Therapy Treatment Research Articles

TERAPI MUSIK UNTUK MENGURANGI KECEMASAN PADA IBU HAMIL TRIMESTER III

Anxiety is often referred to as a condition where the emotional state cannot be controlled and managed well, causing a person's adrenaline to become restless and unfocused on something. A feeling of anxiety is different from a feeling of fear. Anxiety can be expressed by behavior or physiological changes which can cause several other uncontrolled symptoms and will affect a person's personality. Anxiety that lasts a long time and is not resolved quickly will give a bad impression to the welfare of the mother and fetus where there are several things that might happen, such as the mother's uterine contractions being too fast and not appropriate for the gestational age. The aim of this case study was to measure the level of anxiety felt by pregnant women in the third trimester by carrying out music therapy treatment for 7 minutes in 1 consecutive week at BPM Midwife Paulina, Batam City in 2024. The method of care is in the form of a case study. carried out on third trimester pregnant women with mild anxiety with music therapy and using documentation in the form of SOAP. The sample was 1 pregnant woman with mild anxiety at BPM Midwife Paulina. The assessment of maternal anxiety measures uses a questionnaire consisting of 14 questions regarding anxiety. After 1 week with an estimated time of 7 minutes of treatment, it was found that the mother's anxiety had disappeared and was no longer there.

A novel zingerone-loaded zinc MOF coated by niosome nanocomposites to enhance antimicrobial properties and apoptosis in breast cancer cells

Breast cancer (BC) is a prevalent malignancy among women, presenting significant health risks. The development of targeted smart drug delivery has greatly enhanced tumor therapy and antibacterial treatments. In this study, we fabricated a novel Zn-metal organic framework (Zn-MOF) at the nanoscale using an oil bath technique and loaded it with zingerone (ZG) and coated with niosomes (Nio) to form ZG-Zn-MOF@Nio, designed for both anti-microbial and anticancer purposes. We investigated the anti-microbial activity by assessing the minimum inhibitory concentration and zone of inhibition by zingerone, Zn-MOF, and ZG-Zn-MOF@Nio. Scanning electron microscopy (SEM) analysis revealed that the synthesized ZG-Zn-MOF@Nio exhibited well-defined rod and cilia-like morphology. Transmission electron microscopy (TEM) images showed ZG-Zn-MOF@Nio nanoparticles (NPs) with a spherical-like shape and an average diameter of 0.34 µm and a zeta potential of (+22 mV). The encapsulation efficiency of zingerone into Zn-MOF was up to 92.56 %, with a loading capacity of 11.55 % (*P<0.05). Four kinetic models were used to analyze the release mechanism of zingerone at pH 6.5, with the zero-order model showing an excellent fit (R2 = 0.9985, *P<0.05). Additionally, the minimum inhibitory concentration of synthesized zingerone, Zn-MOF, and ZG-Zn-MOF@Nio NPs were tested against Gram-positive Bacillus subtilis (B. subtilis) and Staphylococcus aureus (S. aures), as well as the gram-negative strains Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa). In vitro test revealed that the minimum inhibitory concentration of ZG-Zn-MOF@Nio was 31.25 μg/mL against S. aures and B. subtilis, and 62.5 μg/mL against P. aeruginosa and E.coli were. The MCF-7 cell line was utilized as in-vitro model. The MTT assay demonstrated significant cytotoxicity of ZG-Zn-MOF@Nio against MCF-7 cells, with an IC50 values of 46.2 µg/mL, inducing apoptosis in 94.8 % of the cells.

Personalized Sound Therapy Combined with Low and High-Frequency Electromagnetic Stimulation for Chronic Tinnitus.

