While community volunteers are increasingly recognized for addressing supply-side gaps in healthcare delivery (e.g., provider shortages), their role in mitigating demand-side barriers (e.g., stigma) remains underexplored. This qualitative study investigated the experiences, knowledge, and roles of community volunteers in Goa, India. We examined barriers and facilitators to community-based work, and strategies for integrating community participation and outreach in demand-side interventions. We conducted semi-structured, in-depth interviews with 35 community volunteers who deliver health and socio-developmental programs (e.g., "social workers", village council members, lay health providers). Thematic analysis revealed that volunteers' work encompassed demand-related tasks such as connecting community members to government welfare schemes, organizing educational events, and providing informational or material resources via contextually-relevant, relationship-driven strategies, such as leveraging influential community leaders and social connections (including via WhatsApp). Participants demonstrated awareness of the social origins of distress (e.g., unemployment), especially post-COVID-19, and expressed willingness to vertically integrate mental health in their work. Facilitators included social recognition, personal satisfaction, and family and political backing. Lack of community support and resources (e.g., insufficient government funding) were significant barriers in continuation of work for community volunteers. These findings suggest the potential of community volunteers as demand-side change agents for mental health interventions, underscoring the necessity of integrating local knowledge, social networks, and non-monetary community-based incentives into scalable global health programs.
This article is concerned with the persistence and transformations of local authority 'in-house' volunteering programs-which integrate volunteers recruited in a personal capacity in the delivery of local services-during the United Kingdom's 2010-2020 austerity period. Drawing on qualitative research in Newcastle-upon-Tyne's parks, the article highlights a mismatch between volunteers' expectations of what an in-house volunteering program should feel like and what an austerity-shaped one effectively offers them. It centers the concept of 'boundary work' in understanding the mismatch and examining why volunteers remain involved despite it. The article emphasizes boundary work's relational nature, showing how volunteers' continued participation rests not only on their placement of limits but also on their managers' awareness of and commitment to those. It also highlights how managers' dual process of boundary demarcation and boundary downplaying helps to make volunteers' participation feel at times strictly voluntary and at others like a shared endeavor with paid workers- a fluidity which is key to ensuring volunteers' continued involvement in a changing political economic context.
Recent studies have demonstrated rapid antidepressant effects of inhaled N,N-dimethyltryptamine (DMT); however, long-term effects, including broader well-being dimensions, are sparsely explored across populations. Investigating whether DMT produces sustained improvements in anxiety, life satisfaction, and quality of life, in both healthy individuals and patients with treatment-resistant depression (TRD). In 2 open-label clinical trials, 27 healthy individuals and 14 patients with TRD, respectively, received inhaled DMT in a supportive clinical setting. Repeated assessments were conducted from baseline up to 12 months (only patients), including state anxiety (State-Trait Anxiety Inventory State, STAI-S), life satisfaction (Satisfaction with Life Scale, SWL), and quality of life (World Health Organization Quality of Life Instrument - Abbreviated Version, WHOQOL-BREF, and Spirituality, Religion and Personal Beliefs Module, WHOQOL-SRPB). All volunteers showed reduced state anxiety after inhalation up to 1 day afterward. Healthy volunteers reported increased life satisfaction up to 14 days post-administration. Beyond symptom reduction, patients reported increased life satisfaction after 12 months and sustained improvements in quality of life over that period, including Physical Health, Psychological Health, Social Relationships, and Environment (WHOQOL-BREF), and partially Inner Peace and Hope & Optimism (WHOQOL-SRPB). These findings suggest that inhaled DMT, combined with psychological support, is associated with recovery of daily functioning and health domains in patients with depression. Although limited by open-label design, lacking placebo control, and modest sample size, this exploratory study highlights the value of incorporating multidimensional outcomes in psychedelic research and DMT's potential relevance in both clinical and public health contexts.
