For the precise molecular detection of bloodstream infection, sample processing is critical, as it involves purifying pathogenic DNA to circumvent the inhibitory effect of complex blood components. To integrate the cumbersome workflow encompassing the entire process to realize automated operation, passive methods such as gravity-driven microfluidics eliminate additional driving and controlling modules to simplify device setup and operations. Nevertheless, gravity-driven microfluidics encounters challenges in handling complex flow control and necessitates a relatively large volume of fluid to initiate the flow. In this study, to harness the simplicity of gravity for manipulating the cumbersome processing and achieving the automated detection of bacterial pathogens from whole blood, a novel rotation-programmed microfluidic platform was developed. Through simple procedural rotation of the chip, DNA extraction, LAMP reaction, and detection were integrated into the gravity-driven microfluidic platform. Complex handling procedures, such as sample processing including adsorption, washing, and elution, can be readily automated by antibiotic-modified magnetic nanoparticles on the chip. The sample-to-answer process was completed within 1.5 h, and the limit of detection for S. aureus from whole blood was 102 CFU mL-1. Machine learning-based image processing enabled rapid and accurate result readout through colorimetric detection. Beyond the diagnosis of bloodstream infections, this platform can be potentially extended to other complex and multistep processing applications, such as protein assay, by adjusting the design and programming.
Large language models (LLMs) are used for clinical information retrieval, yet their performance on highly domain-specific documents such as orthopaedic technique guides or instructions for use (IFU) remains poorly understood. Various financial drivers affecting the orthopaedic medical device industry have generated interest in automated perioperative support during surgery using advanced generative artificial intelligence (AI) techniques leveraging LLMs. We sought to establish whether these complex, manufacturer-specific IFUs for surgical planning and intraoperative execution were clinically amenable to substitution by custom LLM applications. We evaluated 5 LLM-based information retrieval solutions, including 4 custom retrieval-augmented generation pipelines and ChatGPT5, in their ability to extract clinically relevant information from 3 distal femoral replacement IFUs. Two fellowship-trained orthopaedic surgeons curated 28 questions spanning literal, enumerative, and reasoned query types. Answers were scored against the expert-generated ground truth using a three-tier rubric (incorrect, partially correct, fully correct). All systems demonstrated low overall accuracy (<50%). A custom multimodal pipeline achieved the highest overall score (44.6%), outperforming commercial systems such as ChatGPT (29.2%). Performance varied by document and question type: literal queries were most accurately answered (up to 53.0%), while reasoned questions yielded the lowest scores across all systems (as low as 15.3%). Current LLM-based retrieval systems, including commercially available tools, are unreliable for extracting complex procedural information from orthopaedic implant protocols. Whether IFUs require further clarity for clinical queries or open source LLMs require enhanced image processing, medical device representatives are far from being replaced by generative AI techniques given their poor performance in safe integration with surgical workflows. Improving LLMs with enhanced image processing and domain-specific training will be necessary before considering medical device representatives' substitution. Prognostic, Level IV. See Instructions for Authors for a complete description of levels of evidence.
This study investigated the effects of polishing duration (15-120 s) in a laboratory abrasive rice polisher on milling quality, grain characteristics, and kernel surface microstructure. The results revealed that the degree of polishing (DOP) increased significantly from 2.38% (15 s) to 15.29% (120 s), which was accompanied by a higher broken content (from 6.35% to 18.45%) and a reduced head rice yield (from 93.6% to 80.3%). The complete removal of bran streaks required a DOP >13.05%, but this threshold also coincided with over-milling and yield loss. Scanning electron microscopy (SEM) images revealed the progressive abrasion of the protuberances and bran layers, with uniform polishing achieved only after 90 s. These findings clearly indicate the trade-off between bran removal and grain integrity, underscoring the need to optimize the polishing time for balanced quality, yield, and sustainability in rice processing. Therefore, this study highlights how optimizing rice polishing through abrasive milling can reduce grain breakage, increase head rice yield, and improve grain uniformity, thereby minimizing postharvest losses. By balancing whiteness, transparency, and surface structure, this research supports more efficient use of harvested rice, promoting food security and sustainability in grain processing.