This study investigates a novel multimodal treatment for chronic tinnitus, a condition that significantly affects quality of life, by combining personalized sound therapy with both low- and high-frequency electromagnetic wave stimulation. Conducted at Tor Vergata University Hospital in Rome, the research involved 55 patients and employed a portable medical device for therapy delivery. Treatment effectiveness was measured through the Tinnitus Functional Index (TFI), Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS), Hyperacusis Questionnaire (HQ), and Short Form-36 Health Survey (SF-36), encompassing initial sound therapy and subsequent multimodal treatment phases. Remarkably, 73% of participants experienced notable improvements in TFI scores, with 39% reporting a significant enhancement of 13 points or more. This improvement was mirrored in secondary outcomes like THI, VAS, and HQ scores, along with certain SF-36 domains, indicating enhanced life quality and reduced tinnitus distress. The study underscored high compliance and no adverse effects, suggesting the combined therapy's promising potential in chronic tinnitus management. The findings advocate for further research to discern the distinct contributions of each treatment modality, positing that this innovative approach could ameliorate tinnitus symptoms and improve patient well-being, confirming its safety and efficacy.

Recovery of Muscular Strength Following Total Hip Replacement: A Narrative Review.

This narrative review analyzes muscle strength recovery following total hip replacement (THR) and looks at various factors affecting postoperative muscle function restoration. The review synthesizes evidence from various studies regarding the timing and degree of muscular strength recovery, different rehabilitation protocols, and patient-specific variables such as age, preoperative physical condition, and comorbidities, among others. Overall, it appears that THR is associated with improved hip function and quality of life, but this usually takes a long time due to individualized physical therapy interventions. In addition, postoperative rehabilitation has been found not to exist without any personal factors involved such as age or gender whereby for instance senior citizens have no alternative but to go for THR surgery, making their lower limbs weaker than those who are younger. Based on the findings in this review on muscle recovery after THR surgeries, one may conclude that this endeavor should begin as early as possible and include regular resistance training programswith performance-focused functional training after surgery. In addition, more longitudinal studies should be conducted regarding post-surgical outcomes comparing other traditional medical practices.

Community-Engaged Implementation Strategies in Occupational Therapy: A Scoping Review.

Despite the potential of community-engaged implementation research (CEIR) in developing strategies to accelerate the translation of evidence-based interventions (EBIs), there is a noticeable knowledge gap in the current state of CEIR in occupational therapy. A synthesis of the concept, purpose, and operationalization of CEIR is necessary. To identify the contexts, purposes, and operationalization of CEIR, focusing on implementation strategies in occupational therapy. PubMed/MEDLINE, Embase, CINAHL, Scopus, and Web of Science. We included studies that were explicit and intentional about CEIR and that focused on implementation strategies to support the translation of occupational therapy interventions, clinical guidelines, practice models, theories, or assessments. We extracted the research context (e.g., partners, recruitment), purpose (e.g., why community-engaged research was used), and operationalization (e.g., community engagement [CE] activities, how their findings inform the research) using thematic analysis. Of 3,219 records, 6 studies were included. Involved partners were mainly occupational therapy practitioners from existing networks. CEIR that focuses on implementation strategies informs various aspects of research design, ranging from study design to sustainability, by developing community-academia partnerships, building implementation capacity, and creating implementation strategies across diverse research areas. Current research has used various but mostly traditional CE activities (e.g., focus groups). We synthesized evidence on CEIR focused on implementation strategies in occupational therapy. Intentional efforts are needed to collaborate with diverse partners, explore innovative CE activities, produce equitable outputs, and develop multilevel implementation strategies to accelerate the translation of EBIs into practice. Plain-Language Summary: In this review, we synthesize evidence on the contexts, purposes, and operationalization of community-engaged implementation research (CEIR), focusing on implementation strategies in occupational therapy research. We found that current implementation efforts mainly rely on occupational therapy practitioners as community partners and use traditional recruitment methods and community engagement activities. In turn, they develop implementation strategies that mainly target practitioners without comprehensive, multilevel implementation support. We suggest more equitable collaboration with diverse partners to effectively promote the implementation and dissemination of evidence-based interventions in occupational therapy practice.

