophoblasts. Results TIIA treatment led to decreased tail artery systolic pressure and 24-hour urine protein levels, increased body and placental weights of offspring, and favorable changes in serum levels of ET-1, sFlt-1, eNOS, and PLGF. Moreover, TIIA treatment resulted in decreased Bax levels and apoptosis in placental trophoblasts, along with increased Bcl-2 levels. Conclusion TIIA can improve the clinical symptoms of preeclampsia in rats induced by l-NAME, alleviate the apoptosis of placental trophoblast cells, and improve vascular endothelial function.

Metabolic revitalization: exploring erythrocyte fatty acid profile following laparoscopic sleeve gastrectomy.

Obesity is linked to metabolic disorders. Bariatric surgery offers a promising therapeutic approach, but its impact on fatty acid (FA) profiles within erythrocytes and the associated clinical implications remain underexplored. This study aimed to assess changes in erythrocytes' membranes FA after Laparoscopic Sleeve Gastrectomy (LSG) and to correlate these alterations with clinical parameters. Sixty-one patients with morbid obesity undergoing LSG and 32 healthy controls were enrolled. Erythrocytes' membranes FA were analyzed using gas chromatography. Clinical parameters were assessed, including BMI, blood pressure, and multiple biochemistry markers. Bariatric intervention reduced BMI (41.1 to 32.0) and fat mass (54.1 to 35.2kg). Also, other anthropometric parameters improved significantly. Favorable changes in FA metabolism post LSG, potentially leading to a reduction in cardiovascular disease (CVD) risk, were observed. The OMEGA-3 Index (1.8 vs 3.0), and the eicosapentaenoic/arachidonic (0.1 vs 0.2) FA ratio increased after surgery. The dynamics of metabolism post-LSG, assessed by exploring the ratios of erythrocytes' FA concentration in baseline and 6 months after the surgery, with the corresponding ratios calculated for clinical parameters, evidenced the impact of linoleic (LA) on obesity reduction. The LA ratios increased along with the reduction of BMI (r=-0.32), fat mass (r=-0.39), and waist circumference (r=-0.33) proportions. The opposite relations of LA were held with Excess Weight Loss percentage (r=0.49), and Excess BMI Loss percentage (r=0.5). The study underscores distinct post-LSG changes in erythrocytes' FA profiles potentially associated with reduced weight and BMI, improved inflammatory status, and lowered CVD risk.

Influence of Perceived Health Risk Factors on Adoption of Community-Led Total Sanitation: A Case of Turkana Central Sub-County, Turkana County, Kenya

The primary objective of Sustainable Development Goal 6 target 2 is to achieve widespread accessibility to sufficient sanitation and hygiene facilities, therefore eliminating the practice of open defecation by the year 2030. One strategy for achieving this objective involves the implementation of Community-Led Total Sanitation (CLTS), a participatory method that allows communities to take on accountability for their sanitation behaviors. However, sustaining favorable changes after the implementation of the intervention continues to be a significant obstacle. The objective of this study was to investigate the influence of perceived health risk factors on adoption of Community-Led Total Sanitation. The study was carried out on the household members of Lodwar township and Kalokol ward, targeting a sample size of 382 respondents The research utilized a convergent design methodology, which combined quantitative and qualitative data collection methods, enabling the simultaneous gathering of both types of data. Quantitative data were collected using structured questionnaires and observation checklist, while qualitative data were collected from Focus Group Discussions. A stratified sampling technique was applied to group the village units into strata and simple random sampling used in selection of household heads. Qualitative results were structured into themes and direct quotes. The study determined that an increase in perceived knowledge regarding health risks was associated with a higher likelihood of latrine presence (p-value&lt; 0.05). Findings from multiple regression analysis also showed that education level was a significant predictor for awareness, understanding, and knowledge (p=0.000&lt;0.05), while gender demonstrated a significant negative relationship with awareness and understanding p= -0.2573, suggested males score lower in these areas compared to females. Age correlated positively with awareness and was marginally significant for understanding (p=0.043), indicating that older individuals had higher scores. The study concluded that increased knowledge regarding health risk in terms of vulnerability and susceptibility influenced latrine presence at the households and thus the adoption of community-led total sanitation programs in Turkana Central Sub-County. The study highlighted the critical role of knowledge in achieving open defecation-free status in the area. The study recommended that CLTS interventions by the Ministry of Health and sanitation implementers place a particular focus on knowledge enhancement, to ensure that communities are better informed, which could lead to a higher likelihood of adopting improved sanitation practices, thereby reducing the prevalence of open defecation and related health issues.