Acceptability is crucial for treatment efficacy, and the World Health Organization emphasizes its impact on patient compliance. Taste plays a significant role in acceptability, with bitter taste often leading to treatment discontinuation. Clozapine, an effective drug for treatment-resistant schizophrenia, faces acceptability challenges that have been connected to its poor taste. The aim of this study was to conduct, for the first time, a human taste assessment of clozapine to directly measure its level of aversiveness. Human volunteer study. Employing a "swirl and spit" method, 23 young healthy adults rated the taste of four clozapine solutions (0.0011-0.018 mg/mL) on a visual analog scale (VAS) ranging from 0 (not aversive) to 100 mm (extremely aversive). Clozapine was not aversive at any concentrations, even at saturation: mean VAS scores ranged from 5.6 to 10.3/100 (median scores ranged between 2 and 4). Reported barriers to compliance linked to taste aversiveness of marketed or extemporaneous dosage forms of clozapine may be linked to factors such as the dosage form itself, other negative formulation or excipients' organoleptic characteristics, packaging, and user instructions linked to dosing frequency and duration, and of course, patient and disease-related factors, which require further investigations. Assessment of clozapine taste in healthy volunteers Clozapine is an antipsychotic used for people who do not respond to other antipsychotics. It is usually taken in tablet form but sometimes patients are given liquid forms of clozapine so that carers can be sure that clozapine has been taken as prescribed. Patients often find the taste of liquid clozapine to be unpleasant, and this aversive taste may make people want to stop taking clozapine. We tested different concentrations of clozapine in volunteers. The taste of clozapine itself was not reported to be unpleasant and most people could taste nothing. We conclude that liquid clozapine has an unpleasant taste because of other chemicals (called excipients) used in making liquid formulations. Clozapine itself appears to be tasteless.
Acute respiratory distress syndrome (ARDS) is characterized by increased alveolar-capillary permeability and neutrophil-driven inflammation. Anumigilimab, a novel, fully human, monoclonal antibody, competitively antagonizes the granulocyte colony-stimulating factor (G-CSF) receptor. This trial aimed to assess its potential in modulating pulmonary inflammation induced by segmental lipopolysaccharide (LPS) challenge. In this randomized, double-blind, placebo-controlled Phase 1b trial (NCT05653713), healthy adults were randomized 1:1 to receive a single intravenous dose of anumigilimab 0.6 mg/kg or placebo (0.9% saline), followed by LPS challenge on Day 3. Biomarkers were measured in bronchoalveolar lavage (BAL) and blood before and after LPS challenge. The primary endpoint was the percentage reduction from baseline in mean absolute neutrophil cell count in BAL following LPS challenge. Secondary endpoints included additional BAL biomarkers of neutrophilic inflammation and tissue injury. Pharmacokinetics, pharmacodynamics, and safety were also assessed. Participants were randomly assigned to anumigilimab (n = 23) or placebo (n = 22). LPS challenge induced expected increases in BAL neutrophils and inflammatory biomarkers, with no significant difference between groups. Target engagement was confirmed by elevated plasma and BAL G-CSF concentrations and transient reductions in peripheral neutrophil counts following anumigilimab administration. Pharmacokinetic/pharmacodynamic parameters were consistent with prior clinical data. Anumigilimab was well tolerated; mild transient neutropenia occurred in four participants treated, with no serious adverse events. While anumigilimab had an acceptable safety profile in healthy volunteers, and favorable pharmacokinetic/pharmacodynamic characteristics, it did not attenuate LPS-induced neutrophilic inflammation. Further preclinical investigations are warranted before advancing its clinical development in ARDS.
