OBJECTIVES: To evaluate PROs from the phase 3 explorer8 study (NCT04082429).
METHODS: Male patients aged ≥12 years with HA/HB without inhibitors were enrolled and randomized 1:2 to no prophylaxis/on-demand treatment (arm 1) or concizumab prophylaxis (arm 2) or allocated to concizumab prophylaxis (arms 3 and 4). PRO questionnaires included the 36-item short-form health survey version 2, Haemophilia Quality of Life Questionnaire for Adults, Hemophilia Treatment Experience Measure, and Haemophilia Patient Preference Questionnaire.
RESULTS: Estimated treatment difference for change in 36-item short-form health survey version 2 "bodily pain" and "physical functioning" from baseline to week 24 between patients in arms 1 and 2 was 9.5 points (95% CI, 2.4 to 16.7) and 0.3 points (95% CI, -5.1 to 5.6), respectively. Estimated treatment difference at week 24 between patients in arms 1 and 2 was -18.0 points (95% CI, -26.4 to -9.5) for Haemophilia Quality of Life Questionnaire for Adults "total score" and -16.8 points (95% CI, -32.2 to -1.4) for "physical health." Hemophilia Treatment Experience Measure and Haemophilia Patient Preference Questionnaire results favored concizumab prophylaxis over no prophylaxis or previous treatment.
CONCLUSION: PRO data from the phase 3 explorer8 study provided additional support for concizumab prophylaxis compared with no prophylaxis as a treatment option for patients with HA/HB.
METHOD: Addressing the research question-What constitutes the core elements of anatomy-related competency for safe clinical practice in preclinical undergraduate medical curricula?-the review adhered to the Joanna Briggs Institute scoping review framework. Employing a rigorous three-step search strategy across three electronic databases (EBSCOhost, PubMed, Google Scholar, and Scopus), two independent reviewers screened abstracts and full-text studies for inclusion. Extracted data encompassed bibliographic details, study characteristics, and potential elements of anatomy competency, analyzed using a tool developed iteratively by the research team.
RESULTS: The identified competency elements were classified into five domains: cognitive, psychomotor, affective, professional behavior, and personal skill competencies. Within each domain, subdomains elucidate specific elements crucial for students to master for proficiency in anatomy.
CONCLUSIONS: This review outlines essential anatomy competencies for safe clinical practice, categorizing them into domains and subdomains to strengthen the curriculum. It also provides educators with key competencies for seamless integration into teaching, enhancing anatomy education.
OBJECTIVE: The primary aim was to develop recommendations on the minimum essential DMTs for MS that should be available in low-resource settings.
METHODS: The Multiple Sclerosis International Federation established an independent, international panel including healthcare professionals and people with MS. This panel, in collaboration with the Cochrane MS Group and McMaster GRADE Centre, reviewed evidence for use of MS DMTs following standardized GRADE protocols including consideration of balance of benefits and harms; certainty of evidence; resources required and cost-effectiveness and values, equity, feasibility and availability in low-resource settings.
RESULTS: For active and/or worsening forms of relapsing MS, the panel recommends use of ocrelizumab, cladribine, fingolimod, dimethyl fumarate, interferon beta and glatiramer acetate. For active and/or worsening forms of progressive MS, the panel recommends use of rituximab, ocrelizumab, glatiramer acetate, fingolimod and interferon beta.
CONCLUSIONS: Recommendations for the minimum essential DMTs for MS in low-resource settings were developed based on robust consideration of evidence and relevant context.
RECENT FINDINGS: There were more Asian studies which reported lower prevalence (0-20%), in contrast to higher rates in Europe, particularly Mediterranean countries. Urbanization, air pollution, and high dust mite exposure may be important factors of nonatopic rhinitis in Asia. Diagnostic approaches, including nasal-specific IgE and provocation tests, vary across studies, impacting prevalence estimates.
SUMMARY: The lower reported LAR prevalence in Asia suggests potential differences in underlying mechanisms or diagnostic limitations. Further research is needed to refine diagnostic criteria, explore environmental triggers, and assess the clinical relevance of LAR in Asian populations. A better understanding of LAR in Asia could guide targeted management strategies and improve recognition of this condition in clinical practice.
AIM: To chart the research on post-stroke cognitive impairment and dementia (PSCID) in SEA.
