Conectar
The aim of this study is to assess nurse practitioner students' perceptions and engagement with Isabel's artificial intelligence (AI) based differential diagnosis tool to support their decision-making skills during their theoretical and clinical placement training.
This pilot study used a cross-sectional design.
Twenty-six nurse practitioner students provided feedback on their use of an AI differential diagnosis tool in both academic and clinical contexts. This survey used the Post-Study System Usability Questionnaire to assess the engagement levels and usability of the AI tool. Additional questions were included to evaluate the usage patterns, adequacy in training and confidence in diagnosis.
There were mixed engagement levels: 44.4% (n = 8/18) used Isabel in two subjects—typically one or both clinical placement units—and 27.8% (n = 5/18) in one subject; students most often used the tool to confirm differential diagnoses. Usability was rated positively with the disease ranking, red flag diagnosis and link to national guideline features demonstrating the highest student usage. While most students found the tool beneficial to use during clinical placement and completing university assignments, some reported challenges due to insufficient training, impacting confidence in clinical application.
Isabel has potential as a valuable educational tool in Nurse Practitioner programs, but successful implementation depends on adequate training and support. The findings highlight the importance of comprehensive training and support to maximise AI tool utilisation, with direct implications for programme curricula, clinical education strategies and potential improvements in diagnostic reasoning skills for future nurse practitioners.
This study provides an example of integrating artificial intelligence (AI) guided clinical decision-making training in nurse practitioner (NP) education. The findings can be used by educational institutions to trial similar AI-integrated learning approaches, enhancing diagnostic competence and potentially improving patient care outcomes.
The Study adhered to the STROBE checklist for reporting.
No patient or public contribution was made to this study.
To examine the feasibility of using a large language model (LLM) as a screening tool during structured literature reviews to facilitate evidence-based practice.
A proof-of-concept study.
This paper outlines an innovative method of abstract screening using ChatGPT and computer coding for large scale, effective and efficient abstract screening. The authors, new to ChatGPT and computer coding, used online education and ChatGPT to upskill. The method was empirically tested using 400 abstracts relating to public involvement in nursing education from four different databases (CINAHL, Scopus, ERIC and MEDLINE), using four versions of ChatGPT. Results were compared with a human nursing researcher and reported using the CONSORT 2010 extension for pilot and feasibility trials checklist.
ChatGPT-3.5 Turbo was most effective for rapid screening and had a broad inclusionary approach with a false-negative rate lower than the human researcher. More recent versions of ChatGPT-4, 4 Turbo, and 4 omni were less effective and had a higher number of false negatives compared to ChatGPT-3.5 Turbo and the human researcher. These more recent versions of ChatGPT did not appear to appreciate the nuance and complexities of concepts that underpin nursing practice.
LLMs can be useful in reducing the time nurses spend screening research abstracts without compromising on literature review quality, indicating the potential for expedited synthesis of research evidence to bridge the research–practice gap. However, the benefits of using LLMs can only be realised if nurses actively engage with LLMs, explore LLMs' capabilities to address complex nursing issues, and report on their findings.
Nurses need to engage with LLMs to explore their capabilities and suitability for nursing purposes.
No patient or public contribution.
We investigated the magnitude and correlates of modern contraceptive non-use among women of reproductive age (15–49 years) in Eswatini (formerly Swaziland).
Secondary analysis of a cross-sectional, nationally representative, population-based, household survey
Eswatini
Women of reproductive age in the Swaziland HIV Incidence Measurement Survey 3 2021 dataset
The primary outcome was non-use of modern contraceptive methods.
Of 3080 reproductive age women whose data were analysed in this study, 53% were aged 20–34 years, and the majority were from rural areas (66.8%). The weighted prevalence of non-use of modern contraceptives was 33%. The risk of non-use of modern contraceptives was lower among women: aged 20–34 (adjusted risk ratio (ARR)=0.85, 95% CI 0.75 to 0.97); from households of middle wealth quintile (ARR=0.82, 95% CI 0.68 to 0.97); who had given birth at least once (ARR=0.84, 95% CI 0.73 to 0.96); who were living with HIV (ARR=0.79, 95% CI 0.70 to 0.89); and among those who reported being sexually active in the past 12 months (ARR=0.54, 95% CI 0.48 to 0.61). On the other hand, adolescent girls aged 15–19 years (ARR=1.31, 95% CI 1.04 to 1.67) and women who lived in the Manzini (ARR=1.21, 95% CI 1.01 to 1.46) and Shiselweni regions (ARR=1.21, 95% CI 1.00 to 1.45) had a higher risk of not using modern contraceptives.