Background Hand grip strength (HGS) is a vital measure of muscular function and serves a pivotal role in the identification of functional impairments, as well as in evaluating the effectiveness of therapeutic interventions in individuals with hand or upper extremity injuries undergoing rehabilitation. HGS represents a simple, objective, and reliable indicator of physical status, muscular performance, cardiovascular fitness, and functional disability. The primary objective of the study was to estimate HGS using a grip force transducer and to establish normative reference data for a healthy population from central India. Secondary exploratory objectives included examining the relationships of HGS with anthropometric and physiological variables, such as age, body mass index (BMI), heart rate (HR), and electromyography (EMG) activity, to provide additional physiological context for interpreting grip strength performance. Methods The study was descriptive and cross-sectional in design and was conducted in the sports physiology laboratory of the Department of Physiology at a rural central Indian medical institute. A total of 400 volunteers aged 17-65 years were selected according to the inclusion criteria. HGS was assessed using a grip force transducer. Surface EMG measurements were obtained through disposable silver-silver chloride electrodes. Data acquisition was performed using the PowerLab system (ADInstruments Pty Ltd., Dunedin, New Zealand), and the analysis was carried out using LabChart Pro software (ADInstruments Pty Ltd., Dunedin, New Zealand). Results Of the 400 participants (220 men and 180 women), the mean age was 34 ± 11 years. The mean HGS was significantly lower in females than in their male counterparts, as revealed by the unpaired t-test. There was also a significant inverse correlation between mean HGS and age in males (r = -0.30) and females (r = -0.36). Although HR was significantly positively correlated with mean HGS, the correlation coefficients were relatively weak (for males, r = 0.23, and for females, r = 0.18), indicating that HR explains only a small proportion of the variability in HGS. The root mean square values of EMG demonstrated a statistically non-significant, weak positive correlation with mean HGS.  Conclusion The present research has established age-specific normative values of HGS, estimated using a grip force transducer, for the healthy population of central India. A statistically significant difference in grip strength was noted between the sexes, with men exhibiting greater grip strength than women. Age and HGS were also found to be inversely related, whereas a statistically significant positive correlation was observed between HR and HGS.
Oral flucloxacillin is widely used for methicillin-susceptible Staphylococcus aureus (MSSA) infections, but its recommended 6-hourly dosing may limit adherence. Probenecid inhibits renal tubular secretion of β-lactams and enhances flucloxacillin exposure, allowing less frequent dosing. This study aimed to determine the effect of repeated dosing of probenecid on serum and urinary concentrations of flucloxacillin and its impact on pharmacodynamic target attainment. Ten healthy adults participated. Flucloxacillin was administered intravenously and orally. Oral flucloxacillin was administered with and without probenecid. Rich plasma sampling was undertaken, with analysis by UHPLC-MS/MS. A population PK model was developed and evaluated, followed by Monte Carlo simulations to assess the probability of target attainment (PTA; target of at least 50% fT > MIC at MIC 0.5 mg/L). Urinary biomarkers (NGAL, KIM-1, glycosaminoglycans), urinary flucloxacillin concentrations and serum creatinine concentrations were monitored. Across 307 plasma samples, unbound steady state flucloxacillin concentrations were higher with probenecid (median 0.74 mg/L) than without (median 0.30 mg/L; p = .002). Probenecid reduced flucloxacillin clearance from 143 to 46.9 L/h. Simulations showed markedly improved PTA for flucloxacillin 1 g 8 hourly with probenecid (84%) compared with 1 g 6 hourly alone (6%). Urinary flucloxacillin concentrations were reduced with probenecid, consistent with decreased renal clearance. Serum creatinine concentrations and urinary biomarkers remained stable, and only non-serious adverse events were reported. Co-administration of probenecid significantly enhanced flucloxacillin exposure, without serious adverse effects. These findings warrant evaluation in a clinical trial of patients with MSSA infection. Clinical trial registered with ANZCTR: ACTRN12623001155684.
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Nurse counselors play a pivotal role in recruiting and facilitating the retention of volunteers in HIV vaccine trials. They act as the primary interface between the research team and volunteers, typically tasked with educating, supporting, and guiding participants through the trial process, including adherence to the study protocol for care and safety. There is limited research on the series of experiences and challenges faced by nurse counselors during the recruitment and retention of volunteers in HIV vaccine trials. This study aimed to describe the experiences of nurse counselors in recruiting and retaining female sex workers in the HIV PrEP and Vaccine (PrEPVacc) trial. This employed a descriptive qualitative study design nested within the larger phase IIb three-arm, two-stage HIV prophylactic vaccine trial conducted in Dar es Salaam, Tanzania. The qualitative data were collected among three nurse counselors and one field worker who participated in 16 debrief sessions. The participants were purposefully selected due to their roles and responsibilities in the recruitment and retention of volunteers. The audio-recorded sessions were transcribed verbatim, and the content analysis approach was applied. The study revealed that nurse counselors felt responsible and honored through enhancing volunteers' recruitment and enrollment, ensuring retention, and facilitating trial interventions. The availability of a supportive trial environment, engagement meetings, collaboration among staff and volunteers, good staff performance, and volunteers' positive attitude were the qualities for effective management of volunteers in the trial. However, the participants described encountering barriers to trial recruitment and retention, such as volunteers' noncompliance with trial requirements, perceived lack of honesty, personal life and family resistance, stigma, and social perception. The nurse counselors can encounter great turmoil while ensuring recruitment and retention in an HIV vaccine trial. Despite the challenges, volunteer engagement and adherence to study protocol are important for maintaining the continuity of trial procedures over time. Collaboration among staff and engagement of volunteers are essential to enhancing retention until the end of the study. The trial was registered with the US clinicaltrials.gov on 29 September 2021 and can be found at https://clinicaltrials.gov/study/NCT04066881. NCT04066881.