Predictors of residual tricuspid regurgitation after interventional therapy: an automated deep-learning CT analysis

Computed tomography (CT) is used as a valuable tool for device selection for interventional therapy in tricuspid regurgitation (TR). We aimed to evaluate predictors of TR reduction using CT and automated deep learning algorithms. Patients with severe to torrential TR and CTs prior to either percutaneous annuloplasty (PA) or tricuspid transcatheter edge-to-edge repair (T-TEER) were enrolled. CTs were analyzed using automated deep learning algorithms to assess tricuspid valve anatomy, right heart morphology, and function. Outcome parameters comprised post-interventional TR ≤ 1 and all-cause mortality. 84 patients with T-TEER (n = 32) or PA treatment (n = 52) were enrolled. Patients with a post-interventional TR ≤ 1 presented lower tenting heights and smaller tenting angles compared to patients with a TR > 1. Tenting height showed the best accuracy for post-interventional TR > 1 with an AUC of 0.756 (95% CI 0.560–0.951) in the T-TEER and 0.658 (95% CI 0.501–0.815) in the PA group, consistent with a suggested threshold of 6.8 mm and 9.2 mm, respectively. Patients with a post-interventional TR ≤ 1 exhibited a mortality of 4% and those with a TR > 1 of 12% during a follow-up of 331 ± 300 and 370 ± 265 days, respectively (p = 0.124). To conclude, tenting is associated with procedural outcomes and should be considered during screening for interventional TR therapy.

Multifunctional endogenous small molecule-derived polymer composite nanoparticles for the treatment of acute sepsis therapy

Multifunctional endogenous small molecule-derived polymer composite nanoparticles for the treatment of acute sepsis therapy

Multimodality Imaging for Right Ventricular Function Assessment in Severe Tricuspid Regurgitation.

Severe tricuspid regurgitation (TR) is a pathological condition associated with worse cardiovascular outcomes. In the vicious cycle of right ventricular compensation and maladaptation to TR, the development of right ventricle (RV) dysfunction has significant prognostic implications, especially in patients undergoing surgical or percutaneous treatments. Indeed, RV dysfunction is associated with increased operative morbidity and mortality in both surgical and percutaneously treated patients. In this context, the identification of clinical or subtle right ventricle dysfunction plays a critical role inpatient selection and timing of surgical or percutaneous tricuspid valve intervention. However, in the presence of severe TR, evaluation of RV function is challenging, given the increase in preload that may lead to an overestimation of systolic function for the Frank-Starling law, reduced reliability of pulmonary artery pressure estimation, the sensitivity of RV to afterload that may result in afterload mismatch after treatment. Consequently, conventional echocardiographic indices have some limitations, and the use of speckle tracking for right ventricular free wall longitudinal strain (RV-FWLS) analysis and the use of 3D echocardiography for RV volumes and ejection fraction estimation are showing promising data. Cardiac magnetic resonance (CMR) represents the gold standards for volumes and ejection fraction evaluation and may add further prognostic information. Finally, cardiac computer tomography (CCT) provides measurements of RV and annulus dimensions that are particularly useful in the transcatheter field. Identification of subtle RV dysfunction may need, therefore, more than one imaging technique, which will lead to tip the balance between medical therapy and early intervention towards the latter before disease progression. Therefore, the aim of this review is to describe the main imaging techniques, providing a comprehensive assessment of their role in RV function evaluation in the presence of severe TR.

A Voyage on the Role of Nuclear Factor Kappa B (NF-kB) Signaling Pathway in Duchenne Muscular Dystrophy: An Inherited Muscle Disorder.