Given that a third of women in Eswatini did not use modern contraceptive methods, there is a need to promote modern contraceptive methods in Eswatini, particularly long-acting methods. The Eswatini Sexual and Reproductive Health Program should strengthen initiatives aimed at promoting modern contraceptive use among adolescent girls and those living in the Manzini and Shiselweni regions, who showed a higher risk of not using modern contraceptives.
Catastrophic health expenditure (CHE) and impoverishment due to out-of-pocket (OOP) expenditure are the most widely used metrics to assess financial protection in health. This study aimed to investigate the impact of OOP expenditure on CHE and impoverishment in Bangladesh and identify their determinants.
A national cross-sectional survey.
We used data from the latest Household Income and Expenditure Survey 2022 in Bangladesh.
14 395 households from eight administrative divisions in Bangladesh.
The well-known methodology developed by Wagstaff and Doorslaer was used in this study to estimate the prevalence of CHE and the effect of OOP spending on impoverishment. We used a generalised linear model with a log link and a gam ma distribution to assess the association between the explanatory variables and annual OOP expenditure.
The prevalence of CHE was estimated to be 17.72% (95% CI 17.71% to 17.73%) and 7.07% (95% CI 7.06% to 7.08%) using 10% and 25% of the total consumption expenditure as thresholds, respectively. Given the 40% of non-food expenditure threshold level, about 9.46% (95% CI 9.45% to 9.47%) of households faced CHE due to OOP expenditure in Bangladesh. In 2022, approximately 3.7% (95% CI 3.7% to 3.71%) of the population (6.13 million people) fell into poverty in Bangladesh. The prevalence of CHE was higher among male-headed households, larger families, households with elderly members, households with members suffering from chronic illnesses, those using hospital care and individuals in the poorest wealth quintiles.
Our study indicated that the financial burden due to OOP expenditure was substantial in Bangladesh. Findings stress the need for prepayment schemes such as national health insurance for safeguarding households against falling into poverty.
by Md. Golam Rabby, Md. Nayim Hossain, Maymuna Islam Keya, Md. Ashrafuzzaman Zahid, Rashida Parvin, Md Syduzzaman
This study evaluated how Monkey jack pulp extract (MJPE) impacted the raw Pangasius (Pangasianodon hypophthalmus) fish balls physicochemical quality, microbiological safety, oxidative, and storage stability while being refrigerated. Fish balls were made with several antioxidants, including control (T0), butylated hydroxytoluene (BHT, T1), ascorbic acid (AA, T2), and MJPE at increasing concentrations (T3 and T4), and kept for 10 days at 4°C. On days 1, 5, and 10, changes in pH, cooking loss, color characteristics (L*, a*, b*, chroma, and hue angle), heme iron content, antioxidant activity (DPPH), lipid oxidation (TBARS), and total viable count (TVC) were assessed. All samples showed quality decrease with increasing storage time. However, antioxidants treated samples showed significantly (P < 0.05) higher stability than the control treated samples in every storage day. T4 successfully inhibited pH rise, decreased cooking loss, maintained higher heme iron levels, and preserved color characteristics rather than other treatments. Additionally, T4 showed higher DPPH scavenging capacity (ranged 72.44% to 65.79%), whereas the control showed the lower DPPH value (ranged 56.57% to 33.39%). TBARS value showed the lowest (0.31 to 0.41 mg MDA/kg sample) in T4 and the highest (0.49 to 0.67 mg MDA/kg sample) in the control. MJPE considerably reduced bacterial growth (0.80 to1.68 Log10 CFU/mL) compared to control and synthetic antioxidants treated samples. In terms of keeping the quality and enhancing the shelf life, MJPE demonstrated significantly improved antioxidant and antimicrobial effects compared to BHT and AA (P < 0.05). MJPE showed significant potential as a natural preservative for fish-based products by improving their physicochemical, microbiological, and oxidative stability during refrigerated storage.by Dulam Devee SivaPrasad, Azees Maria
