Medical Research Articles

A Medical Student Online Community: A Qualitative Analysis of Step 1 Subreddit Posts

A Medical Student Online Community: A Qualitative Analysis of Step 1 Subreddit Posts

Analysis of prognosis and medical resource utilization in elderly patients with trauma: A retrospective cohort study in one trauma center

Background: Trauma is consistently among the top ten causes of death worldwide. The aging population, constituting 15.21% of adults aged over 65 in Taiwan as of November 2019, has significantly impacted healthcare expenditures. This study aimed to explore the prognosis and resource utilization in patients with geriatric trauma. Methods: This retrospective analysis included ER admissions between January 2015 and December 2017 at a Level I trauma center in southern Taiwan. Of the 5,185 eligible patients, 1,743 were elderly. Comparisons between the age groups assessed medical resource use, patient characteristics, trauma profiles, and management. Outcomes examined included mortality, complications, length of hospital stay, duration of ICU stay, and costs. Results: Elderly patients, predominantly women, exhibit more blunt injuries often resulting from accidental falls. They experienced longer hospital stays and higher medical expenses, as well as increased complication and mortality rates. Mortality predictors included age, GCS score, trauma severity score (≥16), complications, surgery, and initial hypotension. Complications correlated with prolonged length of hospital stay (LOS), early blood transfusion, and mortality, impacting overall expenditure along with trauma severity, ICU days, surgery, and AIS score (≥3). Conclusion: Elderly patients had a longer LOS, higher mortality and complication rates, and higher total medical costs. The required medical expenses for elderly trauma cases were relatively higher than those for younger individuals. Relevant authorities should consider patient age when formulating policies for trauma reimbursement. Based on our findings, healthcare resource utilization can be reduced by decreasing the length of hospital stay and mitigating trauma severity. We recommend collecting more detailed data, extending the study period, and engaging in multicenter collaborations to validate our findings and provide a roadmap for further research. We suggested that interventional studies are needed to test strategies aimed at reducing resource utilization and improving outcomes in elderly trauma patients, which would be valuable.

Association Between X/Twitter and Prescribing Behavior During the COVID-19 Pandemic: Retrospective Ecological Study

Background Social media has become a vital tool for health care providers to quickly share information. However, its lack of content curation and expertise poses risks of misinformation and premature dissemination of unvalidated data, potentially leading to widespread harmful effects due to the rapid and large-scale spread of incorrect information. Objective We aim to determine whether social media had an undue association with the prescribing behavior of hydroxychloroquine, using the COVID-19 pandemic as the setting. Methods In this retrospective study, we gathered the use of hydroxychloroquine in 48 hospitals in the United States between January and December 2020. Social media data from X/Twitter was collected using Brandwatch, a commercial aggregator with access to X/Twitter’s data, and focused on mentions of “hydroxychloroquine” and “Plaquenil.” Tweets were categorized by sentiment (positive, negative, or neutral) using Brandwatch’s sentiment analysis tool, with results classified by date. Hydroxychloroquine prescription data from the National COVID Cohort Collaborative for 2020 was used. Granger causality and linear regression models were used to examine relationships between X/Twitter mentions and prescription trends, using optimum time lags determined via vector auto-regression. Results A total of 581,748 patients with confirmed COVID-19 were identified. The median daily number of positive COVID-19 cases was 1318.5 (IQR 1005.75-1940.3). Before the first confirmed COVID-19 case, hydroxychloroquine was prescribed at a median rate of 559 (IQR 339.25-728.25) new prescriptions per day. A day-of-the-week effect was noted in both prescriptions and case counts. During the pandemic in 2020, hydroxychloroquine prescriptions increased significantly, with a median of 685.5 (IQR 459.75-897.25) per day, representing a 22.6% rise from baseline. The peak occurred on April 2, 2020, with 3411 prescriptions, a 397.6% increase. Hydroxychloroquine mentions on X/Twitter peaked at 254,770 per day on April 5, 2020, compared to a baseline of 9124 mentions per day before January 21, 2020. During this study’s period, 3,823,595 total tweets were recorded, with 10.09% (n=386,115) positive, 37.87% (n=1,448,030) negative, and 52.03% (n=1,989,450) neutral sentiments. A 1-day lag was identified as the optimal time for causal association between tweets and hydroxychloroquine prescriptions. Univariate analysis showed significant associations across all sentiment types, with the largest impact from positive tweets. Multivariate analysis revealed only neutral and negative tweets significantly affected next-day prescription rates. Conclusions During the first year of the COVID-19 pandemic, there was a significant association between X/Twitter mentions and the number of prescriptions of hydroxychloroquine. This study showed that X/Twitter has an association with the prescribing behavior of hydroxychloroquine. Clinicians need to be vigilant about their potential unconscious exposure to social media as a source of medical knowledge, and health systems and organizations need to be more diligent in identifying expertise, source, and quality of evidence when shared on social media platforms.