METHODS: The review was conducted and reported using the PRISMA-ScR. A comprehensive search was performed across six databases: CINAHL, Scopus, Embase, PubMed, Web of Science, and APA PsycINFO. The last search date was September 15, 2024.
RESULTS: 9118 references were identified, and 103 articles (from 78 studies) published between 1992 and 2024 were included. Singapore contributed 42 articles, followed by Indonesia with 28, Malaysia with 17 and Thailand with 15. 35 articles each were from cohort and cross-sectional studies, and 13 were case-control design articles. In Indonesia, the prevalence of post-stroke cognitive impairment (PSCI) ranged from 27.6 % to 81.2 %. In Malaysia, it was between 21.6 % and 76 %; in Singapore, it varied from 12 % to 57.2 %; and in Thailand, between 50.3 % and 55 %. The prevalence of post-troke dementia varied between 2.8 % and 48.4 % in the sources. The most risk factors associated with PSCID included increasing age and low levels of education. Mixed findings on the effectiveness of the limited management strategies for PSCI were reported. The region lacks research from low- and lower-middle-income countries (LLMICs). Moreover, thorough research on how PSCID affects survivors' quality of life (QoL) is deficient.
CONCLUSION: PSCID is common in SEA, requiring urgent interventions for improved QoL for survivors. More research focusing on low- and middle-income countries is needed.
METHODS: We used 26 country-validated Optima HIV models (Albania, Armenia, Azerbaijan, Belarus, Bhutan, Cambodia, Colombia, Costa Rica, Côte d'Ivoire, Dominican Republic, Eswatini, Georgia, Kazakhstan, Kenya, Kyrgyzstan, Malawi, Malaysia, Moldova, Mongolia, Mozambique, South Africa, Sri Lanka, Tajikistan, Uganda, Uzbekistan, and Zimbabwe). HIV incidence and mortality were projected across 2025-30 for a status quo scenario (most recent HIV spending continued) and four additional scenarios capturing the effects of anticipated international aid reductions for HIV prevention and testing, plus additional effects on treatment and facility-based testing resulting from immediate discontinuation of President's Emergency Fund for AIDS Relief (PEPFAR) support. Country-specific effects were estimated using sources of country-reported HIV funding. We disaggregated outcomes for children, adults in the general population, and adults in key populations. We extrapolated the scenario outcomes to all low-income and middle-income countries (LMICs) based on the modelled proportion of globally reported international aid by source (the 26 countries representing 49% of overall aid and 54% of PEPFAR aid). Upper and lower bounds reflected different mitigation and absorption assumptions.
FINDINGS: Across all LMICs, an anticipated 24% weighted average of international aid reductions plus discontinued PEPFAR support could cause an additional 4·43-10·75 million new HIV infections and 0·77-2·93 million HIV-related deaths between 2025 and 2030 compared with the status quo. If PEPFAR support could be reinstated or equivalently recovered, this reduced to 0·07-1·73 million additional new HIV infections and 0·005-0·061 million HIV-related deaths. The effects were greatest in countries with a higher percentage of international funding and in those with increasing incidence of HIV among key populations.
INTERPRETATION: Unmitigated funding reductions could significantly reverse progress in the HIV response by 2030, disproportionately affecting sub-Saharan African countries and key and vulnerable populations. Sustainable financing mechanisms are crucial to ensure people have continued access to HIV prevention, testing, and treatment programmes, thereby reducing new HIV infections and deaths.
FUNDING: None.
METHODS: A comprehensive search was conducted across PubMed, Embase, and Web of Science for studies published up to September 20, 2024. Observational studies assessing the association between ENDS use and COPD risk were included. A random-effects meta-analysis was performed using R statistical software (version 4.4). Tobacco smoking, a key confounder in COPD research, was accounted for in many included studies, with adjustments varying across studies.
RESULTS: Fifteen studies met the inclusion criteria. The pooled odds ratio (OR) for current ENDS use and COPD risk was 1.488 (95 % CI: 1.363-1.623). Former ENDS users had an OR of 1.839 (95 % CI: 1.513-2.234), and ever-users had an OR of 1.787 (95 % CI: 1.421-2.247). Sensitivity analyses confirmed the robustness of findings, and no publication bias was detected.