To describe mortality, surgical treatment, and hospitalization patterns in children with congenital diaphragmatic hernia (CDH) using population-based data, linked to congenital anomaly registries across Europe. This cohort study used nine EUROCAT registries in five countries (Denmark, Finland, Italy, Spain, and the United Kingdom) linked to routinely collected hospital and mortality data. Children born alive with CDH between 2005 and 2014 were included and followed until age 5 in hospital data or age 10 in death data, with the final follow-up the end of 2015. Analyses were conducted for all CDH cases and separately for isolated CDH (CDH without additional major congenital anomalies). Standardized data processing and meta-analysis methods were used to generate pooled estimates of mortality, surgical interventions, and hospital stays. Among 567 children with CDH, most were isolated CDH. First year survival was 74.5% for isolated CDH, ranging from 63% to 83% between registries. Similar survival was noted for all children with CDH. Most deaths occurred within the first week. Mortality rates plateaued after infancy, with no deaths recorded after age 5. The median age at surgery was approximately 2 weeks, although this varied by region. Median hospital length of stay in infancy varied from 14 to 29 days between regions. In children with CDH, mortality is highest in the neonatal period, with long-term survival stabilizing after infancy. No deaths occurred after age 5 years. Regional differences in mortality and surgical timing highlight the value of population-based, harmonized data for benchmarking and international comparisons.
Satellite greening has become a key tool for monitoring alpine vegetation change, but a positive vegetation-index trend is not an ecological observation in itself. This perspective shows that interpreting alpine greening requires addressing two sequential challenges: methodological complexity, which can bias trends during image processing, and phenomenological complexity, because different ecological processes can produce similar spectral signals. Progress now depends less on producing more greening maps than on linking robust satellite trends to ground-based ecological processes.
Powdered products for dysphagia are often discussed primarily in clinical terms, yet their performance depends on how texture develops during reconstitution and oral processing. In these systems, wetting, dispersion, hydration, hydrocolloid-matrix interactions, resting time, temperature, and salivary exposure jointly determine whether the prepared bolus will be homogeneous, stable, and functionally appropriate at the time of swallowing. This critical integrative review examines powdered foods for dysphagia from a texture design perspective and brings together evidence on the clinical management of dysphagia, IDDSI implementation, shear and extensional rheology, tribology, powder architecture, and reconstitution science. Electronic searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, and ScienceDirect, with backward and forward citation tracking to capture seminal and recent studies. Taken together, the literature shows that liquids classified within the same IDDSI level may differ materially in flow curve profile, viscoelastic recovery, lubrication, and sensory load, whereas studies on powders show that particle size, agglomeration, porosity, surface composition, solids loading, and mixing protocol govern wetting, dispersion, and structural uniformity. In nutrient-dense matrices, such as systems containing cocoa, dairy ingredients, and fibers, thickener performance is matrix- and time-dependent; therefore, the same nominal thickener dose does not guarantee equivalent oral behavior across different products. The reviewed evidence supports a formulation-driven development agenda in which powder architecture, hydrocolloid choice, preparation instructions, and functional texture verification are optimized in an integrated way. Reconstitutable powders are not inherently superior to ready-to-use products, but they may provide a promising platform for standardization, logistical flexibility, and nutritional densification when reconstitution and oral texture are treated as parts of the same system.
Pornography engagement is frequently examined through exposure-based frameworks that assume higher levels of consumption are associated with adverse psychological outcomes. Emerging evidence suggests that such engagement reflects underlying reward-processing and affect-regulation mechanisms. However, prior findings regarding its association with suicidal ideation remain inconsistent. The present study aimed to examine the association between pornography exposure, consumption motives, depressive symptoms and suicidal ideation among young adults. A cross-sectional sample of 541 university students completed measures of pornography exposure intensity, pornography consumption motives, depressive symptoms and suicidal ideation. Bayesian regression analyses were conducted to examine associations between pornography use, motives, depressive symptoms and suicidal ideation. Depressive symptoms emerged as the most robust predictor of suicidal ideation across all models. Pornography exposure intensity demonstrated a small negative association with suicidal ideation (β = -0.09, 94% highest density interval (HDI) [-0.15, -0.03]) after accounting for depressive vulnerability. Among motivational factors, emotional avoidance was positively associated with suicidal ideation (β = 0.15, 94% HDI [0.06, 0.23]), whereas sexual pleasure motives were negatively associated (β = -0.18, 94% HDI [-0.29, -0.08]) with suicidal ideation. A significant interaction was observed between depressive symptoms and sexual curiosity. The findings suggest that pornography use is not uniformly associated with suicidal ideation. Instead, associations vary depending on various psychological factors and motives for use. As the study is cross-sectional, the findings should be interpreted as associational rather than causal. These results highlight the importance of considering emotional regulation and individual vulnerability when examining the mental health implications of pornography use.