OZONIOTERAPIA EM CONTAMINAÇÃO DE FERIDA CIRÚRGICARELATO DE CASO EM CÃO CAUDECTOMIZADO

Integrative medicine offers a wide variety of therapies that can be associated with conventional medicine, providing patients appropriate treatment with satisfactory results. Among the therapies used in integrative medicine, we have ozone therapy, which is widely used for various purposes due to its bactericidal, fungicidal and virucidal properties and the fact that it has practically no side effects with low toxicity, being used in chronic pathological conditions, in cases of dermatitis, ulcers and redness, burns and wound healing processes. The case report shows a healing process promoted by ozone therapy and associated therapies in a dog, presenting positive results. Ozone is a colorless gas with a characteristic odor and analgesic and anti-inflammatory functions, also contributing to the immune system and body oxygenation of animals. It can be applied in distinct ways, split into local or systemic, and can be subcutaneous, intravaginal, blood therapies, bagging and cupping methods. In addition, the technique offers low cost and promotes an improvement in the animal's quality of life.

Symptom trajectories over time by cannabis use status among patients undergoing cancer treatment.

Adults with cancer may perceive cannabis as beneficial for managing their cancer-related symptoms, but the evidence supporting its medical use is varied and inconclusive. This study characterized associations of cannabis use with cancer-related symptom trajectories. Participants were adults undergoing cancer treatment at the Stephenson Cancer Center (SCC; n = 218) in Oklahoma; they were 71% female, 10% minoritized race, and 45% had stage III or IV cancer. Participants completed surveys at baseline and 2-, 4-, and 6-months post-baseline. Assessments queried about cannabis use behavior, physical and psychological distress via the Rotterdam Symptoms Checklist (RSCL), respiratory symptoms via the American Thoracic Society Questionnaire (ATSQ), and quality of life indices (physical and social functioning, pain interference, sleep quality, fatigue) via the Patient Reported Outcomes Measurement Information System (PROMIS-29). Cannabis use status was categorized based on self-reported past 30-day cannabis use at each assessment as non-use [no use at any assessment], occasional-use [use at 1-2 assessments], or consistent-use [use at 3-4 assessments]. Longitudinal hierarchical linear modeling evaluated associations of cannabis use status with average symptoms and symptom trajectories across all four assessments. One-third (33%) of participants reported past 30-day cannabis use at ≥ 1 assessment. Participants who reported cannabis use (occasional-use and consistent-use) had more severe symptoms overall across assessments. While most cancer symptom trajectories did not differ by cannabis use status, participants who reported consistent cannabis use uniquely showed worsening physical function over time. Cannabis use was associated with greater cancer-related symptom severity over time.

Identifying perceptions and knowledge gaps among pre-clinical and clinical medical students regarding placebo therapy

