Effect of conbercept combined with dexamethasone implantation on macular thickness, visual function, retinal perfusion, and inflammatory markers in patients with diabetic macular edema: A prospective controlled study.

Efficacy of prophylactic adoption of recombinant human granulocyte colony-stimulating factor in advanced lung cancer patients after chemotherapy.

Stress contagion refers to the spread of stress from one person to another. We previously established a standardized, controlled experimental paradigm to study stress contagion in humans. While stress contagion effects have been characterized on a physiological level, potential modulating factors are beginning to be understood. Using our paradigm, we tested for the first time whether the number of observers, i.e. observer group size, modulates physiological stress contagion in stress observers. Our experimental condition comprised three groups of stress observers varying in group sizes of two ("Group 1", n = 30), three ("Group 2", n = 31), or more observers ("Group 3", n = 31), with each group observing one stressed participant. The data assessment comprised up to 5 healthy young male participants, with one participant randomly assigned to undergo an adapted version of the Trier Social Stress Test ("TSST participants", n = 57) and the remaining participants observing him disguised as panel member(s) ("stress observers", n = 92) in addition to one panel confederate. We repeatedly assessed salivary cortisol, salivary alpha-amylase, and heart rate. The TSST induced significant increases in all physiological parameters under study (p ´ s < =.025) without reactivity differences between TSST participants of the three experimental groups (p ´ s > =.23). When comparing the physiological reactivity to direct stress observation, the stress-observer-groups significantly differed in terms of cortisol (p = .029) with overall higher reactivity in smaller observer groups. Further analyses confirmed a linear effect in terms of higher reactivity with lower observer group size (p = .046). There were no group-by-time interactions in salivary alpha-amylase and heart rate reactivity. Our results suggest that when directly observing stress in other individuals, observer group size has a differential effect on physiological stress contagion systems. While we found evidence for modulating effects on hypothalamic-pituitary-adrenal axis reactivity in terms of higher cortisol stress contagion reactivity with lower observer group size, observer group size did not relate to the sympathetic-adrenal-medullary axis. Potential implications remain to be elucidated.

Elderly patients with severe pneumonia face elevated mortality from complex, often resistant, polymicrobial infections. This investigation aimed at assessing the efficacy and determinants of PTZ plus moxifloxacin for severe elderly pneumonia. Retrospectively, this study evaluated 120 elderly severe pneumonia patients (2021-2024), grouped by treatment: Control (n=60): IV piperacillin-tazobactam (PTZ), 4.5g q6h; observation (n=60): PTZ + daily moxifloxacin 400mg. Primary outcomes pathogen resistance/clearance; secondary: 30-day mortality, readmission, CURB-65, ventilation duration, serum biomarkers. Logistic regression identified mortality factors; adverse events were recorded. Baseline characteristics were comparable between groups (P>0.05). The observation group demonstrated superior primary outcomes (P<0.001) and pathogen clearance (P=0.013). No significant intergroup differences were found in secondary outcomes, including mortality, readmission, PLT and adverse events. Post-treatment CURB-65≥3, PCT and CRP significantly correlated with 30-day mortality (all P<0.001). The moxifloxacin-PTZ regimen enhanced microbial clearance without affecting survival, readmission, or adverse event rates, supporting its targeted clinical use.

This study aimed to explore, describe, and analyze efforts to overcome homesickness through self-directed learning steps among students at PP Al-Hikmah Bandar Lampung. The research utilized a descriptive, qualitative approach that was both reflective and collective in nature. Data collection techniques included observation, interviews, documentation, and focus group discussions (FGD). To ensure the validity of the data, source triangulation and technique triangulation were applied. The findings revealed four key steps of self-directed learning that were implemented to address homesickness: planning, implementation, monitoring, and assessment. The study further highlighted how self-directed learning strategies were integrated across the entire school environment, demonstrating its significance as a proactive approach in managing emotional and psychological challenges among students. By fostering a supportive learning environment, these strategies not only helped mitigate homesickness but also promoted resilience, emotional well-being, and personal growth. The study contributes to understanding how self-directed learning can be a valuable tool in addressing non-academic challenges, such as homesickness, and its potential role in supporting student development in Islamic boarding schools.