This study aimed to explore the visceral and embodied experiences of body handlers, examining how the physical body registers, processes, and resists traumatic exposure. Utilizing Interpretative Phenomenological Analysis, a secondary analysis was conducted on narratives from twenty Jewish male IDF reservists tasked with identifying and processing human remains following the October 7th attack. Drawing on Foucault's metaphor of the mirror, the findings reveal a dialectical struggle between two somatic states: a "utopian" identification, where the self is pulled into the "there" of death through sensory contamination and the dissolution of boundaries, and a "heterotopic" resistance that asserts the "here" of life through mechanization, metabolic drives, and kinetic exertion. The results suggest that the body functions as a visceral archive of the event, mounting an existential assertion of vitality when cognitive defenses are overwhelmed. These findings underscore the necessity of somatic therapeutic interventions for individuals exposed to extreme corporeal horror.
Both secular and religious resources and coping strategies have been shown to alleviate distress post-bereavement, but few studies have directly compared their relative contributions to adjustment, which is the aim of the present study. Structural equation modeling examined direct and indirect pathways from resources through coping to outcomes in 168 recently bereaved individuals identifying as Christian. Mindfulness directly predicted lower depression and grief and higher Christian flourishing. Religious commitment directly predicted higher Christian flourishing and indirectly predicted Christian flourishing (through religious coping) and grief (through both positive reappraisal and religious coping). Coping strategies of seeking emotional social support, positive reappraisal, and religious coping were positively associated with grief symptoms, perhaps reflecting active grief processing. Considering secular and religious resources and coping together yields important information about bereavement adjustment. Findings suggest the importance of supporting both mindfulness-based interventions and religious coping practices for bereaved Christians while normalizing grief experiences.
Acellular dermal matrix (ADM) has become an established adjunct in implant-based breast reconstruction, improving implant coverage, pocket control, and soft-tissue support and hastening the adoption of prepectoral techniques. Notwithstanding its more than two decades of use in breast reconstruction, breast reconstruction remains an off-label indication for ADM use in the US. Human, porcine, and bovine sources have all been used to provide ADMs. They undergo distinct processing and sterilization methods that may affect matrix architecture, host integration, and clinical performance. Following implantation, ADM serves as a biologic scaffold for cellular infiltration and neovascularization. However, its use remains associated with important complications, including seroma, infection, red breast syndrome (RBS), mastectomy skin flap necrosis (MSFN), implant exposure, and reconstructive failure. Reported outcomes vary widely across the literature, likely due to differences in reconstructive technique, mastectomy flap perfusion, ADM characteristics, perioperative management, and patient risk factors. Elevated body mass index (BMI), smoking, diabetes, prior radiation, larger ADM burden, and compromised skin flap vascularity consistently emerge as contributors to adverse outcomes. From a clinical standpoint, successful ADM use depends on judicious application, meticulous technique, and early recognition of evolving complications. Despite its off-label status, ADM use in breast reconstruction remains widespread and an important tool for plastic surgeons.