Background: Misleading definitions and perceptions of placebo and placebo effect result in fewer realizations on the subject, hence reducing its perceived importance and applications. This study aims to assess undergraduate medical students' perceptions and knowledge gaps regarding placebo therapy across different stages of their education. Methods: A comparative cross-sectional study was conducted for six months, from December 2022 to May 2023, among 350 pre-clinical students (1st and 2nd year MBBS) and 526 clinical students (3rd, 4th, and Final-year MBBS) to assess their perceptions regarding placebo and placebo effect through a validated questionnaire. SPSS was used for analyses, and Pearson's Chi-square was applied, keeping the statistically significant value of <0.05. Results: The study included 876 medical students, with 350 pre-clinical and 526 clinical participants. The mean age was 21.32 years (±1.606). A significant gender distribution was observed, with 45.5% males and 54.5% females. Clinical students demonstrated a greater acceptance of placebo use (68.3% vs. 62.3%, p=0.031) and were more likely to find placebo therapy ethical in psychological cases (70.3% vs. 60.3%, p=0.006). Knowledge assessment revealed that 65% had fair knowledge of placebo therapy, 31.8% had good knowledge, while only 3.2% were highly knowledgeable. Conclusion: The study revealed that many pre-clinical and clinical students held misconceptions about placebo therapy, believing it permissible and beneficial in treating organic disorders. This highlights a significant knowledge gap, emphasizing the need for improved education on placebo use and ethics.

A Computational Protocol for the Knowledge-Based Assessment and Capture of Pathologies.

We propose that one of the main hurdles in delivering comprehensively informed care results from the challenges surrounding the extraction, representation, and retention of prior clinical experience and basic medical knowledge, as well as its translation into time- and context-informed actionable interventions. While emerging applications in artificial intelligence-based techniques, for example, large language models, offer impressive pattern association capabilities, they often fall short in producing human-readable explanations crucial to their integration into clinical care. Moreover, they require large well-defined and well-integrated data sets that typically conflict with the availability of such data in all but a few areas of medicine, for example, medical imaging and neuroimaging, noninvasive monitoring of bio-electrical activity, etc. In this chapter, we argue that approximate reasoning rooted in the knowledge that is explainable to the human clinician may offer attractive avenues for the introduction of such knowledge in a systematic way that supports formal retention, sharing, and reuse of new clinical and basic medical experience. We outline a conceptual protocol that targets the use of sparse and disparate data of different types and from different sources, seamlessly drawing on our collective experience and that of others. We illustrate the utility of such an integrative approach by applying the latter to the assessment and reconciliation of data from different experimental models, human and animal, in the example use case of a complex health condition.

Health Diagnostic Assistant using LLMs

The Health Diagnostic Assistant leverages advanced Large Language Models (LLMs) and Natural Language Processing (NLP) techniques to enhance patient diagnosis and healthcare decision-making. This innovative system employs Retrieval-Augmented Generation (RAG) to combine the strengths of pre-trained language models with a dynamic retrieval mechanism, allowing it to access and synthesize real-time medical knowledge from a wide array of databases. By analyzing patient symptoms, medical histories, and contextual data, the assistant generates accurate, context-aware recommendations and insights. The project aims to streamline the diagnostic process, reduce the burden on healthcare professionals, and improve patient outcomes by providing evidence-based suggestions tailored to individual cases. Through continuous learning and integration of user feedback, the Health Diagnostic Assistant aspires to evolve into a reliable tool for both patients and clinicians, fostering informed decision-making in the healthcare landscape.

Revisiting a Faculty Career Management Life Cycle Model: Anticipating and Navigating Career Transitions in Academic Medicine.

Career management models are valuable tools for faculty pursuing a career in academic medicine. These models help faculty transition through various stages of their careers, including commonly pursued academic advancements from assistant professor to full professor, as well as less common transitions like moving from full-time to part-time status, taking sabbaticals, going on medical leave, or assuming executive leadership roles. The success of faculty members across these stages is influenced by both environmental factors and individual-level characteristics. Recognizing career stages and transitions, as well as the impact of personal and environmental factors on career growth, is crucial. The proposed Faculty Career Self-Management Model (FCSM) provides a visual and descriptive framework to guide individual faculty and the professionals who support them in understanding, preparing for, and navigating career stages and professional transitions to build and sustain meaningful careers in academic medicine. The FCSM serves as a framework to explore, develop, and share best practices in supporting faculty vitality across the career lifespan.