BACKGROUND Schizophrenia presents complex challenges in older patients due to cognitive and social decline. Existing drug treatments offer limited benefits and pose risks, while aerobic exercise shows promise as a noninvasive intervention whose impact remains underexplored. AIM To investigate the effects of aerobic exercise on cognitive and social function in older patients with schizophrenia. METHODS A retrospective study was conducted in 158 older patients with schizophrenia treated at The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College (June 2023 and December 2024). The patients were divided into an observation group (n = 86), which received 3 months of aerobic rehabilitation alongside routine treatment, and a control group (n = 72), which received routine treatment alone. Cognitive function was assessed using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery, social function using the Inpatient Psychiatric Rehabilitation Outcome Scale (IPROS), and psychotic symptoms using the Positive and Negative Syndrome Scale. RESULTS Post-treatment, Positive and Negative Syndrome Scale total scores were lower in the observation group than in the controls (P &lt; 0.001), with significant improvements in positive, negative, and general symptoms. Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery domain scores were improved in processing speed, working memory, verbal/visual learning, and executive function (all P &lt; 0.05). IPROS total scores were decreased (P &lt; 0.001), indicating better social functioning. Longer exercise duration correlated with greater cognitive gains and lower social function deficits. Body mass index declined (P &lt; 0.001), and adverse events were mild and transient (9.3%). Multivariate linear regression confirmed that aerobic exercise was independently associated with a significant reduction in IPROS scores (Adjusted β = -4.57, 95% confidence intervals: -6.08 to -3.05, P &lt; 0.001). CONCLUSION Aerobic exercise effectively improves cognitive function, social function, and psychotic symptoms in older patients with schizophrenia, is safe, and serves as a valuable adjunctive intervention.

Objective: To compare and analyze the efficacy and safety of immune checkpoint inhibitors (ICIs) combined with tyrosine kinase inhibitors (TKIs) as adjuvant therapy after surgery for hepatocellular carcinoma (HCC) with microvascular invasion (MVI). Methods: Patients with HCC accompanied with MVI who underwent R0 liver resection at the First Medical Center of the PLA General Hospital between January 2016 and December 2024 were retrospectively enrolled. The clinicopathological data, surgical details, and follow-up data were recorded. Adverse events after medication were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Recurrence-free survival (RFS) and overall survival (OS) curves were plotted using the Kaplan-Meier method and compared with the Log-rank test. The Cox proportional hazards regression model was used to analyze factors influencing recurrence. Results: The study included 39 patients in the adjuvant therapy group and 41 patients in the follow-up observation group. There were no significant differences in baseline characteristics between the two groups (all P>0.05). The follow-up time [M(Q1, Q3)] was 21.8 (10.9, 50.7) months. The RFS rates at 6, 12, 24, and 36 months in the adjuvant therapy group were 92.3%, 76.0%, 71.2%, and 51.8%, respectively, all higher than those in the follow-up observation group (75.1%, 56.3%, 44.3%, and 16.9%). The median RFS in the adjuvant therapy group was 46.7 months (95%CI:15.19-78.22), significantly better than the 19.33 months (95%CI: 3.22-35.44) in the follow-up observation group (P=0.004). The median OS was not reached in either group(P=0.480). Multivariate Cox analysis showed that postoperative adjuvant therapy (HR=0.46, 95%CI: 0.24-0.89, P=0.020) and liver cirrhosis (HR=2.22, 95%CI: 1.00-4.92, P=0.050) were influencing factors for RFS. In terms of safety, 43.59% (17/39) of patients in the adjuvant therapy group experienced grade 1-4 adverse events, and 15.38% (6/39) experienced grade 3 or higher adverse events, primarily manifested as abnormal liver and kidney function, rash, etc. No treatment-related deaths occurred, and the safety profile was manageable. Conclusion: For patients with HCC accompanied by MVI, postoperative adjuvant therapy with immunotherapy combined with targeted therapy significantly prolongs recurrence-free survival, reduces the risk of recurrence, and demonstrates a manageable safety profile.