Increased atmospheric carbon dioxide (CO2) emissions in the atmosphere due to excessive usage of fossil fuels, rapid industrial development and human growth have raised a global interest in the greenhouse effect. CO2 conversion is important not just because it is a greenhouse gas that causes a variety of climate consequences, but also because it is the most abundant source of valuable organic chemicals. Upgrading CO2 into valuable chemicals and materials offers a pathway toward net-zero or even carbon-negative production of fuels, pharmaceuticals, alcohols, plastics, etc. However, current CO2 conversion technologies have the problems of high operational costs, high energy consumption, limited to a few-carbon products, and a risk of secondary pollutants. Microbial electrosynthesis (MES) is a novel microbial electrochemical technology that integrates the metabolic activities or genetic behaviour of microorganisms on electrodes to convert CO2 into organics with electrical energy input. Recent developments in electrode and reactor design, synthetic biology-based strain engineering, and genetic engineering have enhanced the production rates and selectivity of MES. This review explores the transformative potential and recent progress of MES with CO2 upgrading strategies, aiming to identify the determinants of the process and its future research directions.It also highlights the current challenges of MES related to upscaling, long-term stability, selecting optimal microbial strains, achieving net-negative carbon emissions, and other operational limitations that need to be addressed for commercial viability.
Receptors that bind antibodies are essential for protective adaptive immune responses against antibody-opsonized pathogens, yet their engagement by antibody-autoantigen complexes can drive chronic inflammation in autoimmune diseases. Megakaryocytes, the precursor cells of platelets, express such receptors. However, their response to immunoglobulin G antibodies remains unclear. We used both systemic lupus erythematosus and COVID-19 as relevant examples of autoimmune and infection-driven contexts in which antibodies are involved to characterize human and mouse megakaryocyte responses. We found that megakaryocytes internalized immune complexes composed of autoantigens or SARS-CoV-2. In both human and mouse megakaryocytes, immune complexes triggered the release of chemokines and procoagulant extracellular vesicles. This process required FcγRIIA engagement, downstream Syk (spleen tyrosine kinase) signaling, and protein translation. A detailed analysis revealed that megakaryocyte-derived extracellular vesicles did not contain organelles and were largely indistinguishable from a subset of small-sized extracellular vesicles released by activated platelets. In FcγRIIA-transgenic mice, we analyzed megakaryocytes in both the bone marrow and lungs in a lupus model, whereas megakaryocytes were examined in the lungs in a COVID-19 model. In all cases, immunoglobulins were detected in close proximity to FcγRIIA-expressing megakaryocytes. Notably, the chemokine CXCL2 was increased in FcγRIIA-expressing mice under disease conditions. Tissue spatial analysis revealed that CXCL2 predominantly localized to megakaryocytes, supporting these cells as a major source. Furthermore, SARS-CoV-2 stimulated megakaryocytes to release CXCL2 only in the presence of IgG from SARS-CoV-2 immune individuals, and this response was strictly dependent on FcγRIIA expression. These findings suggest that megakaryocytes contribute to adaptive immune responses through FcγRIIA-mediated signaling.
Deep brain stimulation (DBS) is an established therapy for advanced medication-resistant Parkinson's disease (PD), yet its ability to alter the course of the disease remains uncertain. Although preclinical research using toxin-induced PD models demonstrate neuroprotective effects, clinical studies in PD patients undergoing DBS have not substantiated these findings. This disconnect may be attributed to factors such as the initiation of DBS late in disease, stimulation protocols targeting symptoms rather than pathology, and the limited translational relevance of animal models lacking hallmark alpha-synuclein (α-Syn) aggregation. Incorporating α-Syn-based models may bridge this gap by facilitating the discovery of early electrophysiological biomarkers of pathological progression, refining stimulation parameters to enhance α-Syn clearance, and assessing if early DBS intervention can mitigate neurodegeneration. Yet, only a limited number of DBS studies have employed α-Syn models to date. This review examines the translational gap between preclinical neuroprotection claims and clinical outcomes, focusing on how α-Syn-based models could resolve current limitations in DBS research. Prioritizing these models could clarify whether DBS has the potential to extend beyond symptomatic relief and directly engage PD's underlying neurodegenerative mechanisms. Achieving this goal requires systematic investigation of DBS influences on α-Syn accumulation and its electrophysiological correlates in disease-relevant models. Deep Brain Stimulation in Alpha-Synuclein Models of Parkinson's Disease: Bridging the Translational GapPlain language summaryDeep brain stimulation (DBS) is an effective treatment that helps people with Parkinson's disease manage their movement symptoms, like tremors and stiffness. But while it provides relief, a big question remains: could DBS also slow down the disease progression itself? Studies in animals suggest it might protect brain cells, but these promising results have not yet translated to human patients. The reason may lie in key differences between research and real-world treatment.Most animal studies use methods that do not fully replicate Parkinson's disease in humans—particularly the gradual buildup of harmful alpha-synuclein protein aggregates that are linked to Parkinson's disease. Additionally, DBS is typically given to patients only after their symptoms become severe, when significant damage has already occurred. Current DBS settings are also optimized for symptom control rather than targeting the disease process directly.Research using alpha-synuclein-based animal models which may better mimic human disease hints that DBS might have untapped potential. Some studies show it could help clear alpha-synuclein aggregates or protect brain cells, while others find no such benefit. This mixed evidence tells us we need a deeper understanding of how timing, brain targets, and stimulation settings influence DBS's effects.Looking ahead, researchers are exploring whether DBS could be used earlier—perhaps even before symptoms appear—to intervene in the disease process. The goal is to shift DBS from solely managing symptoms to potentially slowing or even preventing disease. While much work remains, these advances could one day transform how we treat Parkinson's disease, offering hope for more than just symptom relief.