Oxidative Stress in Canine Diseases: A Comprehensive Review

Oxidative stress (OS), defined as a disruption in redox balance favoring oxidants, has emerged as a major contributor to numerous diseases in human and veterinary medicine. While several reviews have explored the implication of OS in human pathology, an exhaustive review of the canine species is lacking. This comprehensive review aims to summarize the existing literature on the role of OS in canine diseases, highlighting its potentially detrimental effect on various organs and systems. Some inconsistencies among studies exist, likely due to varying biomarkers and sample types. However, there is substantial evidence supporting the involvement of OS in the development or progression of numerous canine disorders, such as cardiovascular, oncologic, endocrine, gastrointestinal, hematologic, renal, neurologic, infectious, and parasitic diseases, among others. Additionally, this review discusses the efficacy of antioxidant and pro-oxidant therapeutic agents for these conditions. Dietary interventions to counteract OS in dogs have gained significant attention in recent years, although further research on the topic is needed. This review aims to serve as a foundational resource for future investigations in this promising field.

Exploring barriers and ethical challenges to medical data sharing: perspectives from Chinese researchers.

The impetus for policies promoting medical data sharing in China has gained significant traction. Nonetheless, the present legal and ethical framework governing the research use of medical data in China, is characterized by a more restrictive rather than permissive approach. The proportion of Chinese medical data being leveraged for scientific research still has room for improvement at present, indicating a significant untapped potential for advancing medical knowledge and improving healthcare outcomes. Building upon this research, we aim to delve deeper into the challenges researchers encounter in the sharing of medical data through focus group interviews. We conducted two focus group interviews study with researchers representing diverse disciplines to explore their perspectives on 21 June 2021 and 28 July 2021. A total of seventeen researchers willingly participated in this study, representing various professional backgrounds. Similar codes were merged. Research team discussions were also utilized to select interviewees' statements that were regarded as typical or representative. The respondents demonstrated a strong understanding that medical data should not be disseminated arbitrarily, recognizing the importance of sharing data in compliance with laws. Through the interview, we found that although respondents stressed the importance of careful consideration regarding if and when this information can be responsibly released, none of the respondents raised the issue of necessitating consent from data subjects for the research use of medical data. This observation sharply contrasts with the stringent separate consent provisions for secondary data use outlined in the PIPL. The findings from the focus group studies shed light on researchers' barriers and ethical challenges towards medical data sharing for scientific research, highlighting their deep concern for data security and cautious approach to sharing. The key objectives aimed at facilitating and enabling the reuse of medical data encompass enhancing interoperability, harmonizing data standards, improving data quality, safeguarding privacy, ensuring informed consent, incentivizing patients, and establishing explicit regulations pertaining to data access and utilization.

Evaluation of Integrative Medicine in Residency-Psychiatry Curriculum.

This study describes knowledge change, self-assessed confidence in providing integrative medicine approach, and respondents' perspective on value and feasibility for the Integrative Medicine in Residency-Psychiatry (IMR-Psychiatry) curriculum, a 100-h elective offered during psychiatry training. Residents/fellows completed pre-post Medical Knowledge tests and self-assessment instruments tracking self-rated confidence. Participants were also interviewed for feedback about their experience using a semi-structured design after completion of the program. Thirty-five of 37 (94.6%) participants completed all elective requirements. Items on the self-assessment instrument with the greatest positive pre-post change (p < 0.001) included ability to identify authoritative sources about botanicals (Cohen d = 2.15), effectively respond to patients' questions regarding the use of herbs/supplements (Cohen d = 2.67), and interpret labels on nutraceuticals (Cohen d = 2.28). Mean score on the Medical Knowledge test (n = 30) increased from 64.7% correct at pretest to 81.6% at posttest. Responses tracking self-assessed confidence in providing an IM approach to address 18 common medical and psychiatric conditions all increased significantly pre to post (p < 0.001). Qualitative interviews provided important insights into challenges and recommendations for improvement, and all participants highly recommended the curriculum and found it feasible to complete during training. The IMR-Psychiatry curriculum provides trainees skills that promote comprehensive person-centered care; as a tool to optimize patient care and safety while enhancing physician well-being, wider-spread incorporation of the curriculum into psychiatry residency programs would be beneficial.