A recessive X-linked illness called Duchenne muscular dystrophy (DMD) is characterized by increasing muscle weakening and degradation. It primarily affects boys and is one of the most prevalent and severe forms of muscular dystrophy. Mutations in the DMD gene, which codes for the essential protein dystrophin, which aids in maintaining the stability of muscle cell membranes during contraction, are the cause of the illness. Dystrophin deficiency or malfunction damages muscle cells, resulting in persistent inflammation and progressive loss of muscular mass. The pathophysiology and genetic foundation of DMD are thoroughly examined in this review paper, focusing on the function of the NF-κB signaling system in the disease's progression. An important immune response regulator, NF-κB, is aberrantly activated in DMD, which exacerbates the inflammatory milieu in dystrophic muscles. Muscle injury and fibrosis are exacerbated and muscle regeneration is hampered by the pro-inflammatory cytokines and chemokines that are produced when NF-κB is persistently activated in muscle cells. The paper also examines our existing knowledge of treatment approaches meant to inhibit the progression of disease by modifying NF-κB signaling. These include new molecular techniques, gene treatments, and pharmacological inhibitors that are intended to lessen inflammation and improve muscle healing. Furthermore covered in the analysis is the significance of supportive care for DMD patients, including physical therapy and corticosteroid treatment, in symptom management and quality of life enhancement. The article seeks to provide a thorough understanding of the mechanisms causing DMD, possible therapeutic targets, and developing treatment options by combining recent research findings. This will provide clinicians and researchers involved in DMD care and research with invaluable insights.

The Clinical Significance of Mulligan's Mobilization with Movement in Shoulder Pathologies: A Systematic Review and Meta-Analysis.

Background: Mulligan's mobilization with movement (MWM) is a manual therapy technique designed to address musculoskeletal pain and joint mobility. Despite immediate reported improvements by patients, the clinical significance of MWM compared with other interventions remains uncertain. Objective: To assess the clinical effectiveness of MWM for shoulder pathologies compared with other treatment methods. Methods: The databases PubMed, Web of Science, Cochrane Library, Scopus, and the Physiotherapy Evidence Database (PEDro) were searched up to June 2024. Inclusion criteria were limited to randomized controlled trials published in English and Turkish languages, focusing on the MWM technique for shoulder pathologies. Two independent reviewers evaluated methodological quality based on the PEDro scale. Outcome data were analyzed for pain, function, and range of motion (ROM) using SPSS Statistics 29.0. Results: Twenty-seven studies (1157 participants) were included. MWM demonstrated statistical superiority in function (MD = -11.24, 95% CI: [-18.33, -4.16], p = 001) and shoulder flexion and abduction ROM compared with other mobilization techniques. There was a significant MD in pain intensity, which was -1.55 cm (95% CI: [-2.60, -0.51], p = 0.00), with high heterogeneity (I2 = 93%), favoring MWM in comparison with control group. MWM was significantly better for shoulder abduction ROM in comparison with physical therapy interventions (MD = -14.44, 95% CI: [1.98, 26.90], p = 0.02) with high heterogeneity (I2 = 90%) and control group (SMD = 56.67, 95% CI: [7.71, 111.63], p = 0.02) with high heterogeneity (I2 = 96%). However, clinical significance was not consistently achieved. Conclusions: Although some statistical significance was found when comparing MWM with other her treatment methods, it was observed that most of the statistically significant data did not reach clinical significance. Upon closer examination, outcome measures that showed clinical significance, either the interventions in the comparison group were inadequate, not evidence-based, or the improvements within the group were not logical.

Predictors of distant metastatic recurrence in intermediate-risk papillary thyroid carcinoma.