ObjectiveThis study aimed to preliminarily evaluate the impacts of narrative-based palliative care on psychological stress, end-of-life acceptance, and quality of life in elderly terminally ill cancer patients and their family caregivers.MethodsThis single-center, small-sample randomized controlled study enrolled 50 elderly terminal cancer patients. Patients were randomly assigned to either the observation group or the control group (n = 25 each). The observation group received narrative-based palliative care, while the control group received routine standard care. Family psychological stress was assessed using the Relative Stress Scale (RSS), and patients' perceived stress was evaluated with the Perceived Stress Scale-10 (PSS-10). Caregiver satisfaction was measured using a hospital-developed questionnaire. Patients' quality of life was evaluated using the SF-36, Chinese Version of the Death Attitude Profile (DAP-C), and Pittsburgh Sleep Quality Index (PSQI), respectively.ResultsBaseline characteristics did not differ significantly between the two groups (P > .05). Post-intervention, the observation group demonstrated significantly lower psychological stress among family members and higher caregiver satisfaction (P < .05). Patients in the observation group reported better quality of life, improved sleep, and greater acceptance of death than those in the control group (P < .05).ConclusionAs a small-sample, single-center study, these findings offer preliminary evidence that narrative-based palliative care may reduce psychological stress in elderly terminal cancer patients and caregivers while enhancing patients' quality of life, sleep quality, and acceptance of death. However, the limited sample size, single-site design, and narrow inclusion criteria restrict generalizability. Larger multicenter trials are needed to confirm these results.

Otitis media with effusion (OME) is a common condition in children that can lead to hearing loss and developmental delays. Although tympanostomy tube (TT) placement is the standard treatment for persistent OME, recurrence after tube extrusion and the need for reoperation remain significant concerns. To evaluate the clinical effectiveness of autoinflation in reducing OME recurrence and reoperation rates after TT extrusion in pediatric patients. This prospective randomized clinical trial, conducted from September 2019 to August 2022 at a tertiary hospital, enrolled children with chronic OME who underwent TT placement with 2 years of follow-up after TT extrusion. The statistical analysis took place between March 2024 and February 2025. After TT extrusion, patients were randomized to receive autoinflation with the autoinflation device for 5 weeks or to undergo observation alone. The main outcomes were OME recurrence and reoperation rates using otoscopic and tympanometric evaluations. Sixty-six children enrolled in the study; 54 were included in the final analysis (26 in the autoinflation group and 28 in the observation group). Among 54 children (mean [SD] age, 55.5 [18.5] months; 30 [55.6%] male), the recurrence rate was 5 of 26 patients (19.2%) in the autoinflation group and much higher at 10 of 28 patients (35.7%) in the observation group (difference, 16.5 percentage points [pp]; 95% CI, -7.4 pp to 37.8 pp), while the reoperation rate was much lower in the autoinflation group at 2 of 26 patients (7.7%) compared to the observation group at 8 of 28 patients (28.6%; difference, 20.9 pp; 95% CI,-0.29 pp to 40.2 pp). In the autoinflation group, tympanometry showed minimal change from the first follow-up after TT extrusion to after 5 weeks of autoinflation therapy (type A tympanogram: 19 of 26 patients [73.1%] to 20 of 26 patients [76.9%]; type C tympanogram: 7 of 26 patients [26.9%] to 6 of 26 patients [23.1%]). In contrast, the observation group exhibited a decline in type A tympanograms (21 of 28 patients [75.0%] to 16 of 28 patients [57.1%]) and an increase in type C tympanograms (7 of 28 patients [25.0%] to 12 of 28 patients [42.9%]). In this randomized clinical trial, autoinflation after TT extrusion was safe, feasible, and associated with a reduced need for repeat surgical intervention. The observed difference in recurrence was compatible with a clinically meaningful reduction. These findings support the use of autoinflation as a noninvasive rehabilitative strategy to enhance eustachian tube function and maintain middle ear ventilation following TT extrusion. ClinicalTrials.gov Identifier: NCT07122999.