A retrospective clinico epidemiological study of pattern of dermatosis involving trigeminal distribution in a tertiary care center

Trigeminal nerve is the principal sensory nerve of face. Many dermatological conditions known occur in relation to trigeminal nerve distribution clinically presenting as unilateral facial lesions with strict midline demarcation. To study the clinical pattern and epidemiological determinants of dermatoses along trigeminal nerve among the patients of both the sexes, involving all the age groups. Thirty two patients presenting with skin lesions along trigeminal nerve presenting to Dermatology department of a tertiary care center, Bangalore, Karnataka, are selected for the study. Study design is retrospective hospital record based study conducted from January 2023 to January 2024. In this study, out of 32 patients most common dermatoses along trigeminal nerve were infection of which herpes zoster was seen thirteen (40.62%) patients, followed by nevi (n=6, 18.75%), pigmentary disorders (n=5, 15.62%), vascular disorder (n=4, 12.5%) and auto inflammatory disorder (n=4, 12.5%) was seen. Most common branch affected was ophthalmic followed maxillary branch .Females were more common and mean age was 24 years. Small sample size and rare clinical cases are included Studies focusing on the pattern of dermatoses involving the trigeminal nerve contribute to the advancement of medical knowledge and facilitate the development of novel diagnostic techniques and therapeutic modalities. By elucidating the underlying pathophysiological mechanisms and identifying potential risk factors, research in this field can lead to the development of more effective treatment strategies tailored to the specific needs of patients.

Race, Gender, and Faculty Retention in Academic Medicine.

Poor retention may be associated with lack of faculty diversity in academic medicine. To examine differences in faculty retention by gender, degree type, and race and ethnicity using data from US medical schools. This cohort study analyzed data from 155 medical schools for 1978 to 2021, which were obtained from the Association of American Medical Colleges. Retention rates were calculated by gender, race and ethnicity, and degree type. Time to attrition was estimated using Kaplan-Meier curves and adjusted Cox proportional hazards models were used to examine the differences in retention by gender and race. Data were analyzed from March 2021 to November 2022. The duration of continuous employment in academic medicine and variations in retention based on gender, race, ethnicity, and terminal degree. Among 390 766 faculty members (232 829 [59.6%] men; 1190 American Indian, Alaska Native, Native Hawaiian, or Pacific Islander [0.3%]; 72 490 Asian [18.6%]; 14 920 Black [3.8%]; 20 345 Hispanic, Latino, of Spanish origin, or multirace Hispanic [5.2%]; 251 670 non-Hispanic White [64.4%] participants; and 30 151 [7.7%] other race), 259 628 (66.4%) had MD or MD-equivalent terminal degrees. Women left academic medicine a median of 1 year earlier (median retention, 8.33 years; 95% CI, 8.18-8.41 years) than men (median retention, 9.35 years; 95% CI, 9.25-9.42 years). Compared with White faculty (median retention, 9.91 years; 95% CI, 9.83-9.92 years), multiracial and faculty of other races had the lowest retention (median retention, 5.42 years; 95% CI, 5.33-5.55 years), followed by Alaska Native, American Indian, Native Hawaiian, and Pacific Islander (median retention, 6.00 years; 95% CI, 5.62-6.62 years), Black (median retention, 7.78 years; 95% CI, 7.50-8.00 years), Asian (median retention, 8.00 years; 95% CI, 8.00-8.11 years) and Hispanic faculty (median retention, 9.00 years; 95% CI, 8.75-9.16 years). Women faculty in the 1970s were 20% more likely than men to leave academia, whereas women in the 2010s had no greater risk of leaving, mainly due to a decline in retention of men. Gender differences in faculty retention have decreased in the most recent decade; however, men had lower retention compared with earlier cohorts. In this study, faculty who were underrepresented in medicine left academic medicine a median of 1 to 4 years earlier than White faculty. Greater attrition among men and women for recent cohorts suggests that enhanced retention efforts are imperative to maintain an experienced and diverse faculty.