CONCLUSION: This meta-analysis provides evidence of a significant association between ENDS use and increased COPD risk, even after adjusting for tobacco smoking. Future research should standardize smoking adjustments and investigate the independent impact of ENDS use on COPD.
METHODS: The antibacterial activity of leaf extracts of M. cajuputi was assessed using the broth microdilution assay. Scanning electron microscopy (SEM) was used to investigate the effects of MAE on the morphology of bacterial cells. Meanwhile, the chemical composition of the MAE was analyzed using Fourier transform infrared (FTIR) spectroscopy and gas chromatography-mass spectrometry (GC-MS). AutoDock Vina was used for molecular docking analysis to unveil the interactions between the ligands and the active sites of the target bacterial proteins.
RESULTS: The crude extracts were obtained through cold maceration. The methanolic extract demonstrated the most significant antibacterial activity, with minimum inhibitory concentration (MIC) values spanning 0.25 mg/mL to 2 mg/mL. After 12 h of treatment with 1 × MIC of the methanolic extract, the bacteria showed discernible morphological alterations, including disrupted cell wall and membrane integrity. Thirty compounds were identified in the MAE and subsequently subjected to molecular docking studies against target bacterial proteins. Amongst the compounds, methylanthracene, cycloisolongifolene, diphenyl imidazole, benzil monohydrazone, and trimethoxybenzoic acid showed pronounced binding affinities towards Klebsiella pneumoniae membrane protein (PDB ID: 5O79), peptide binding protein (PDB ID: 7RJJ), Streptococcus agalactiae cell wall surface anchor (PDB ID: 2XTL), pilin (PDB ID: 3PHS), Staphylococcus aureus transglycosylase (PDB ID: 3VMQ), and penicillin-binding proteins (PDB ID: 3VSK). The binding energy scores for these interactions varied between - 6.0 kcal/mol and - 7.5 kcal/mol. Molecular dynamics simulations validated the stability of these interactions, reinforcing the in vitro findings of cell wall and membrane disruption.
CONCLUSION: The findings of this study indicated that the methanolic extract of M. cajuputi leaves displayed potent antibacterial activity against Klebsiella pneumoniae, S. agalactiae, and S. aureus. The molecular docking analysis reveals significant binding interactions between the identified compounds and the target bacterial proteins, highlighting the potential of M. cajuputi as a novel source of anti-infectives targeting bacterial infections.
OBJECTIVE: We aimed to describe the needs and perspectives of older adult stroke survivors regarding a stroke app.
METHODS: We employed an empirical phenomenological approach for a qualitative study. Using purposive and snowball sampling, older adult stroke survivors were recruited from three tertiary hospitals in Hunan province. Face-to-face semi-structured interviews were conducted between August and October 2024. Data were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method.
FINDINGS: Thirteen older adult stroke survivors (eight men and five women aged 63-84 years) participated in the study in China. Three main categories and ten subcategories were extracted. The themes were the following: (1) optimism about the app (a good thing and eager to use); (2) desire for an app tailored to the unique (particular to older adults, information at fingertips, and reminding); and (3) concern (privacy issues, more depersonalized interactions with their doctors, the validity of the information provided on the app, cost, and having problems in using the app).
CONCLUSION: This study pinpointed crucial factors from users' needs and perspectives that should be considered in developing a mobile app for older adult stroke survivors. Future research on app development should gather users' needs and preferences to enhance acceptability and increase the likelihood of successful implementation.
METHOD: The review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis - Scoping Review extension. Two authors extracted data items from 45 eligible studies.
RESULTS: Three research aims were identified in previous studies: examining the effects of learning-related factors on attention captured by portable EEG (n = 23), developing attention classification algorithms (n = 7) and software for monitoring and promoting attention (n = 10), and verifying the signal quality of EEG derived from portable EEG in attentional tasks (n = 5). The testing sites and tasks were predominantly out-of-lab controlled settings and structured learning materials. To quantify attention, 8 studies employed a theory-driven approach, e.g., using EEG measures based on prior research correlating specific spectral power with attention. In contrast, 37 studies used data-driven approaches, e.g., using spectral power as input features for machine learning models to index attention.
DISCUSSION: Portable EEG has been a promising approach to measuring attention in educational settings. Meanwhile, there are challenges and opportunities related to the better translation of cognitive neuroscience research into practice.