Adolescent idiopathic scoliosis (AIS) affects physical and psychosocial health, with treatments including surgery, bracing, and observation. However, the long-term effects on health-related quality of life (HRQoL) are still uncertain. The aim of the present study was to evaluate the long-term HRQoL outcomes in untreated AIS patients compared to those undergoing surgical or brace interventions through systematic review and meta-analysis. A systematic search was conducted across multiple databases (PubMed, Scopus, WoS, and Medline). Study quality was assessed using the Methodological Index for Non-randomized Studies (MINORS) tool, and evidence certainty was evaluated using the GRADE system. The primary outcomes of the meta-analysis were measured using SRS-22r and SF-12 scales for the assessment of HRQoL, evaluating domains including function, mental health, pain, self-image, and satisfaction after a minimum ten-year follow-up period. Eight studies published between 2010 and 2023 that assessed HRQoL after a follow-up period of ten years or more were included in the systematic review. Six studies were included in the meta-analysis. The observation group showed better outcomes in functional (MD 0.43, 95% CI 0.01-0.84) and mental health domains (MD 0.12, 95% CI 0.03-0.20) compared to the surgical group. No significant differences were found in pain, self-image, and satisfaction domains. Comparison between observation and brace groups showed equivalence across all domains. Evidence certainty ranged from moderate to low. Long-term HRQoL in AIS shows no clear benefit of surgery or bracing over observation, which may offer equal or better mental and functional outcomes. This supports personalized care. Further high-quality research is needed to strengthen the evidence base.

Education in Indonesia faces significant challenges related to disparities in quality, particularly the lack of access to educational technology essential for implementing data-driven education. Suara Muhammadiyah, as a leading mass media outlet, plays a crucial role in educating the public about data-driven education and influencing public attitudes. This study aims to answer the following research questions: How does Suara Muhammadiyah’s communication strategy support the implementation of data-driven education in Indonesia? What are the measurable impacts of these communication strategies on educational stakeholders and the public? This study explores the role of Suara Muhammadiyah in shaping public understanding and influencing education policy discussions on data-driven education in Indonesia. Using a qualitative approach with a case study methodology, data were collected through direct observation, in-depth interviews, and Focus Group Discussions with informants from Suara Muhammadiyah and the Muhammadiyah central board. Content and thematic analyses were employed to identify communication patterns. The study finds that Suara Muhammadiyah successfully raises awareness about data-driven education and simplifies complex data for a broad audience. Challenges include limited reach beyond the Muhammadiyah community and the need for more in-depth data analysis. Despite these challenges, the audience’s high engagement and strong collaborations with government and educational institutions highlight the positive impact. The study contributes to the understanding of how media outlets can influence education policy and improve public understanding through strategic communication.

Objective:This study aimed to investigate the effect of posterolateral mini-incision hip hemiarthroplasty (HHA) on pain and hip function in elderly patients with hip fractures.Methods:Sixty hip fracture patients treated at our hospital between January 2023 and January 2024 were randomly assigned to two groups, with 30 patients in each group. The control group underwent traditional posterolateral approach HHA, while the observation group received HHA using the posterolateral mini-incision approach. General data were collected from both groups. Surgical indicators, including surgical time, time to ambulation, and length of hospital stay, were compared between the two groups. Adverse reactions and postoperative complications were recorded. Postoperative pain was assessed using the Visual Analog Scale (VAS) 24 hours after surgery. Treatment efficacy was evaluated with the Harris Hip Score (HHS), and balance ability was assessed using the Berg Balance Scale.Results:No significant differences were observed in baseline characteristics between the two groups (P > 0.05). The observation group demonstrated better surgical outcomes, with shorter operation and recovery times, as well as fewer adverse reactions and complications (P < 0.05). Postoperative VAS scores were significantly lower, and both HHS and Berg Balance Scale scores were higher in the observation group compared with the control group (P < 0.05).Conclusion:The posterolateral mini-incision approach for HHA in elderly patients with hip fractures can optimize surgical outcomes, reduce postoperative pain and complications, improve hip joint function, and promote better postoperative recovery, resulting in overall superior effects.