Patients with intermediate-risk papillary thyroid carcinoma (PTC) have a favorable prognosis with standard treatment of total thyroidectomy (TT) and adjuvant radioactive iodine therapy (RAIT). However, the benefits of TT or adjuvant RAIT remain undetermined, and they are often omitted in Japan. We investigated risk factors for life-threatening distant recurrence in patients with intermediate-risk PTC who are optimal candidates for adjuvant RAIT. Outcomes without RAIT were retrospectively examined in 4030 intermediate-risk conventional PTC cases underwent initial surgery from 2005 to 22 (IRB approval 20200709-1). Lobectomy (LT) and TT was performed in 11.5% and 88.5%, respectively. Recurrent laryngeal nerve paralysis and hypoparathyroidism was less commonly observed in LT (1.3% and 0%) than TT (2.4% and 3.5 %). Fifty-six cases (1.4%) had distant recurrence. Recurrence-free survival rates at 10years was 93.5%. There was no significant difference in recurrence rate between LT and TT. Age ≥55, cN1b, and tumor diameter >30mm significantly associated with distant recurrence. There was a strong relationship between the number of positive risk factors and recurrence; the distant recurrence rate in cases of 0, 1, 2, and 3 positive factors was 0.3% (4/1203), 1.3% (25/1889), 2.7% (23/830) and 7.1% (4/52) (HR 6.46 (2.34-17.86), Log-rank <0.001). For intermediate-risk conventional PTC, there is no difference in prognosis even if LT was selectively conducted. However, in patients with risk factors for distant metastatic recurrence, such as age ≥55years, cN1b, and tumor size >30mm, adjuvant RAIT was considered eligible.

Therapeutic delivery of CCL2 modulates immune response and restores host-microbe homeostasis.

Many chronic inflammatory diseases are attributed to disturbances in host-microbe interactions, which drive immune-mediated tissue damage. Depending on the anatomic setting, a chronic inflammatory disease can exert unique local and systemic influences, which provide an exceptional opportunity for understanding disease mechanism and testing therapeutic interventions. The oral cavity is an easily accessible environment that allows for protective interventions aiming at modulating the immune response to control disease processes driven by a breakdown of host-microbe homeostasis. Periodontal disease (PD) is a prevalent condition in which quantitative and qualitative changes of the oral microbiota (dysbiosis) trigger nonresolving chronic inflammation, progressive bone loss, and ultimately tooth loss. Here, we demonstrate the therapeutic benefit of local sustained delivery of the myeloid-recruiting chemokine (C-C motif) ligand 2 (CCL2) in murine ligature-induced PD using clinically relevant models as a preventive, interventional, or reparative therapy. Local delivery of CCL2 into the periodontium inhibited bone loss and accelerated bone gain that could be ascribed to reduced osteoclasts numbers. CCL2 treatment up-regulated M2-macrophage and downregulated proinflammatory and pro-osteoclastic markers. Furthermore, single-cell ribonucleic acid (RNA) sequencing indicated that CCL2 therapy reversed disease-associated transcriptomic profiles of murine gingival macrophages via inhibiting the triggering receptor expressed on myeloid cells-1 (TREM-1) signaling in classically activated macrophages and inducing protein kinase A (PKA) signaling in infiltrating macrophages. Finally, 16S ribosomal ribonucleic acid (rRNA) sequencing showed mitigation of microbial dysbiosis in the periodontium that correlated with a reduction in microbial load in CCL2-treated mice. This study reveals a novel protective effect of CCL2 local delivery in PD as a model for chronic inflammatory diseases caused by a disturbance in host-microbe homeostasis.

Cost-effectiveness of automated digital CBT (Daylight) for generalized anxiety disorder: A Markov simulation model in the United States

This study examines the cost-effectiveness and cost-benefit of a fully automated smartphone-delivered digital cognitive behavioral therapy (CBT) intervention for Generalized Anxiety Disorder (GAD). In a simulated Markov model, 100,000 individuals with GAD were studied under one of five (n = 20,000 per arm) treatments (digital CBT [Daylight], individual CBT, group CBT, pharmacotherapy, or no GAD treatment). Model inputs were determined from the literature and included direct treatment costs and disease costs. Net monetary benefit (NMB) determined whether digital CBT is cost-beneficial from both a private payer and societal perspective in the United States in 2020. Digital CBT was found to generate the lowest 12-month total cost ($167.02m) and the second highest number of total quality-adjusted life years (14,711.86). Digital CBT showed a positive NMB relative to each alternative treatment and to no treatment for GAD in both a payer and societal perspective. Relative to no treatment, the average NMB of digital CBT was $1,836.83 from the payer perspective and $4,126.88 from the societal perspective. Digital CBT generates the most value in both a payer and societal perspective, and results were robust to sensitivity analysis with respect to effectiveness, pricing, and attrition parameters.