Vehicular Ad Hoc Networks (VANETs) have been developed as an important technology for improving road safety and traffic efficiency in intelligent transport systems. However, due to the increase in the number of cyberattacks, they have become vulnerable to several security threats that must be addressed. Although several works related to authentication and key agreement protocols have been proposed in the past, there is a significant overhead in both communication and computation. To overcome this burden, a Chebyshev chaotic map-driven anonymous authentication scheme with a key agreement scheme is proposed in this work. This work shows integrates a chaotic map with anonymous authentication, thereby balancing security and efficiency. The proposed scheme removes the bilinear pairing operations, thereby reducing the time required for cryptographic operations, which leads to a significant reduction in computation overhead. Moreover, Quantitative evaluation shows that the proposed scheme achieves a total execution time of only 0.9494ms representing a (49.7%−71%) reduction compared to existing schemes (1.8878-3.7756 ms) and a communication overhead of 264 bytes, which is (13.2%−57.4%) lower than most related works (84–620) bytes. Furthermore, the security analysis section addresses the secure nature of the proposed protocol in contrast to different types of security attacks. The efficiency of the proposed schema is validated against similar works based on the computation time of cryptographic operations using the Cygwin platform and is proven to be noteworthy.To gain consensus and prioritise barriers to effective pressure injury prevention for at-risk patients and to collaboratively generate, discuss and recommend intervention strategies that could address these prioritised barriers in the acute medical-surgical hospital context.
Nominal Group Technique.
Participants involved in pressure injury prevention across acute medical-surgical services in a tertiary hospital in Australia were purposively sampled. Pre-reading materials informed the discussion on barriers to prevention. Participants ranked 11 barriers that were collaboratively developed and identified practical context-specific solutions. Data were analysed using inductive content analysis.
Nine multidisciplinary participants prioritised three final barriers to effective pressure injury prevention: inadequate skin assessment and monitoring, competing priorities and workflow pressures and insufficient education and inconsistent knowledge. Proposed solutions focused on developing concise, accessible decision support tools such as quick reference flowcharts to enhance confidence, consistency and timeliness of appropriate pressure injury prevention practices.
The Nominal Group Technique enabled consensus-building, guided the development of actionable priorities and informed targeted intervention strategies to address key barriers in acute care nursing practice.
Findings from this study offer nurse leaders and researchers practical insights to co-create an intervention that drives evidence-based pressure injury prevention practice change in acute medical-surgical settings. Adoption of these targeted approaches may enhance hospital patient safety through pressure injury prevention implementation.
Reporting guideline for PRIority Setting on health research (REPRISE).
No patient or public contribution.
by Md. Naziur Rahman, Abu Yousuf Hossin, Shahriar Mannan Imon Talukder, Mt. Sumaiya Siddika, Md. Harun-Ur-Rashid, Shahanaz Parveen, Md. Ridwanul Islam, Md. Yeamin Hossain, Mahfuj Ahmed, Brototi Chakraborty Dyuti, Zarin Tabassum, Ajoy Kumer
Non-small-cell lung cancer (NSCLC) remains the leading cause of lung cancer–related mortality, largely driven by aberrant activation of the epidermal growth factor receptor (EGFR). Despite the clinical success of EGFR tyrosine kinase inhibitors (TKIs), intrinsic and acquired resistance, coupled with safety concerns, highlight the need for novel, safer inhibitors. Natural products represent an underexplored source of structurally diverse bioactive compounds with favorable biocompatibility. In this study, a comprehensive in silico approach is used to evaluate phytochemicals from Adenium obesum as potential candidate EGFR-targeting compound. Initially, sixteen phytochemicals were first assessed for predicted antineoplastic activity using PASS. High-scoring molecules were docked against the EGFR kinase domain (PDB ID: 1M17), besides performed detailed protein–ligand interaction analysis, drug-likeness and ADMET profiling, toxicity prediction and 100-ns molecular dynamics (MD) simulations. PASS-based bioactivity prediction revealed strong anticancer potential among the sixteen screened compounds, with consistently high antineoplastic and antiproliferative activity probabilities (Pa > 0.79) and low inactivity scores, supporting their selection for subsequent docking, ADMET, and molecular dynamics analyses. Next, several phytochemicals exhibited strong docking affinities, with Cardenolide achieving the highest binding score (–9.9 kcal/mol) and forming stable interactions with key catalytic residues. A 100-ns MD simulation confirmed the structural stability, persistent binding, and dynamic integrity of the EGFR–Cardenolide complex under physiological conditions. Importantly, interaction mapping revealed that Cardenolide engages conserved and functionally critical regions of the EGFR kinase domain associated with catalytic activity and structural stability, supporting its mechanistic relevance as an ATP-competitive scaffold. Additionally, predicted