METHODS AND DESIGN: The Fuzzy Delphi Method (FDM) is utilised to gather insights from a panel of experts in nephrology, psychology, Islamic studies, and VR technology. A total of 11 experts was selected based on their expertise and experience in relevant domains to ensure the credibility and validity of the findings.
RESULTS: Key themes emerging from the study include VR's potential to create immersive and meaningful spiritual experiences, alleviate psychological distress, and enhance coping mechanisms. Factors concerning accessibility, cultural sensitivity, and integration into clinical settings are also highlighted as important considerations.
CONCLUSION: The study explores how VR technology can aid Muslim haemodialysis patients in spiritual routines. It underscores the significance of holistic healthcare methods in addressing patients' spiritual and psychological needs. Future research should aim to develop VR-based therapies tailored for these patients while considering practical and ethical challenges in medical settings.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The findings of this study have significant practical implications for designing and implementing VR interventions in healthcare settings. Developing VR content that is culturally sensitive and aligned with Islamic practices is crucial for its acceptance and effectiveness. Integrating VR into the spiritual practices of Muslim haemodialysis patients also raises ethical and pragmatic considerations.
PATIENT OR PUBLIC CONTRIBUTION: No patient or public contributions were made in this study.
AREAS COVERED: We summarize the development and a quarter-century of real-world evidence with palivizumab. We highlight its positive impact on the burden of RSV in high-risk children. Based on lessons learnt from its implementation, we suggest strategies for effective and equitable deployment of newer RSV preventives.
EXPERT OPINION: Following failure of the formalin-inactivated RSV vaccine in 1967, RSV intravenous immunoglobulin was approved in 1996 after three decades' research. Subsequently, palivizumab emerged as the most effective and safe RSV preventive, demonstrated by the IMpact trial, and was licensed in 1998 in the United States. Over the last 25 years, the benefits of palivizumab have been firmly established through a wealth of evidence, predominantly from high-income countries (HICs). To achieve a global impact with the newer RSV preventives, evidenced-based universal guidelines must be developed and endorsed by regulatory authorities and relevant scientific societies. Independent economic evaluations should incorporate all RSV-associated healthcare costs, reduction of long-term respiratory sequelae, and standardized outcomes. Most importantly, equity in product availability and implementation, particularly in low- and middle-income countries (LMICs) is essential.
METHODS: In our study, we investigated the projections from the LPBn by performing stereotaxic injections of AAV2/2Retro-hSyn-EGFP (abbreviated as EGFP) into the bed nucleus of the stria terminalis (BNST) and AAV2/2Retro-hSyn-tdTomato (abbreviated as tdTomato) into the central amygdala (CeA) in mice. The animals subsequently underwent spared nerve injury (SNI) surgery on the contralateral side to the AAV injections. To examine the expression of calcitonin gene-related peptide (CGRP) and c-Fos, we conducted immunofluorescent histochemistry.
RESULTS: Our results indicated that approximately 26 % of the LPBn neurons retrogradely labeled with either EGFP or tdTomato were dual-labeled with both markers. Moreover, a significant majority (85.49 %) of these double-labeled neurons were CGRP positive (CGRP+). In mice subjected to SNI, nearly all of these neurons (93.25 %) were c-Fos positive (c-Fos+), indicating that they were activated.
CONCLUSION: These findings suggest that a subset of CGRP+ neurons in the LPBn projects to both the BNST and CeA via axon collaterals. Notably, under SNI conditions, these neurons may play a critical role in the transmission of chronic pain.
METHODS: We included a MASLD cohort from 16 centers, including 3273 individuals with baseline histology and 5455 with serial vibration-controlled transient elastography measurements during the follow-up. "Burnt-out" MASLD was defined by steatosis grade ≤S1 and fibrosis stage ≥F3. Trajectory analysis identified "burning-out" patients with continuous trends of decreasing controlled attenuation parameter and increasing liver stiffness measurement values.
RESULTS: Of 3273 patients with histologic evaluation included, 435 had "burnt-out" MASLD. Compared with those with pronounced steatosis in advanced fibrosis, patients with "burnt-out" had higher risks of all-cause mortality (hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.14-4.02), liver-related events (LREs; HR, 1.77; 95% CI, 1.12-2.78), and hepatic decompensation (HR, 1.83; 95% CI, 1.11-3.01). Of 5455 patients with vibration-controlled transient elastography included for trajectory analysis, 176 were identified as "burning-out" MASLD. The incidence rates of all-cause mortality, LREs, and decompensation were 7.28, 26.47, and 21.92 per 1000 person-years in "burning-out" patients, respectively. The "burning-out" group had higher cumulative incidences of adverse outcomes than patients with consistently high controlled attenuation parameter and moderate/low liver stiffness measurement values (P < .0001).
CONCLUSIONS: Continuous hepatic fat loss accompanied by fibrosis progression, referred to as "burning-out," was observed in advanced MASLD and associated with high rates of all-cause mortality, LREs, and hepatic decompensation.
OBJECT: The ethanolic extract of Rhodiola rosea roots, rich in bioactive compounds like alkaloids and flavonoids, was optimized into a phytosomal complex to improve absorption and dermal retention.
METHOD: Characterization through GC-MS revealed compounds, such as 2-Heptadecenal and Bicyclo[ 4.1.0]Heptane and 7-Pentyl. FTIR confirmed the successful encapsulation within the phospholipid bilayer, while SEM showed smooth, spherical particles.
RESULT: The Box-Behnken design optimized formulation parameters, achieving high yield (92.64%), small particle size (355 nm), and high entrapment efficiency (93.98%). In vitro release studies displayed a consistent release profile, aligning with Zero-order and Hixson-Crowell models. In vivo evaluation on Wistar rats showed that the phytosomal gel significantly enhanced wound healing, achieving 98.16% wound reduction by day 14, compared to 95.17% for R. rosea extract and 97.13% for standard treatment. Histopathological analysis demonstrated complete tissue regeneration and well-organized collagen fibers in the phytosomal gel group.
CONCLUSION: This research highlights the potential of Rhodiola rosea phytosomal gel as an effective wound healing therapy, with future studies suggested for extended stability tests and human skin permeation studies.