AIM: This study aimed to evaluate a blended online and offline teaching module for surgical nursing apprenticeship using the Learning Pass mobile application.
DESIGN: A clustered randomised control trial was conducted among 166 nursing students at a university.
METHODS: The intervention group received online and offline blended teaching methods using the Learning Pass mobile application (n = 83), while the control group used traditional face-to-face teaching methods (n = 83). Participants were assessed on self-directed learning ability before and after the experiment. Skill performance and learning attitude were measured post-experiment.
RESULTS: A significant increase in self-directed learning ability was observed in the intervention group compared with the control group (t = 2.379, p = 0.019). The skill scores also showed a significant increase in the intervention group compared with the control group (t = 3.623, p
METHODS: Using territory-wide public electronic health records in Hong Kong, patients older than 60 years with chronic kidney disease and with hyperlipidaemia (defined as elevated LDL cholesterol of ≥2·6 mmol/L) were identified for inclusion in the analyses and were included on a rolling basis in each calendar month from January, 2008, to December, 2015. Patients were categorised into different age groups (ie, 60-74 years, 75-84 years, and ≥85 years) for analysis, and the 60-74 years age group was used as a benchmark group to test the validity of our emulated trial since the effect of statin therapy is well established in this age group. The framework of target trial emulation was adopted to investigate the association between statin therapy and the risk of overall cardiovascular disease incidence, specific cardiovascular disease subtypes (ie, myocardial infarction, heart failure, and stroke), and all-cause mortality, as well as major adverse events (ie, myopathies and liver dysfunction). The primary outcome was overall cardiovascular disease incidence. The hazard ratios for the outcomes were estimated by pooled logistic models in the intention-to-treat analysis and the per-protocol analysis.
FINDINGS: 711 966 person-trials from 96 trials were eligible for inclusion in the study. 19 423 unique individuals with chronic kidney disease aged 60-74 years, 22 565 unique individuals with chronic kidney disease aged 75-84 years, and 8811 unique individuals with chronic kidney disease aged 85 years and older were identified for inclusion in the analyses. In patients aged 75-84 years, a significant risk reduction was observed for overall cardiovascular disease incidence in both the intention-to-treat analysis (hazard ratio [HR] 0·94 [95% CI 0·89-0·99]) and in the per-protocol analysis (0·86 [0·80-0·92]) and for all-cause mortality (0·87 [0·82-0·91] in the intention-to-treat analysis and 0·78 [0·72-0·84] in the per-protocol analysis). This risk reduction was also observed among patients aged 85 years and older for cardiovascular diseases (HR 0·88 [0·79-0·99] in the intention-to-treat analysis and 0·81 [0·71-0·92] in the per-protocol analysis), and for all-cause mortality (0·89 [0·81-0·98] in the intention-to-treat analysis and 0·80 [0·71-0·91] in the per-protocol analysis). Substantial risk reduction for myocardial infarction, heart failure, and stroke were also observed across all age groups. No significantly increased risk of myopathies or liver dysfunction was observed in any of the age groups.
INTERPRETATION: Statin therapy is beneficial for hypercholesterolemic older patients with chronic kidney disease aged 75 years and older regarding the primary prevention against cardiovascular diseases and all-cause mortality, without posing an increased risk of major adverse events. The benefits and safety persist in those aged 85 years and older.
FUNDING: National Natural Science Foundation of China Excellent Young Scientists Fund (Hong Kong and Macau).
NEW METHODS: Fingolimod-loaded solid lipid nanoparticles (FNG-SLNs) were prepared using the solvent evaporation method and formulation factors (lipid concentration; X1, speed; X2, surfactant concentration; X3) and response were established by factorial design. FNG-SLNs were characterized for particle size, entrapment efficiency and in-vitro drug release. Optimized formulations were characterized for in-vivo efficacy study in ethidium bromide-induced MS rat model.
RESULT: Obtained data revealed that the particle size and entrapment efficiency of FNG-SLNs optimized formulation was 125.4 nm and 79.86 % w/w respectively. In-vitro drug release study showed an initial burst release of the FNG up to 32.52 % in 30 min followed by sustained drug release up to 78.22 % in 24 h. Furthermore, in-vivo data of FNG-SLNs on ethidium bromide-induced MS rat model revealed better treatment response by showing several evidence such as signs of remyelination, restoration of neuron shape, and the recovered oligodendrocytes.
COMPARISON WITH EXISTING METHODS: To the best of our knowledge this article demonstrates improved efficacy of FNG using SLNs.
CONCLUSION: This study demonstrates the successful development of FNG-SLNs to enhance the therapeutic efficacy of FNG for the treatment of multiple sclerosis.