Gla-rich protein (GRP) is a vitamin K-dependent protein involved in the regulation of ectopic calcification and inflammatory processes. However, data on circulating GRP concentrations in healthy adults remain limited. This cross-sectional observational study evaluated serum total GRP (tGRP) concentrations in 254 healthy adult blood donors (48% male), aged 18-65 years, using a sandwich enzyme-linked immunosorbent assay (ELISA) (GenoGla Diagnostics, Faro, Portugal). Participants were stratified by age tertiles, and associations between serum tGRP concentrations and demographic and laboratory parameters were assessed using non-parametric statistical tests, Spearman correlation, and stepwise linear regression. The median serum tGRP concentration in the overall population was 1809.5 pg/mL (interquartile range: 1197.4-2476.0 pg/mL). Serum tGRP concentrations differed significantly across age tertiles (P = 0.038), with higher concentrations observed in younger adults. Serum tGRP concentrations showed a weak but statistically significant inverse correlation with age (r = - 0.30, P = 0.001), while no significant differences were observed between sexes (P = 0.420). In multivariable analysis, age and serum calcium concentration remained independently associated with serum tGRP concentrations, jointly explaining approximately 7% of their variability. This study establishes robust reference data for circulating tGRP concentrations in healthy adults, providing a foundation for the interpretation of GRP measurements in future clinical and epidemiological research.
Co-production is an important practice for addressing health disparities and developing equitable services with underserved communities. Co-production aims to ensure that underserved communities are central to the design of services that reflect community needs. African and Caribbean heritage communities (ACHC) face heightened risks of HIV due to stigma, discrimination, social, economic and structural factors, leading to significant health inequities. Despite a national target to end new HIV transmissions by 2030, HIV remains prevalent. Common Ambition Bristol (CAB) is a co-production project aiming to increase HIV knowledge and testing. CAB's Project Delivery Group (PDG) involves ACHC community members and sexual health staff working in equal partnership to improve sexual health services for ACHC. A longitudinal qualitative evaluation explored the process of CAB's co-production over time. Interviews were conducted with members of CAB's PDG at three time points. Interviews examined PDG views and experiences of the co-production process. Data were analysed thematically. Five themes are reported which relate to equitable power-sharing and inclusive decision-making: (1) Acknowledging power imbalances and negotiating roles, (2) Appreciating commonalities and the importance of language, (3) Benefits of sharing lived and sexual health experiences, (4) Negotiating different opinions safely and (5) Co-production: the messy middle. Findings underscore the potential of co-production to drive meaningful progress in health equity. Key elements of co-production which promote equitable power-sharing and effective decision-making are: (1) acknowledging and addressing unequal power structures which may affect group dynamics; (2) fostering reciprocal learning from lived experience and sexual health expertise; (3) recognising and appreciating personal and sexual health commonalities; (4) negotiating and developing ways to ensure equitable decision-making and (5) agreeing a shared language which reflects 1-4.