To compare the clinical efficacy of the progressive suspension method and conventional thoracoscopic pulmonary resection in right upper lobectomy. A prospective cohort study was conducted involving 60 patients admitted to the Department of Thoracic Surgery at Cangzhou Central Hospital from January 2024 to March 2025. Patients were randomly divided into the observation group (n = 30, using the progressive suspension method, including 15 cases of trans-thoracic puncture fixation and 15 cases of intra-thoracic suture fixation) and the control group (n = 30, conventional thoracoscopic pulmonary resection). Surgical field exposure, operative fluency, lymph node dissection, perioperative indicators, and hospitalization costs were compared between the two groups. The observation group demonstrated significantly superior surgical field exposure (83.3% vs. 50.0%, p = 0.008) and operative fluency (73.3% vs. 33.3%, p = 0.002). The operative time [(87.5 ± 23.2) min vs. (112.4 ± 35.6) min, p < 0.001], intraoperative blood loss [50 (20, 50) mL vs. 80 (50, 120) mL, p < 0.001], postoperative drainage [150 (100, 200) mL vs. 250 (180, 300) mL, p = 0.003], VAS pain score [(3.2 ± 1.1) vs. (4.8 ± 1.5), p < 0.001], and hospitalization costs [(4.5 ± 0.8) vs. (5.2 ± 1.1) ten thousand yuan, p = 0.009] were all significantly better in the observation group. The number of lymph nodes dissected [(10.3 ± 3.1) vs. (8.5 ± 2.8), p = 0.021] showed a statistically significant difference, while the complete lymph node resection rate (93.3% vs. 80.0%, p = 0.143) and complication rate (16.7% vs. 33.3%, p = 0.132) showed no significant difference. No statistical differences were observed between the two suspension subgroups (p > 0.05). The progressive suspension method in thoracoscopic right upper lobectomy provides superior surgical field exposure, improved operative fluency, higher surgical efficiency, and better postoperative recovery compared to the conventional method, making it a safe and effective surgical approach.

This study examined how pedagogical strategies can support student-coaches’ (SCs) empowerment and promote preservice teachers’ (PSTs) professional learning within Sport Education (SE) seasons. Sixty-seven tenth-grade students (aged 15–18) participated in SE units taught by three PSTs (two males, one female, aged 22–25) enrolled in a master’s degree program in Teaching of Physical Education in Primary and Secondary Education in northern Portugal. Data were collected through participant observation, informal and focus group interviews, and PSTs’ reflective diaries within a Collaborative Action Research (CAR) framework and analyzed thematically. Three CAR cycles addressed key challenges: (1) encouraging SCs to assume responsibility for their role, (2) fostering inclusive and supportive team interactions, (3) strengthening SCs’ sport-specific and instructional knowledge. Guided by a facilitator, PSTs implemented strategies including pre-lesson meetings, structured communication routines, task-modification and feedback cards, accountability systems, and visual identification of SCs. Findings suggest that SCs’ empowerment was progressively constructed through interconnected psychological, relational and pedagogical processes, supported by structured mediation and iterative reflection. Simultaneously, engagement in CAR cycles enabled PSTs to develop adaptive instructional decision-making and mediation strategies. The study highlights how empowerment in SE is shaped through relational and pedagogical conditions and illustrates how CAR can foster reciprocal learning between SCs and PSTs in authentic teacher education contexts.