Microplastic pollution poses a global threat to all marine ecosystems, and citizen science provides a valuable method for monitoring its presence and distribution. However, volunteers lack access to costly and complex laboratory techniques, such as Raman and FTIR spectroscopy, for accurate identification of microplastics. The purpose of the study was: 1) to develop a simple, low-cost, and field-adaptable protocol that allows volunteers to identify and quantify microplastics by distinguishing them from organic matter and non-plastic materials based on their melting behaviour, and 2) to examine the polymer composition. A dedicated support tool and thermal verification method were developed and tested in the laboratory before field trials. Samples were collected with a Manta net during the 2024 and 2025 Expedition MED campaigns in the Mediterranean Sea, followed by wet sieving, visual characterisation, and thermal deformation analysis. The identification error rate was determined by measuring the proportion of visually selected particles that failed to melt during the thermal verification. Trials involving 39 volunteers showed that the melting verification method effectively reduces misidentification, thereby decreasing the overestimation of microplastic particles. In the 2024, 926 were tested with a 4.6% error rate. By comparison, the 3,421 particles tested in 2025 yielded a higher error rate of 8.8% due to a much higher concentration of microplastics and a greater proportion of particles in the smallest size classes (e.g., < 2.5 mm). Citizen scientists from diverse socio-demographic backgrounds successfully applied the protocol in the field after a mentored training, demonstrating that volunteers can contribute meaningfully to both the collection and analysis of microplastics by providing accurate results comparable to laboratory research. Overall, this approach offers a reliable and accessible method to improve data quality in citizen science microplastics research.
BackgroundWhole-body (WB) magnetic resonance imaging (MRI) is increasingly being used in children and often includes the paranasal sinuses.PurposeTo examine the prevalence of paranasal sinus opacifications by age and over time, as seen on WB-MRI.Material and MethodsProspective, population-based, bi-center study including healthy volunteers aged 6-18 years, undergoing WB-MRI (1.5 T) for research purposes only during 2018-2020, of whom 88 had a follow-up after a mean of 88 days. Paranasal sinuses and mastoid complexes were assessed separately for symmetry, presence of a nasal septal spur, bullous or inverted conchae, mucosal thickness, and presence/thickness of fluid levels. Opacification was graded on a scale of 0-3, as none/<2 mm, <33%, 33%-65%, and 66%-100% and according to the Lund-Mackay scoring system.ResultsA total of 171 volunteers (85 boys; mean age=11.9 ± 3.3 years) were included. On a 0-3 scale, 120/171 (70.2%) participants had opacification grade ≥1 in at least one paranasal sinus (67.8%) or mastoid air cell (6.4%). Corresponding findings for each sinus pair separately were 51.4% of the maxillary, 39.2% of the ethmoid, 23.4% of the sphenoid, and 4.7% of the frontal sinuses. Mean Lund-Mackay score for the initial scans was 2.85, with 47/171 (27.5%) scoring ≥4; 40.9% had a score of 0 or 1. In the majority, the grade of opacification remained stable over time.ConclusionThe prevalence of paranasal sinus opacifications in healthy 6-18-year-olds is high, with nearly one-third having a Lund-Mackay score ≥4, which, in a clinical setting, supports a diagnosis of rhinosinusitis.