Exosomal miRNA-146a and miRNA-424 as possible predictors of immune checkpoint inhibitors therapy response in clear cell renal cell carcinoma

Clear cell renal cell carcinoma (ccRCC) is a malignant kidney tumor with a poor prognosis and difficult to treat. Despite significant advances in the treatment of ccRCC, immune checkpoint in-hibitors (ICI) still have limited therapeutic efficacy. A growing body of work has demonstrated that exosomal microRNAs are key modulators of tumor signaling and determinants of the tumor microenvironment. Disruption of microRNA regulation may affect ccRCC immunogenicity and response to ICI therapy, making them attractive for use as prognostic molecular genetic bi-omarkers. We evaluated exosomal miRNAs (miRNA-424,-146a,-503, -144) expression levels before and after ICI therapy in plasma samples obtained from 42 ccRCC patients. Expression analysis was performed by real-time PCR method. The results showed that the expression levels of miRNA-424 and miRNA-146a were upregulated after ICI therapy treatment (miRNA-424 = Mean ± SEM 1.202 ± 0.15 and miRNA-146a = 12.22 ± 1.45) compared expression levels before therapy (miRNA-424=Mean±SEM 0.63 ± 0.17; p-value = 0.03 and miRNA-146a = 7.03 ± 0.90; p-value = 0.006). miRNA-424 and miRNA-146a can be used to create a panel of molecular markers for evaluating the effectiveness of immune checkpoint inhibitors therapy. Even though this is very preliminary and requires further studying on a larger sample, it further increases the interest in using microRNAs, as additional ICI therapeutic markers capable of modulating immune tolerance.

Importance of physical activity in the treatment of hemophilia

Hemophilia is a genetically determined bleeding disorder characterized by a tendency for spontaneous bleeding, mainly into the joints, which can lead to arthropathy and significantly reduce the quality of a patient's life. The objective of this paper is to review the published literature on the impact of physical activity on the course of the disease and its role in current therapeutic protocols. Online databases were used to search for literature. The retrieved articles were analyzed. The review mainly included literature published after 2016. In the past, physical exercise was not recommended for people with hemophilia, primarily due to concerns about joint bleeding and the development of hemophilic arthropathy. Currently, regular, moderate physical activity plays a crucial role in the management of hemophilia, helping to strengthen muscles and improve joint stability, which can reduce the risk of bleeding. This shift in perspective is largely due to the availability of effective therapeutic options, mainly involving the replacement clotting factors. However, entirely new hopes for a permanent cure and the maintenance of physical fitness are brought by modern gene therapy treatments. Physical activity is essential for maintaining the health and fitness of individuals with hemophilia, and most exercises are safe due to effective prophylactic treatment. In addition to the benefits for joint health, regular exercise also helps prevent many lifestyle-related diseases.

ADHESIVE DISEASE OF THE ABDOMINAL CAVITY: ETIOMORPHOPATHOGENESIS, CLINIC, DIAGNOSIS, TREATMENT AND PREVENTION AT THE PRESENT STAGE