METHODS: The study, which spanned 10 months, involved a cross-sectional survey of 303 community pharmacists across Arabic-speaking nations. The translation process followed the standard "forward-backward" technique from English to Arabic. Validation employed confirmatory factor analysis (CFA) and structural equation modeling, with indices like root mean square error of approximation (RMSEA), incremental fit index (IFI), normed fit index (NFI), McDonald's fit index (MEI), and comparative fit index (CFI). Convergent validity was assessed using average variance extracted (AVE) and composite reliability (CR), while discriminant validity was evaluated through latent factor correlation in the three-factor model against the square root of AVE values. Reliability was gauged using Cronbach's alpha and the intraclass correlation coefficient (ICC).
RESULTS: CFA confirmed the Professional Collaborative Practice Tool's structural validity in Arabic. The model's robustness was indicated by fit indices (CFI: 0.974, NMI: 0.954, IFI: 0.974, MEI: 0.887, RMSEA: 0.063). AVE values exceeding 0.50 validated the explanatory power of the latent constructs. CR values (≥0.70) indicated strong internal consistency and reliability. The tool demonstrated superior discriminant validity, with lower inter-factor correlations than the square root of AVE values. High Cronbach's alpha coefficients (>0.70) across all factors and the model reflected excellent internal consistency. The ICC (0.95) suggested exceptional long-term reliability.
CONCLUSION: This study successfully translated, validated, and enhanced an instrument measuring collaborative practice among community pharmacists in Arabic-speaking countries. The tool effectively assesses collaboration levels crucial for services like comprehensive medication reviews, thereby influencing patient outcomes. It supports the essential role of strengthening the partnership between physicians and community pharmacists in delivering patient-centered healthcare services. The validated instrument can be incorporated into regular assessments in community pharmacies to monitor and improve collaborative behaviors.
MATERIALS AND METHODS: Using APOLLO individual patient data (IPD) and OPTIMISMM aggregate covariate data plus pseudo-IPD for outcomes, the APOLLO population was re-weighted to match OPTIMISMM aggregate baseline characteristics. Bayesian posterior distributions of DPd versus PVd for progression-free survival (PFS) and overall survival (OS) were estimated using a likelihood-weighted Bayesian Cox model with fixed weights.
RESULTS: At baseline, APOLLO included a higher proportion of patients who received ≥ 2 prior lines of therapy, were refractory to prior therapies, and had advanced International Staging System stage versus OPTIMISMM, which would otherwise disadvantage APOLLO versus OPTIMISMM. The PFS hazard ratio (HR) favored DPd over PVd at 0.59 (95% credible interval [CrI]: 0.36, 0.89) with 99% probability of DPd superiority versus PVd. The OS HR appeared to favor DPd over PVd at 0.80 (95% CrI: 0.45, 1.30), with 83% probability of DPd superiority versus PVd; however, the estimated OS benefit was not conclusive.
CONCLUSION: This analysis suggests that DPd improves PFS and might improve OS versus PVd in patients with RRMM. Additional evidence from head-to-head trials or real-world patient databases are warranted to confirm these results.
RESULTS: In terms of d32, viscosity and creaming index, 4 g kg-1 of NCC effectively stabilized 200 g kg-1 (20%) of palm oil to formulate Pickering emulsions with a mean d32 of 4 μm and zeta potential of -49.09 ± 1.63 mV and demonstrating high stability against creaming. NCC-PE remains stable for at least 14 days when stored at room temperature (25 °C). The d32 and zeta potential of Pickering emulsions were evaluated under different pH (4-10), temperature (-18 to 75 °C) and ionic strength (0-250 mmol L-1), exhibiting satisfactory performance and high stability against creaming, except at pH 2 and 100 °C. Results indicated slower lipid hydrolysis in NCC-PE (62.47 ± 2.5%) compared with coconut milk (67.9 ± 1.14%) in a simulated gastrointestinal model.
CONCLUSION: Our results highlight the potential of NCC-PE to act as substitute for coconut milk, influencing the release of free fatty acids. © 2025 The Author(s). Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
METHODS: A survey was conducted among 439 undergraduate students using the Basic Psychological Needs Scale, Learning Motivation Scale, Academic Engagement Scale, and Psychological Well-being Scale.
RESULTS: Basic psychological needs were significantly and positively correlated with undergraduate students' psychological well-being. Academic engagement partially mediated the relationship between basic psychological needs and psychological well-being. However, autonomous motivation did not mediate this relationship. Furthermore, autonomous motivation and academic engagement served as chain mediators in the relationship between basic psychological needs and psychological well-being.
CONCLUSION: Basic psychological needs are not only directly related to undergraduate students' psychological well-being but are also indirectly associated with their psychological well-being through the mediating role of academic engagement and the chain mediating role of autonomous motivation and academic engagement.