Prothrombin time (PT) and activated partial thromboplastin time (aPTT) are widely used coagulation assays whose results can vary due to pre-analytical and analytical factors. Understanding these sources of variability is essential for reliable laboratory practice and external quality assessment (EQA). This study evaluates the impact of pre-analytical storage and method-dependent sensitivity on PT and aPTT measurements and provides guidance for EQA programmes and clinical interpretation. Plasma samples from 42 healthy volunteers were analysed within 4 h of collection or after storage at -20 °C, -80 °C, or snap-frozen in liquid nitrogen (LN₂) and subsequent storage at -80 °C. Additionally, pooled plasma was spiked with direct oral anticoagulants, heparins, and lupus anticoagulant antibodies to assess reagent-specific sensitivity. PT and aPTT were measured on multiple routine platforms using commonly used reagents from 4 different manufacturers. Storage at -80 °C or LN₂ preserved PT and aPTT values, whereas storage at -20 °C caused variable prolongation. In healthy volunteers, PT and aPTT showed marked inter-method variability. Sensitivity to anticoagulants and lupus anticoagulant also differed considerably between reagents, with the largest variation observed for edoxaban. This study provides an overview of inter-method variability, which may affect clinical decision-making and inter-laboratory comparability. PT and aPTT are screening tests whose accurate interpretation depends on optimal sample handling and awareness of reagent- and method-specific sensitivities. These differences can affect clinical decision-making in anticoagulated patients. EQA programmes could increase their value by using frozen plasma, including clinically relevant anticoagulants, and implementing case-based scenarios rather than reporting only clotting times.
To evaluate whether super-resolution deep learning reconstruction (SR-DLR) improves two-dimensional (2D) brain fluid-attenuated inversion recovery (FLAIR) image quality while preserving automated white matter hyperintensity (WMH) volumetry, compared with Gaussian-filtered reconstruction (GA) and denoising DLR (dDLR). Thirty-six healthy volunteers underwent 3T axial 2D FLAIR. Images were reconstructed using GA, dDLR, and SR-DLR (twofold in-plane upscaling). Quantitative metrics (noise, SNR, CNR, sharpness) were measured in standardized regions of interest. Two radiologists independently scored qualitative image quality. In a WMH-positive subgroup, WMH volumes were obtained using a transformer-based U-Net segmentation model on GA, dDLR, SR-DLR, and a high-resolution acquisition (HR-dDLR). Quantitative image-quality metrics were compared using one-way ANOVA, WMH volumes using paired t-tests, and interobserver agreement using weighted kappa. SR-DLR demonstrated the lowest image noise and the highest SNR, CNR, and sharpness compared with GA and dDLR (all p < 0.001). Qualitative scores for noise, sharpness, and overall image quality were significantly higher for SR-DLR (p < 0.001), with perfect inter-observer agreement for sharpness and overall quality. Mean WMH volumes did not differ significantly across reconstructions, and SR-DLR volumes closely matched those of HR-dDLR. SR-DLR substantially improves 2D brain FLAIR image quality at 3T by reducing noise and increasing SNR, CNR, and sharpness while preserving WMH volumetry consistent with high-resolution reference standards.
Alzheimer's disease (AD) is associated with retinal amyloid-related changes, which may help identify amyloid positron emission tomography (PET) positive (+) individuals. Previously, in a small cross-sectional study, we reported higher retinal spot counts (RSCs) in preclinical amyloid PET (+) individuals screened for the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) trial compared to control individuals enrolled in the Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) trial before drug treatment. Eligible volunteers had retinal scans 48 hours after consuming curcumin. Scans were processed and quantified via NeuroVision. Participants were grouped by amyloid status and treatment to assess the effect of solanezumab on RSC. RSC did not differ significantly over time between groups and was not modified by treatment, diverging from the cross-sectional retinal amyloid findings observed in A4/LEARN. Curcumin-based retinal amyloid labeling shows promise but needs standardized protocols and validation in larger cohorts to understand its relationship to amyloid PET.