Exosomes, peptides and peri-procedure management – comparative investigations

Introduction: Exosome technology is a promising new advancement in therapeutic options but is still in its early stages, leading to uncertainties. A small pilot study compared traditional peptide technology (Regenerating Skin Nectar with TriHex Technology® and TriHex Technology® peptide + Octapeptide) to two leading exosome products (Stem cell derived Lyophilized exosomes and Platelet derived exosomes) for post-procedure use. These studies were carried out on pre-clinical (ex vivo) and clinical front to investigate effects on the extracellular matrix, dermo-epidermal junction, and skin tolerance as post-procedure outcomes. Methods and materials: The ex vivo model study was conducted by 3D Genomics using photodamaged skin from facelift patients. The skin was divided, processed under BSL2 conditions and cultured in transwells with specific media. Treatments, including peptides and platelet-derived products, were applied daily for 7 days, while stem cell-derived exosomes were applied as a single application as per the described usage. One set was left untreated as a control. Skin samples were treated and analyzed using immunohistochemistry staining for tropoelastin and CD44. RNA was isolated after treatments and sequenced to assess changes in gene expression. The study aimed to compare the effects of different treatments on skin regeneration and tolerance. Clinically, the participants underwent microneedling of the face and applied exosomes and peptides on each side of the face as comparisons. Participants completed questionnaires on Day 0. On Days 0,1,2,3 and 4 participants completed their self-healing ratings and were also assessed by an assessor on their healing rating on a 5-point scale. Results: The plated exosome products exhibited significant toxicity in the ex vivo model and neither of the exosome products produced relevant changes in gene expression or regenerative effects in this model. Participants in the small clinical series experienced unpleasant burning and stinging in keeping with the effects seen in the ex vivo model. In contrast, the peptide technology showed favorable gene expression upregulation and histological changes in the extracellular matrix and was well-tolerated and comfortable for post-procedure use, as has been demonstrated in multiple clinical trials. Conclusion: The overall impression from these pilot studies suggests that peptide formulations are better tolerated and more effectively target ECM regenerative effects. Conversely, exosome preparations appear to be prone to skin reactions and lack clear targeting of skin regenerative pathways.

Effectiveness of a psychoeducational program for caregivers of persons with acquired brain injury: a randomized controlled trial (EDUCA-V)

ABSTRACT Objective To assess the effectiveness of a psychoeducational intervention program (PIP) compared to standard attention in reducing caregiver burden after the intervention (at 4 months) and at follow-up (at 8 months). Methods A multicenter, evaluator-blind, randomized controlled trial. The experimental group received a PIP intervention consisting of 10 weekly group sessions, while the control group received standard attention. The primary outcome was measured as the change scores from baseline on the caregiver’s burden (ZBI). The secondary outcomes evaluated included caregiver mental health (GHQ-28), anxiety (STAI), and depression (CES-D). Trial registration: ISRCTN16513116. Results The sample comprised 76 informal caregivers (41 allocated in the intervention condition and 35 in the control). The caregiver’s burden (ZBI) did not show significant differences between groups at 4 months or 8 months. There were favorable and significant changes in the caregiver’s mental health (GHQ) and depression (CES-D) at 4 months in the PIP group. There were no significant differences between groups in anxiety during the trial. Conclusions The PIP intervention group reported positive effects on general mental health and depression after the intervention but not at follow-up. We need more studies which interventions follow expert recommendations and can sustain positive results over time.