In surgery of the gastrointestinal tract, peritoneal adhesions are detected in 80-90% of cases, including open surgical interventions, abdominal adhesions occur in 70-90% of patients, with laparoscopic – in 24-35% of patients. The number of deaths in adhesive disease ranges from 14 to 52%, and in patients with concomitant pathology, whose age exceeds sixty years, reaches 68%. The main etiological factors of the formation of adhesions are mechanical, chemical, physical and infectious effects. The pathogenesis of the formation of adhesions includes three processes: inhibition of fibrinolytic and extracellular matrix degradation systems; inflammatory reaction with cytokine production, mainly TGF-β1; tissue hypoxia as a result of interruption of blood supply to mesothelial cells and submesothelial fibroblasts. The clinical picture of SBBP, as a rule, is characterized by dyspeptic disorders in the early stages, and is accompanied by symptoms of intestinal obstruction in the advanced ones. The "gold standard". Treatment of adhesive disease can be carried out using conservative therapy or surgical intervention. To date, prevention is the most preferred method to prevent the consequences of the development of adhesive disease. Despite the improvement of surgical techniques, the development of new approaches to treatment and diagnosis, adhesions remain an inevitable consequence of intra-abdominal operations. Understanding the pathogenesis of the formation of the adhesive process and adhesion, the possibility of their transformation, especially at the cellular and molecular level, can help in the further development of more effective methods of treatment and prevention of SBP.

Atrial Functional Mitral Regurgitation: From Diagnosis to Current Interventional Therapies.

Mitral regurgitation (MR) is one of the most common valvular pathologies worldwide, contributing to the morbidity and mortality of several cardiovascular pathologies, including heart failure (HF). Novel transcatheter treatment for MR has given the opportunity for a safe and feasible alternative, to surgery, in order to repair the valve and improve patient outcomes. However, after the results of early transcatheter edge-to-edge repair (TEER) trials, it has become evident that subcategorizing the mitral regurgitation etiology and the left ventricular function, in patients due to undergo TEER, is of the essence, in order to predict responsiveness to treatment and select the most appropriate patient phenotype. Thus, a novel MR phenotype, atrial functional MR (AFMR), has been recently recognized as a distinct pathophysiological entity, where the etiology of the regurgitation is secondary to annular dilatation, in a diseased left atrium, with preserved left ventricular function. Recent studies have evaluated and compared the outcomes of TEER in AFMR with ventricular functional MR (VFMR), with the results favoring the AFMR. In specific, TEER in this patient substrate has better echocardiographic and long-term outcomes. Thus, our review will provide a comprehensive pathogenesis and mechanistic overview of AFMR, insights into the echocardiographic approach of such patients and pre-procedural planning, discuss the most recent clinical trials and their implications for future treatment directions, as well as highlight future frontiers of research in the setting of TEER and transcatheter mitral valve replacement (TMVR) in AFMR patients.

Physical therapy for the management of global function, fatigue and quality of life in amyotrophic lateral sclerosis: systematic review and meta-analyses.

To critically evaluate the effectiveness of physical therapy interventions in improving global function, quality of life and fatigue in individuals with amyotrophic lateral sclerosis (ALS). Systematic review and meta-analyses. MEDLINE, EMBASE, Cochrane Library (CENTRAL) and Physiotherapy Evidence Database (PEDro) were searched through 31 January 2023. We included randomised clinical trials (RCTs) that compared physical therapy interventions that act on global function, fatigue and quality of life in individuals with ALS with any other non-physiotherapeutic methods and techniques, placebo or non-intervention. The primary outcome measure was the evaluation of global function. Secondary outcomes were quality of life, fatigue and adverse events. Two independent authors used a researcher-developed extraction form and the Rayyan software to search, screen and code included studies. The risk of bias was assessed using the PEDro scale. Meta-analyses were conducted employing random effects. Outcomes were succinctly presented in Grading of Recommendations, Assessment, Development and Evaluation evidence profiles. Our searches identified 39 415 references. After study selection, three studies were included in the review. Such studies involved 62 participants with a mean age of 54.6 years. In the evaluated trials, 40 were male, while 22 participants were female. Regarding the type of onset of the disease, 58 participants had spinal onset of ALS, and four had bulbar. Physical therapy intervention may improve the global function of individuals with ALS in the short term; however, clinically, it was inconclusive. In terms of quality of life and fatigue, physical therapy intervention is not more effective than control in the short term. Adverse events are not increased by physical therapy intervention in the short term. Due to significant methodological flaws, small sample sizes, wide CIs and clinical interpretation, our confidence in the effect estimate is limited. CRD42021251350.