Enzymes encoded by Helicobacter pylori are involved in various metabolic processes. Using a Mendelian randomization (MR) framework, we investigated the metabolites associated with six antibodies against H. pylori and explored the potential underlying biological pathways. A meta-analysis of 65 genome-wide association studies was conducted to assess the genetic predisposition to approximately 3,550 metabolites. Summary-level data for > 10 million genetic variants associated with H. pylori antibodies were extracted from the UK Biobank. MR analysis was performed using inverse-variance weighting, weighted median, and Egger regression to ensure robust findings. Significant metabolites were further analyzed using enrichment analysis to identify the relevant biological pathways. A total of 100 metabolites were positively associated with H. pylori antibodies (cytotoxin-associated gene A [CagA], 16; catalase, 25; GroEL, 16; outer membrane protein [OMP], 22; urease [UREA], 15; and vacuolating cytotoxin [VacA], 6). These metabolites were linked to pathways involving the metabolism of alanine, aspartate, glutamate, glycine, serine, threonine, purine, and tryptophan in four antibodies. Additionally, 67 metabolites were negatively associated with H. pylori antibodies (CagA, 11; catalase, 6; GroEL, 13; OMP, 11; UREA, 11; and VacA, 15). These metabolites were primarily involved in pyrimidine metabolism in the three antibodies. Our study identified numerous metabolites linked to H. pylori antibody levels, indicating that metabolic alterations are associated with infection. These changes were particularly enriched in pathways involved in amino acid, nucleotide, and coenzyme metabolism and biosynthesis. These findings highlight the systemic metabolic impact of H. pylori infection and offer insights into the biological mechanisms underlying host-pathogen interactions.
Proteins droplets formed by liquid-liquid phase separation (LLPS) gradually lose fluidity and mature into aggregated and fibrillar states, initiating fibrillation of amyloidogenic proteins. Despite increasing interest in droplet maturation, high-throughput methods for visualizing this process remain undeveloped. In this study, we report a fluorescence-based method for real time visualization of droplet maturation using dual-emission fluorophores. Coumarin-based fluorophores conjugated with electron-withdrawing rings exhibit dual fluorescence originating from multiple ground-state conformers although predicting this behavior from molecular structure remains challenging. Here, we synthesized coumarin-based fluorophores bearing directly conjugated electron-withdrawing five-membered ring to increase the abundance of twisted conformers through steric hindrance. The dual-emission properties and fluorescence quantum yield were tuned by varying the heteroatoms within the five-membered ring. Upon covalent conjugation of the probe to proteins, ratiometric confocal microscopy revealed that the emission ratio faithfully reflected the maturation process of liquid droplets, enabling quantitative evaluation of maturation timescale and heterogeneous internal environments. Furthermore, by combining this probe with the photoactive yellow protein (PYP) tag strategy, we visualized differences in the internal environments of protein droplets in living cells. This strategy allows continuous monitoring of droplet maturation and provides new insight into the mechanism of LLPS, amyloidogenic proteins fibrillations, and inhibitor screening against amyloid formation.
Polydeoxyribonucleotide (PDRN) has been shown to have consistent regenerative and anti-inflammatory properties in a wide range of applications. Selective activation of the A2A receptor (A2AR) and induction of the phosphate scavenger system constitute its primary actions, which overlap the mechanism of skin regeneration after a surgical procedure; thus, PDRN can potentially be added to the post-surgical aesthetic surgery protocol of laser resurfacing, chemical peeling, microneedling, and radiofrequency. Literature search was conducted in the PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases with the following keywords: polydeoxyribonucleotide (PDRN) or polynucleotide, wound repair, aesthetic recovery, erythema, scar, lasers, and skin regeneration. No stipulated date limit was applied. Interventional and observational human studies, any available relevant preclinical evidence, and published systematic reviews were included. The studies were chosen based on their applicability to the biological processes of PDRN and their clinical application in skin repair situations that can be implemented in aesthetic practice. Narrative synthesis was used for thematic analysis. The pro-resolving immune reaction of PDRN works through a two-pronged mechanism: balancing the pro-inflammatory cytokine A2AR-mediated action (tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, and IL-1 beta) and vascular endothelial growth factor-mediated nucleotide provisioning to growing keratinocytes and fibroblasts. There is human clinical evidence (including randomized controlled trials (RCTs), comparative cohort studies, and split-face trials) that PDRN enhances the period of re-epithelialization, erythema, scarring, and melanogenesis, which are the direct clinical outcomes with respect to post-procedural aesthetic recovery. PDRN has also shown non-inferior short-term cosmetic results compared to hyaluronic acid filler, with indications of greater biostimulatory stability. The adverse event profile in all published studies is invariably positive. The limitations of the technique, however, are a lack of RCTs (with human aesthetic cohorts), small sample sizes, variability in formulations, and a lack of long-term follow-up. Thus, the findings discussed in the current paper make PDRN an appealing and bio-plausible clinical partner in enhancing post-surgical recovery of patients undergoing aesthetic surgery. The available mechanistic and translational evidence establishes a credible biological basis for integrating PDRN into post-procedural care. On the basis of this evidence, its use may be considered a reasonable adjunct in clinical practice, subject to individual patient assessment and institutional protocol.