Objective To observe the clinical efficacy of Quhong Zhiyang ointment via shortwave radiofrequency-assisted delivery in the treatment of facial seborrheic dermatitis. Methods Seventy-two individuals who were diagnosed with seborrheic dermatitis and who received treatment and completed a 3-month follow-up period were enrolled in this retrospective analysis, with 36 patients in each group. The control group was given oral compound glycyrrhizin tablets, vitamin b6 tablets, and topical butyl flufenamic acid ointment; the observation group was given shortwave radiofrequency-assisted delivery of Quhong Zhiyang ointment treatment on top of the control group, with 4 weeks as a course of treatment. The clinical efficacy, symptom score, VISIA score, and Malassezia score were compared between the two groups. Results The total effective rate in the observation group was 94.44% (34/36), which was greater than that in the control group (75.00% (27/36), and the difference was statistically significant (P < 0.05). The scores of the two groups decreased, the improvement in the observation group was greater than that in the control group, and the difference was statistically significant (P < 0.05). After treatment in the observation group, the VISIA-red zone score decreased, and the difference was statistically significant (P < 0.05). After treatment, there was no significant change in the VISIA-wrinkle, texture, and rhodopsin score, and the difference was not statistically significant (P > 0.05). Conclusion The shortwave radiofrequency-assisted delivery of Quhong Zhiyang ointment has significant efficacy in the treatment of seborrheic dermatitis and can effectively relieve clinical symptoms, improve local inflammation, and inhibit the growth of Malassezia.

Lymphatic invasion (LI) is a significant risk factor for lymph node metastasis (LNM) following endoscopic submucosal dissection (ESD). Nevertheless, only some cases of early gastric cancer with LI exhibit LNM. This study aimed to compare the incidence of LNM based on the degree of LI. A retrospective analysis was conducted on 5032 patients who underwent ESD at Samsung Medical Center between January 2000 and January 2024. A total of 420 patients had specific data on the degree of LI in ESD specimens. LNM of 347 patients who underwent additional gastrectomy (AG) was analyzed according to the categorized three groups: Ly-s (LI in a single focus), Ly-i (two or three foci), and Ly-m (more than three foci). The Ly-s patients exhibited no LNM, whereas Ly-i and Ly-m demonstrated LNM in 11 cases (11/141, 7.8%) and 22 cases (22/112, 19.6%). Multivariable analysis revealed that Ly-m was significantly associated with LNM (ref, Ly-s; Ly-m, OR 28.09, 95% CI 1.95 - 405.32, P = 0.014). Survival analysis indicated no recurrences in the observation group of Ly-s, while the Ly-i and Ly-m observation groups experienced more recurrences than the treated (AG) groups (5-year disease-free survival; Ly-i: AG 99.3% vs. observation 81.4%, P = 0.144 and Ly-m: AG 99.1% vs. observation 60.3%, P = 0.012). The absence of LNM in patients with a single focus of LI suggests that AG might be unnecessary in these cases. Further standardization of LI assessment criteria and larger sample sizes are needed to confirm these findings.

The incidence of postoperative dysphagia in oral cancer patients is high, significantly impacting their quality of life. This study aimed to investigate the efficacy of a PDCA cycle in reducing the incidence of postoperative dysphagia in oral cancer patients. A non-synchronous pre-post control design was employed. From January to June 2024, 120 patients undergoing radical surgery for oral cancer were assigned to the control group, receiving routine care. While 120 patients admitted between July and December 2024 formed the observation group, receiving multidisciplinary swallowing rehabilitation management based on the Plan-Do-Check-Act (PDCA) cycle. Primary outcomes comprised the incidence of moderate-to-severe dysphagia at 1, 2, and 4weeks post-surgery. Secondary outcomes included length of hospital stay, hospital costs, and nasogastric tube retention duration. There were no statistically significant differences between the two groups in terms of demographic and clinical characteristics. The proportions of patients with moderate to severe dysphagia 12.5% and 10%, preoperatively (P > 0.05). The observation group exhibited significantly lower rates of moderate-to-severe dysphagia at 2weeks (50% vs.72.5%) and 4weeks (27.5% vs 60%) postoperatively compared to the control group (p < 0.05). The observation group exhibited significantly reduced hospital stays (15.73 ± 6.217 vs 20.63 ± 2.713), lower hospital costs (4.30± 1.930 vs 5.16 ± 1.889), and shorter nasogastric tube retention times (13.07 ± 1.465 vs 15.08 ± 1.612) (p < 0.05). The PDCA cycle management model, through systematic and standardized multidisciplinary collaboration, effectively reduces the incidence of moderate-to-severe dysphagia in oral cancer patients postoperatively. It promotes recovery of swallowing function, shortens hospital stays, and reduces medical costs, thereby serving as an effective method for improving the quality of dysphagia management following oral cancer surgery.