Fructose-Based Metal–Organic Framework as a Means to Synthesize Sr-Loaded Chitosan Nanospheres with NLO Properties for Theranostic Applications in Radiotherapy

Chitosan is a biodegradable polymer derived from chitin, which is a versatile material for various biological applications due to its attractive properties such as biocompatibility, biodegradability, and non-toxicity. Furthermore, chitosan possesses Second Harmonic Generation (SHG) properties that are useful for biosensing applications. In this work, we explored the possibility of exploiting chitosan-based nanospheres as SHG-based biosensors, and also as carriers of 89Sr radionuclide, an Active Pharmaceutical Ingredient (API) for radiopharmaceutical treatments in cancer therapy. To opportunely load the Sr ion on the nanospheres, we used a fructose-based Metal–Organic Framework, with the formula [Sr(C6H12O6)2(H2O)2]Cl2·H2O, because the sugar was able to drive the Sr ions on the chitosan matrix. Sr-loaded chitosan nanospheres were synthesized, characterized, and their SHG response was measured. The results encouraged us to propose the nanospheres for theranostic purposes, i.e., valuable for both therapeutic and diagnostic applications at the same time.

Addressing depression and comorbid health conditions through solution-focused brief therapy in an integrated care setting: a randomized clinical trial

BackgroundCo-occurring physical and mental health conditions are common, but effective and sustainable interventions are needed for primary care settings.PurposeOur paper analyzes the effectiveness of a Solution-Focused Brief Therapy (SFBT) intervention for treating depression and co-occurring health conditions in primary care. We hypothesized that individuals receiving the SFBT intervention would have statistically significant reductions in depressive and anxiety symptoms, systolic blood pressure (SBP), hemoglobin A1C (HbA1c), and body mass index (BMI) when compared to those in the control group. Additionally, we hypothesized that the SFBT group would have increased well-being scores compared to the control group.MethodsA randomized clinical trial was conducted at a rural federally qualified health center. Eligible participants scored ≥ 10 on the Patient Health Questionnaire (PHQ-9) and met criteria for co-occurring health conditions (hypertension, obesity, diabetes) evidenced by chart review. SFBT participants (n = 40) received three SFBT interventions over three weeks in addition to treatment as usual (TAU). The control group (n = 40) received TAU over three weeks. Measures included depression (PHQ-9) and anxiety (GAD-7), well-being (Human Flourishing Index), and SFBT scores, along with physical health outcomes (blood pressure, body mass index, and hemoglobin A1c).ResultsOf 80 consented participants, 69 completed all measures and were included in the final analysis. 80% identified as female and the mean age was 38.1 years (SD = 14.5). Most participants were white (72%) followed by Hispanic (15%) and Black (13%). When compared to TAU, SFBT intervention participants had significantly greater reductions in depression (baseline: M = 18.17, SD = 3.97, outcome: M = 9.71, SD = 3.71) and anxiety (baseline: M = 14.69, SD = 4.9, outcome: M = 8.43, SD = 3.79). SFBT intervention participants also had significantly increased well-being scores (baseline: M = 58.37, SD = 16.36, outcome: M = 73.43, SD = 14.70) when compared to TAU. Changes in BMI and blood pressure were not statistically significant.ConclusionThe SFBT intervention demonstrated efficacy in reducing depressive and anxiety symptoms and increasing well-being but did not affect cardio-metabolic parameters over a short period of intervention.Trial RegistrationThe study was pre-registered at ClinicalTrials.gov Identifier: NCT05838222 on 4/20/2023. *M = Mean, SD = Standard deviation.