Barriers and Facilitators to Becoming a Medical Physicist in Bangladesh

The notion of gender equity is debatable, and worldwide health professionals are exploring the argument. However, the contextual situation and experience are different in each country and vary across cultures. There is an extensive amount of literature that presents women’s participation and involvement as increased in science, technology, engineering and mathematics over the last decades (Frize et al., 2022); however, there are variations in data and analyses documented which refer to the gender disparity of medical physicists (MPs) Worldwide (Barabino et al., 2020; Crowe and Kairn, 2016). Medical physics is one of the fields in health care where women are underrepresented, with only 29.8% of the workforce reported identifying as females in this sector (Tsapaki et al., 2018; Tsapaki and Rehani, 2015). Historically, the healthcare profession is male-dominated (Witz, 1990), with women being underrepresented in many specialist fields like academic medicine, surgical specialities and leadership positions (Kramer et al., 2021). The Nursing profession is, however, excluded from this category and considered a woman’s job. Furthermore, women’s contributions to the healthcare industry are not frequently acknowledged (Paradis et al., 2021). Moreover, the career trail for men and women in the healthcare profession is suggestively different (Baig, 2020). Broadly, regarding leadership positions and the range of decision-making, there are observable gender discrepancies in the industry. One of the main reasons for this is social restrictions, which women in specific geographic locations like Bangladesh encounter frequently. The lack of support or a platform for women to practice their profession with autonomy impedes their progress or movement upward in their careers. Women's unhindered involvement, participation and career development in patient care will improve healthcare provision, especially in caring for vulnerable patient groups like the elderly, individuals with significant co-morbidities, and minorities (Covington et al., 2020). In addition, involving more women in healthcare will not only reduce the gender disparity and empower them but also create a sense of confidence in the professions and services provided and, as a result, improve overall well-being. This study will aim to understand the views and experiences of gender-based discrimination among practising medical physicists in Bangladesh.

Environmental Antimicrobial Resistance: Implications for Food Safety and Public Health

Antimicrobial resistance (AMR) is a serious global health issue, aggravated by antibiotic overuse and misuse in human medicine, animal care, and agriculture. This study looks at the different mechanisms that drive AMR, such as environmental contamination, horizontal gene transfer, and selective pressure, as well as the severe implications of AMR for human and animal health. This study demonstrates the need for concerted efforts across the scientific, healthcare, agricultural, and policy sectors to control the emergence of AMR. Some crucial strategies discussed include developing antimicrobial stewardship (AMS) programs, encouraging targeted narrow-spectrum antibiotic use, and emphasizing the significance of strict regulatory frameworks and surveillance systems, like the Global Antimicrobial Resistance and Use Surveillance System (GLASS) and the Access, Watch, and Reserve (AWaRe) classification. This study also emphasizes the need for national and international action plans in combating AMR and promotes the One Health strategy, which unifies environmental, animal, and human health. This study concludes that preventing the spread of AMR and maintaining the effectiveness of antibiotics for future generations requires a comprehensive, multidisciplinary, and internationally coordinated strategy.

Pharmacokinetic-Pharmacodynamic Modeling of the Immune-Enhancing Effect of Shikimic Acid in Growing Pigs.

Shikimic acid (SA), extracted from the fruit of shikimi-no-ki, is used both as a preservative in the food industry and as an intermediate for a variety of active ingredients with a wide range of pharmacological functions. A deeper understanding of the pharmacokinetic process of SA in pigs and its impact on humoral immunity could prove invaluable in facilitating its clinical application in veterinary and human medicine. The pharmacokinetic study employed a two-period, two-sequence, crossover design to animal experiments and developed a novel method of pig plasma preparation using water as an extractant and ionization promoter, followed by purification and enrichment on a MAX solid phase extraction (SPE) column. The results showed that SA is rapidly absorbed after intragastric administration (50 mg/kg BW), reaching a plasma Cmax of 10,823.44 ng/mL at 1.78 h, followed by rapid elimination, with a t1/2 of 1.81 h, consistent with a one-compartment model. The results for intravenous administration (2 mg/kg BW) were consistent with a two-compartment open model with a t1/2 of 3.66 h, with concentrations below the limit of quantification (LOQ) observed beyond 12 h postdose. The absolute bioavailability of SA in pigs was calculated to be 21.68%. Furthermore, the Pearson's correlation analysis demonstrated a strong positive correlation between SA concentration in pig plasma and the changes of C3, C4 and IgG, IgA, and IgM (0.6 < R < 1, P < 0.0001). A more detailed pharmacokinetic-pharmacodynamic (PK-PD) modeling analysis of the intravenous group revealed the EC50/Cmax values of approximately 10%, with all γ values exceeding 3. This study was the inaugural investigation into the pharmacokinetics of SA in growing pigs, and it also revealed that SA has the potential to act as an immunopotentiator.