Human milk oligosaccharides (HMOs) are complex carbohydrates unique to human milk, and a wealth of observational and mechanistic studies indicate that HMOs are key to infant health by supporting gut microbiota and immune development. This review synthesizes evidence from randomized clinical trials evaluating whether supplementation with human-identical milk oligosaccharides (HiMOs), i.e., synthetic HMOs, in infants and young children improves health outcomes. We identified 12 randomized clinical trials: 8 in healthy infants, 3 in special populations of infants, and 1 in young children. We selected only trials with a randomized, parallel group design; most of the included trials also had an observational human milk-fed control group. The most widely evaluated HiMO was 2'-fucosyllactose used alone or in combination with other HiMOs. In some trials, other bioactive components were included in the control and/or intervention formula groups, complicating interpretation. All trials in healthy infants confirmed the noninferiority of HiMO-supplemented formula on growth and tolerability relative to control formula. Results were mixed with respect to reductions in morbidity, and all studies were underpowered for more severe morbidity outcomes. Stool microbiota and biomarkers of inflammation and gut function generally shifted in a direction closer to human milk-fed infants with HiMO intervention. Some growth improvements were noted in association with HiMO intervention in preterm infants and in infants with severe acute malnutrition. HiMO supplementation may be a promising intervention to improve child health, but due to the heterogeneity and limitations of the clinical trials that have been undertaken, many questions remain about the nature of the benefits and the specific populations who might benefit.

Exercise is recommended for metabolic dysfunction-associated steatotic liver disease (MASLD, previously known as nonalcoholic fatty liver disease [NAFLD]), but the optimal exercise mode remains unclear. We compared high-intensity interval training (HIIT) versus moderate-intensity continuous training (MCT) on cardiorespiratory fitness in patients with MASLD. This randomized trial assigned patients with ultrasonography-confirmed NAFLD/MASLD to HIIT (n = 46) or MCT (n = 49) for 24 weeks; a non-randomized observation group (OBS; n = 20) was also recruited. Both exercise groups performed self-directed treadmill training thrice weekly in free-living settings (home, residential gyms, or community fitness facilities). HIIT: 5 cycles of 4-min intervals at 80%-90% peak oxygen consumption (V̇O2peak) with 3-min recovery at 50% V̇O2peak. MCT: 30-40 min at 60% V̇O2peak. Outcomes were assessed at baseline and week 24. Both HIIT and MCT significantly reduced hepatic steatosis versus OBS (both p < 0.05), with no between-group difference. HIIT achieved greater V̇O2peak improvements than MCT and OBS (p < 0.05). Both exercise groups increased minute ventilation and carbohydrate utilization at moderate-to-high intensities versus OBS (p < 0.05). HIIT and MCT equally reduce hepatic steatosis in patients with MASLD, suggesting exercise participation matters more than intensity for liver fat reduction. Importantly, HIIT provides superior cardiorespiratory benefits. Trial Registration: ClinicalTrials.gov (NCT04463667).

This study investigated the effectiveness of a flipped classroom approach based on the CDIO (Conceive, Design, Implement, Operate) framework in training newly recruited gynecologic operating room nurses in laparoscopic nursing. A total of 74 nurses were randomly assigned to either a control group receiving traditional instruction or an observation group receiving CDIO-based flipped classroom teaching. Key learning outcomes were compared between the two groups, including performance in laparoscopic surgery assistance, procedural proficiency, theoretical knowledge, critical thinking, self-directed learning, and teaching satisfaction. Results showed that while both groups improved after training, the observation group outperformed the control group in all measured areas (P < 0.05). Nurses in the flipped classroom group showed better understanding of endoscopy, more accurate instrument handling, and greater gains in theoretical knowledge. They also demonstrated significantly improved critical thinking and independent learning skills, along with higher satisfaction with the teaching experience. These findings suggest that integrating the CDIO framework with a flipped classroom model can significantly enhance the clinical competence and learning engagement of new gynecologic OR nurses, making it a more effective alternative to traditional teaching methods.