Enhancing total knee arthroplasty outcomes: the role of individualized femoral sagittal alignment in robotic-assisted surgery - A randomized controlled trial

BackgroundOptimal sagittal alignment of the femoral prosthesis is critical to the success of total knee arthroplasty (TKA). While robotic-assisted TKA can improve alignment accuracy, the efficacy of default femoral alignment versus individualized alignment remains under scrutiny. This study aimed to compare the differences in prosthetic alignment, anatomical restoration, and clinical outcomes between individualized femoral sagittal alignment and default sagittal alignment in robotic-assisted TKA.MethodsIn a prospective randomised controlled trial, 113 patients (120 knees) underwent robotic-assisted TKA were divided into two groups: 61 with individualized femoral flexion (individualized alignment group) and 59 with default 3–5° flexion (default alignment group). The individualized alignment was based on the distal femoral sagittal anteverted angle (DFSAA), defined as the angle between the mechanical and distal anatomical axes of the femur. The radiographic and clinical outcomes were compared.ResultsDespite similar postoperative femoral flexion angles between groups (P = 0.748), the individualized alignment group exhibited significantly lower incidences of femoral prosthesis extension and higher rates of optimal 0–3° prosthesis flexion (9.8% vs. 27.1%, P = 0.014,78.7% vs. 55.9%, p = 0.008, respectively). The individualized alignment group also demonstrated more favourable changes in sagittal anatomy, with higher maintenance of postoperative anterior femoral offset within 1 mm (54.1% vs. 33.9%, P = 0.026) and posterior condylar offset within 1 mm and 2 mm (44.3% vs. 25.4%, p = 0.031,73.8% vs. 50.8%, p = 0.010, respectively). Although slight improvement in the Hospital for Special Surgery Knee Score (HSS) at three months was observed (P = 0.045), it did not reach a minimal clinically important difference.ConclusionIndividualized tailoring of femoral sagittal alignment in robotic-assisted total knee arthroplasty (TKA) enhances prosthetic alignment and anatomical restoration, suggesting potential improvements in postoperative outcomes.

Effect of a Phytochemical-Rich Olive-Derived Extract on Anthropometric, Hematological, and Metabolic Parameters.

Extra virgin olive oil is a fundamental component of the Mediterranean diet. It contains several molecules that sustain human well-being by modulating cellular metabolism and exerting antioxidant, anti-inflammatory, and anti-ageing effects to protect normal tissues, and it can exert anti-angiogenic and pro-apoptotic effects on cancer cells. Metabolites found in different parts of the olive tree, including leaves, also possess properties that might help in cancer prevention and promote wellness in aging. Olive mill wastewater (OMWW), a liquid residue produced during olive oil extraction, represents an environmental issue. However, it is rich in phytochemicals with potential beneficial properties. Dietary supplements based on OMWW can be produced for nutritional supplementation with advantages to the ecology. This work aims to measure hematochemical, anthropometric, and metabolomic parameters in volunteers taking an OMWW dietary supplement, Oliphenolia® (OMWW-OL). The supplementation of OMWW-OL 25 mL twice daily for 30 days was tested on a pilot cohort of volunteers with characteristics close to metabolic syndrome. Hematochemical, anthropometric, serum biomarkers and serum metabolomic parameters were analyzed before the intervention, at 30 days, and 30 days after stopping consumption. A total of 29 volunteers were enrolled, and 23 completed the study. The participants' parameters at baseline were measured, and then twice daily at 30 days of treatment and 30 days after assumption discontinuation. Although treatment was with an olive derivative, their weight did not increase. Their body mass index, instead of augmenting, slightly decreased, particularly in the women. Also, hydration increased, especially in the women, while blood pressure, glycemia, and insulin decreased. Cholesterol, high-density lipoproteins, and triglycerides were stable, and LDL levels decreased, while vitamin D levels, alongside calcium, perceptibly increased. Albumin also increased. All the values were in support of an equilibrium, with no damaging effects. By mass spectrometry analysis, we also found favorable changes in the vitamin D/histamine and homocysteine/methionine ratios, an increase in a new metabolite of unknown formula, and the vitamin D/unknown metabolite ratio. Supplementation of OMWW-OL has no detrimental effects and might imply the beneficial modulation of several biological parameters. Although this is a small pilot study, with limited potency, it preliminarily suggests that the OMWW extract use could be potentially valuable for people at risk of metabolic syndrome. Some of these parameters could also be relevant in supporting healthy ageing and in cancer prevention.