A Roadmap of Peptide-Based Materials in Neural Regeneration.

Injuries to the nervous system lead to irreversible damage and limited functional recovery. The peripheral nervous system (PNS) can self-regenerate to some extent for short nerve gaps. In contrast, the central nervous system (CNS) has an intrinsic limitation to self-repair owing to its convoluted neural microenvironment and inhibitory response. The primary phase of CNS injury, happening within 48h, results from external impacts like mechanical stress. Afterward, the secondary phase of the injury occurs, originating from neuronal excitotoxicity, mitochondrial dysfunction, and neuroinflammation. No golden standard to treat injured neurons exists, and conventional medicine serves only as a protective approach to alleviating the symptoms of chronic injury. Synthetic peptides provide a promising approach for neural repair, either as soluble drugs or by using their intrinsic self-assembly propensity to serve as an extracellular matrix (ECM) mimic for cell adhesion and to incorporate bioactive epitopes. In this review, an overview of nerve injury models, common in vitro models, and peptide-based therapeutics such as ECM mimics is provided. Due to the complexity of treating neuronal injuries, a multidisciplinary collaboration between biologists, physicians, and material scientists is paramount. Together, scientists with complementary expertise will be required to formulate future therapeutic approaches for clinical use.

Ten Steps for a Successful Hand Surgery Mission Trip - Experiences from Supporting Paediatric Hand in Vietnam and Honduras.

Domestic and global access to surgical care for paediatric hand and upper limb conditions is challenged by limited resources, increasing direct and indirect costs of care and a growing number of patients who require specialty care. There are numerous barriers for patients from developing countries to receiving medical care in Japan due to the substantial costs, which include travel, uninsured medical expenses and fees imposed by intermediaries. To address this issue, I realised that I needed to take a more direct approach - by travelling to these countries, not only to provide treatment, but also to teach and train local doctors. By emphasising on the education of local clinicians through the sharing of knowledge and skills, it is possible to expand the timely access to paediatric hand surgery and improve outcomes for children in need. Our mission is rooted in the belief that every nation holds its own unique treasures - its culture, food, beauty and joy - that are worth celebrating and preserving. By fostering sustainable relationships built on mutual respect and understanding, we can make a greater impact; engagement with local surgeons will ultimately elevate the level of care that they can provide in their own communities, through improving core competencies of medical knowledge, technical/surgical skills and resource allocation for simple and complex conditions. This work not only reflects my personal commitment, but also my focus on expanding our team of fellows and strengthening organisational support. We aim to actively pursue these efforts throughout Asia, fostering cross-cultural collaboration and, ultimately, helping to heal the hands and futures of children worldwide. The aim of this review article is to share with readers how we started our mission trips to Vietnam and highlight 10 steps that I feel are critical to a successful mission trip.

Immortalized mammosphere-derived epithelial cells retain a bioactive secretome with antimicrobial, regenerative, and immunomodulatory properties.

The secretome of primary bovine mammosphere-derived epithelial cells (MDECs) has been shown to exert antimicrobial, regenerative, and immunomodulatory properties in vitro, which warrants its study as a potential biologic treatment with the potential to be translated to human medicine. Currently, the use of the MDEC secretome as a therapy is constrained by the limited life span of primary cell cultures and the decrease of secretome potency over cell passages. To address these limitations, early-passage bovine MDECs were immortalized using hTERT, a human telomerase reverse transcriptase. The primary and immortal MDECs were compared morphologically, transcriptomically, and phenotypically. The functional properties and proteomic profiles of the secretome of both cell lines were evaluated and compared. All experiments were performed with both low and high passage cell cultures. We confirmed through in vitro experiments that the secretome of immortalized MDECs, unlike that of primary cells, maintained antimicrobial and pro-migratory properties over passages, while pro-angiogenic effects of the secretome from both primary and immortalized MDECs were lost when the cells reached high passage. The secretome from primary and immortalized MDECs, at low and high passages exerted immunomodulatory effects on neutrophils in vitro. High passage immortalized MDECs retain a bioactive secretome with antimicrobial, regenerative, and immunomodulatory properties, suggesting they may serve as a consistent cell source for therapeutic use.