Although the use of laser Doppler perfusion imaging has a potential application to monitor internal load associated to exercise, its use in sport science is scarce and the relatively long scanning time required for each region of interest may constrain its use. The aim of this study was to evaluate the effect of running on skin perfusion five hours after exercise across different regions of interest in the lower limbs, and to examine the relationship between these perfusion responses and changes in other physiological and environmental outcomes. A total of 22 volunteers were divided into two groups: an exercise group, which performed a 50-min outdoor run between measurements, and a control group. Skin perfusion (laser Doppler perfusion imaging device, moorLDI2) and skin temperature (infrared thermography, Flir E54) in 6 regions of interest (anterior thigh, anterior knee, anterior leg, posterior thigh, posterior knee and posterior leg), heart rate and heart rate variability (Polar H10) and estimated core temperature (heat flux, Calera Research) were measured before and 5 hours after running in an outdoor temperature of 28 -31 °C. The exercise group presented a higher increase of skin perfusion than the control group for the anterior thigh (95%CI[7, 58%], p=0.02 and ES = 1.0), anterior leg (95%CI[1, 79%], p=0.04 and ES = 0.3), and posterior thigh (95%CI[8, 56%], p<0.01 and ES = 0.5). A regression model obtained (R2 = 0.22) showed how a greater increase in skin perfusion was associated with a higher maximum estimated core temperature during exercise, a higher variation of estimated core temperature at rest and a higher variation of skin temperature. The posterior leg was one of the ROIs with the greatest skin perfusion increase. In conclusion, the anterior thigh can be considered the most appropriate region for evaluating post-exercise skin perfusion responses following aerobic running under warm environmental conditions. These responses are primarily related to the thermal stress generated by the exercise and the environmental conditions.
Hypertension is a leading cause of cardiovascular disease and premature mortality, disproportionately affecting low- and middle-income countries such as Nepal, where awareness, treatment, and control remain low. Female Community Health Volunteers (FCHVs) have been effective in maternal and child health programs and may support noncommunicable disease management. This hybrid type 2 effectiveness-implementation study evaluated the effectiveness and implementation outcomes of an FCHV-led intervention for hypertension prevention and control in rural Nepal. We conducted a cluster randomized controlled trial (ClinicalTrials.gov: NCT06163859) in Namobuddha Municipality, Nepal, randomizing 12 public primary healthcare facilities (1:1) to intervention or control arms. In intervention clusters, 34 FCHVs delivered a community-based hypertension program through bi-monthly group sessions over three months, including blood pressure monitoring, health education, lifestyle counseling, medication adherence support, and referral for uncontrolled hypertension. Implementation strategies were developed using an Implementation Research Logic Model and stakeholder consultations. Adults aged 30-75 years with elevated blood pressure were recruited through community screening. Implementation outcomes were assessed using the RE-AIM framework and effectiveness outcomes at three months. Analyses followed intention-to-treat principles using generalized estimating equations. Reach was 56.9%, with higher male participation than female participation (63.5% vs. 50.4%; p = 0.045). Adoption was 100% across facilities. Fidelity was moderate, with 76.5% attending at least four of six sessions and 71.1% of meetings achieving at least 70% attendance. No significant differences were observed in systolic blood pressure, diastolic blood pressure, or hypertension control. However, the intervention significantly improved hypertension knowledge and treatment adherence. The FCHV-led intervention was feasible and achieved moderate reach, universal adoption, and reasonable fidelity. Although blood pressure outcomes did not improve over three months, longer interventions with sustained support may improve clinical outcomes and support scale-up within Nepal's noncommunicable disease program.
Synaptic plasticity markers are known to be altered in schizophrenia. The objectives of the study were to analyse neurexin-3 levels and their relation with severity in schizophrenia. A total of 216 schizophrenia patients and 216 healthy volunteers were enrolled. Neurexin-3 was analysed by enzyme-linked immunosorbent assay. The severity of schizophrenia was determined using the Positive and Negative Syndrome Scale (PANSS) scores. Neurexin-3 levels were significantly reduced (p < .001) and positively associated with negative symptom score (p = .037), general psychopathological score (p = .025) and total PANSS score (p = .019) in schizophrenia cases. Neurexin-3 was significantly increased (p < .05), and disease duration (p < .05) was significantly reduced in schizophrenia patients with marked illness compared to those with mild illness. We conclude that neurexin-3 is reduced and is associated with the severity of schizophrenia.