To identify the barriers and facilitators to implementing interventions for improving medication adherence in older patients with hypertension. This review was designed according to the Arksey and O'Malley framework for scoping reviews. Six electronic databases (PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO) were searched. This review is written in a consistent format in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Fifteen studies were included in the final analysis. Barriers and facilitators were mapped to 14 constructs across the four CFIR domains. Barriers mapped to 'intervention characteristics' spanned multiple constructs, more than any other domain. Similarly, the most frequently mentioned facilitators were derived from the 'intervention characteristics' domain. Overall, the intervention content of the existing studies was not generalisable and accessible, whereas other factors such as family involvement in the 'process' were effective in facilitating interventions implementation. This review identified barriers and facilitators to the implementation of interventions to improve medication adherence in older patients with hypertension. Future research should focus on reducing barriers and reinforcing facilitating factors to ensure improved medication adherence in the older population with hypertension. This review provides a systematic overview of the barriers and facilitators to the implementation of interventions for improving medication adherence in older patients with hypertension. Whether as a barrier or a facilitator, the 'intervention characteristics' are predominant. This review will provide guidance for improving medication adherence in older patients with hypertension. No Patient or Public Contribution.
Upper gastrointestinal (GI) tract disorders are a major cause of morbidity and mortality worldwide. While endoscopic examination provides direct visualization of mucosal lesions, histopathological examination remains the gold standard for definitive diagnosis, particularly for distinguishing between non-neoplastic and neoplastic conditions. This study aims to correlate clinical and endoscopic findings with histopathological diagnoses and to assess the prevalence of Helicobacter pylori in gastric biopsies. A cross-sectional study was conducted at Gandhi Medical College and Associated Hospitals, Bhopal, from May 2023 to October 2024. A total of 100 patients undergoing upper GI endoscopy for various indications were included. Biopsies were taken from lesions in the esophagus, stomach, and duodenum. Tissue samples were routinely processed and stained with hematoxylin and eosin (H&E). Giemsa stain was used to detect Helicobacter pylori. Results: The most common clinical indications for endoscopy were abdominal pain and dyspepsia. Ulcer was the most frequent endoscopic finding (26 (26%)), followed by erosions (14 (14%)). On histopathological evaluation, non-neoplastic lesions predominated in younger age groups (41-50 years), while neoplastic lesions were more frequent in older patients (51-60 years) (p = 0.023). The esophagus was a common site for squamous cell carcinoma, while adenocarcinoma was the most frequent malignancy in the stomach. The diagnostic accuracy of endoscopy for detecting neoplastic lesions, using histopathological diagnosis as the reference standard, was 88%, with a sensitivity of 69%, a specificity of 96%, a positive predictive value (PPV) of 87%, and a negative predictive value (NPV) of 88%. Histopathology detected a higher proportion of neoplastic lesions (29%) compared to endoscopy (23%), highlighting its superior diagnostic accuracy. Endoscopic biopsy is an essential diagnostic tool that correlates strongly with histopathological findings. While endoscopy is effective for initial screening and identifying suspicious growths, histopathology is crucial for confirming malignancy and identifying specific inflammatory conditions, such as H. pylori gastritis. Age and clinical symptoms such as dysphagia are significant predictors of neoplastic pathology in the upper GI tract.