Listening with quiet curiosity: Feminist and queer reflections on interviews with the “wrong” people

Queer and feminist research centralises issues of power and relationalities; methodologies frequently emphasise the process of conducting research with people who are marginalised. The queer and feminist methodological literature also opens a door to complicating binary understandings of “right”/ “wrong” “powerful”/ “disempowered” relations, including those between the researcher and her research subjects. The “wrong” people are those who do not conform with expectations of typical queer and feminist research participants.In this paper, we introduce interviews conducted in Ireland with people who held concerns or oppositions to socio-legal changes in favour of increased rights related to gender, sexualities and/or abortion. We explore three moments in which Carol, author 1 for this article, did not contradict statements with which she disagreed. Building on queer and feminist insights for research that listens quietly with curiosity, we argue in favour of methodological approaches that move past considerations of complicity and platforming, to explore what discomfort can tell us about the interplay between research encounters and dynamic contexts.

Transforming Sedentary Lifestyles: The impact of remote VR and flat-screen interventions on affective attitudes towards physical exertion, guided by avatar or human trainers

This study advances understanding of the impact of flat-screen and virtual reality (VR) remote exercise environments in a home setting on affective attitudes towards physical exertion, with either a human or an avatar trainer.Employing a two-by-two factorial design, we manipulated both the medium (flat screen vs. VR) and the type of trainer (human vs. avatar). A total of 108 participants engaged in the study using a custom VR application for the Oculus Quest 2 headset or training videos, both prepared specifically for this study. The participants underwent a 15-min high-intensity interval training (HIIT) regimen, completing six workouts in their homes within fourteen days. Data on their exercise experiences and their affective attitudes towards exercise were collected using the CAWI technique. These were next analysed using a model that presumes that exercise experiences can increase motivation to exercise. We also studied the roles of spatial presence and trainer relatedness.Our results show that VR physical training shifted affective attitudes towards exercise positively, in contrast to the flat-screen groups. Moreover, using a digital avatar as a trainer had no negative effect on this favourable change in attitude. The change in affective attitude was influenced primarily by baseline levels and the wellbeing experienced during training. The factors we added to the original model—relatedness to the trainer and spatial presence—also contributed significantly to wellbeing. Perception of competence was a critical determinant of wellbeing, while perceived exertion was largely irrelevant. The HIIT protocol in the study was suitable for VR exercise.

Didier Eribon vs. ‘The People’—A Critique of Chantal Mouffe’s Left Populism

In this article, I develop a critique of Chantal Mouffe’s leftist populism and its construction of ‘the people’ against an opposed ‘them’, from a perspective informed by the thought of Didier Eribon. I draw on both his public interventions and his theoretical work, employing his concepts of return, society as verdict, and his two principles of critical thinking to question the desirability of crafting ‘the people’ in the first place. I contend that Eribon’s critique renders Mouffe’s proposal problematic on three accounts. First, her approach is too politically volatile; its instability leaves it devoid of a critical analysis of the differences between concrete social positions, struggles, and subjectivities within ‘the people’. Consequently, the political becomes merely a function of the social. Yet, the social and its determining power remain mostly unaddressed by her framework. Second, its simplistic opposition of an overly generalised ‘the people’ against ‘the oligarchy’ is susceptible to right-wing populist appropriations. Third, for a shot at hegemony and a general appeal, it eclipses plurality and dissensus within ‘the people’. In contrast, Eribon encourages a connection between the social and the political by suggesting that a self-critical analysis be mutually intertwined with social analysis. Instead of merely mobilising affects, they must be critically interrogated. Instead of summoning ‘the people’, a return to their respective genesis must be attempted. Unless both principles of critical thinking, the insights of return, and societal verdicts are deployed to come to terms with the social determinisms at hand, the ‘people’s’ mobilisation against an opposed ‘them’ risks sacrificing pluralism and equality alike and neglecting the criteria of the desirability of specific changes in favour of a “whatever it costs” attempt at hegemony.