Malaria is responsible for more than half a million deaths each year. Parenteral artesunate is the recommended first-line treatment for severe malaria, but prompt treatment is often delayed affecting patient outcomes. Rectal artesunate is recommended as a pre-referral treatment but shows variable absorption and can be problematic when treating children with gastrointestinal disturbances. Nasal drug administration offers a non-invasive and user-friendly alternative that enables rapid drug absorption. A Phase I, first in human trial was conducted to evaluate the safety, tolerability and pharmacokinetic properties of increasing doses of a novel intranasal formulation of artesunate powder. Three dosing regimens were assessed in adult volunteers. Plasma samples were collected for up to 24 h post-dose for drug measurements of artesunate and dihydroartemisinin. Intranasal artesunate was safe and well tolerated. Only mild adverse events were reported shortly after drug administration. No severe adverse events were observed. Pharmacokinetic analysis confirmed rapid systemic absorption of artesunate but with high inter-individual variability. Dose-normalized exposures to dihydroartemisinin suggested a non-linear dose-exposure relationship. Further evaluation of this novel formulation of artesunate is needed to establish safety and efficacy in patients with malaria. This, first in human, phase 1 provides justification for subsequent phase 2 clinical trials.
This randomized clinical study aimed to assess implant placement accuracy and radiographic outcomes of computer-guided versus freehand ridge split and expansion with simultaneously inserted implants in patients with horizontally deficient maxillary anterior ridges over a 2-year follow-up period. Twenty-two volunteers were randomly allocated (1:1) to either a computer-guided or a freehand group. The primary outcome was implant placement accuracy. Secondary outcomes included postoperative complications, marginal bone loss, horizontal ridge width changes, and peri-implant defect resolution. All parameters were evaluated radiographically at baseline, immediately after surgery, and at 3, 6, 12, and 24 months. The computer-guided group demonstrated lower angular deviation versus the freehand group (1.45 ± 0.43° vs. 10.02 ± 3.24°; p < 0.001) and entry point deviation (0.54 ± 0.19 mm vs. 2.16 ± 0.31 mm; p < 0.001). Depth deviation showed a non-significant difference. Three, six, and twelve months after surgery, the freehand group exhibited higher marginal bone loss (1.02 ± 0.13, 1.57 ± 0.13, 1.58 ± 0.13, and 1.73 ± 0.17 mm, respectively) than the computer-guided group (0.27 ± 0.13, 0.35 ± 0.13, 0.36 ± 0.13, and 0.39 ± 0.15 mm, p < 0.001). The computer-guided approach also was associated with minimal ridge collapse and enhanced peri-implant defect fill. The present preliminary findings suggest that computer-guided ridge split and expansion were associated with improved implant placement accuracy and peri-implant hard tissue preservation compared with the conventional freehand approach over 2 years. Both techniques achieved successful implant outcomes without major complications. However, these observations should be interpreted cautiously as preliminary evidence requiring external validation, given the limited sample size, single-operator design, and mid-term follow-up duration. Multicenter studies with larger cohorts and longer follow-up are required before confirming definitive clinical superiority. The present preliminary findings suggest that integrating the digital workflow into ridge split and expansion may enhance surgical precision and peri-implant hard tissue stability in narrow maxillary ridges. Nevertheless, the potential advantages of the guided approach require confirmation through larger, well-designed clinical trials before recommending widespread, routine clinical implementation. The study was prospectively registered in the ClinicalTrials.gov registry (Identifier: NCT06135506) on 11/11/2023 under the title "Artificial Intelligence/Computer Guided Ridge Splitting for Treating Horizontal Ridge Defects." gov PRS: Record Summary NCT06135506.
Aedes vexans, a widespread mosquito species in Germany, is a major nuisance pest and a demonstrated or putative vector of numerous pathogens affecting humans and animals. To document its spatial and temporal occurrence, both passive and active mosquito monitoring programmes have been conducted across Germany.Passive monitoring is carried out through the citizen-science project "Mückenatlas", in which volunteers collect and submit mosquito specimens from across the country. All citizen-collected specimens are subsequently identified by professional entomologists. Active monitoring is performed by experts using a variety of standardised entomological methods, including trapping, aspirating and netting adults, as well as sampling larvae and pupae by dipping and sieving. Portions of the resulting dataset have already been used in scientific publications. This data paper presents a comprehensive dataset on the occurrence of Aedes vexans in Germany, comprising 6,422 records collected between 26.04.2011 and 21.11.2023. Of the total occurrence records, 2963 originate from citizen-science contributions, while the remainder derive from active monitoring efforts. The dataset documents 225,565 individual mosquitoes from 2,784 distinct locations.