pharmacokinetic and toxicity profiles further supported Cardenolide’s suitability as a drug-like candidate. Collectively, these results identify Cardenolide as a computationally prioritized candidate with favorable predicted EGFR-binding characteristics, structural stability, and physicochemical and toxicity profiles. However, as the present study is based entirely on computational analyses, these findings should be considered hypothesis-generating and do not establish EGFR inhibitory activity or therapeutic efficacy. Experimental validation, including biochemical kinase inhibition and cellular assays, is therefore required to determine the actual EGFR inhibitory potential and anticancer activity of Cardenolide. Nevertheless, the findings provide a rational basis for prioritizing Cardenolide for further experimental investigation and illustrate the potential of Adenium obesum phytochemicals as a source of candidate EGFR-targeting compounds for future NSCLC drug discovery.Low- and middle-income countries (LMICs) experience recurrent public health emergencies, including infectious disease outbreaks, climate-related shocks and humanitarian crises, which expose persistent weaknesses in health system preparedness and response. Although resilience—defined as the capacity of health systems to anticipate, absorb, adapt to and recover from shocks—has gained increasing attention, there is no comprehensive synthesis of tools specifically designed to evaluate the resilience of public health emergency preparedness and response (PHEPR), particularly in LMICs contexts.
To identify, describe and critically appraise existing tools and frameworks used to evaluate PHEPR resilience, and to assess their methodological robustness, availability and applicability to LMICs health systems.
This systematic review protocol is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) 2015 statement and will follow the PRISMA 2020 reporting guideline. A comprehensive search will be conducted in PubMed, Scopus, Web of Science, WHO Institutional Repository for Information Sharing (IRIS), Africa Centres for Disease Control and Prevention repositories and relevant governmental and organisational platforms. Eligible sources will include peer-reviewed and grey literature published in English between 2005 and 2025 that describe, develop, validate or apply PHEPR resilience assessment tools. Two reviewers will independently undertake screening, full-text review and data extraction using a piloted 24-item extraction form. Methodological quality of empirical studies will be appraised using appropriate Joanna Briggs Institute critical appraisal tools, while resilience assessment instruments will be evaluated using structured qualitative criteria examining their conceptual foundations, development methods, validation evidence and implementation characteristics
Ethical approval was not required because this review will use publicly available literature. Findings will be disseminated through peer-reviewed publication, conference presentations and policy briefs to inform future development and implementation of resilience assessment tools for public health emergency preparedness and response in LMICs.
CRD420251243633.
Moral injuries (MIs) may result from individuals being exposed to potentially morally injurious events (PMIEs). PMIEs have been a feature of work within much of the National Health Service (NHS) for many years, and the understanding of MI is now more commonplace, having been highlighted during the COVID-19 pandemic; however, understanding of how such events affect workers over the long term is lacking.
To understand the development of healthcare workers’ (HCWs) experiences of PMIEs over a period of 3 years.
We carried out follow-up semistructured qualitative interviews with 15 NHS staff who were previously interviewed on the same topic in 2021. All interviews were recorded, transcribed and analysed using reflexive thematic analysis following an inductive approach.
Three main themes and six subthemes were identified: (1) internal context and subjective experiences, (1.i) control in a rigid system, (1.ii) psychosocial dynamics, (2) external context and the moral cost of culture, (2.i) organisational culture, (2.ii) sources of MI, (3) responses to PMIEs, (3.i) maladaptive responses, (3.ii) adaptive responses. Key issues identified included perceptions of insufficient control over their work and work environment, low psychological safety and perceived misunderstanding of the value of their work from patients and colleagues, leading to a challenging organisational culture. We found that in the 3 years between the interviews many staff reported developing ‘secondary’ feelings of betrayal as a result of perceived ongoing governmental neglect of recognition for HCWs’ sacrifices during the pandemic and a lack of acknowledgement of governmental mistakes made in the acute period.
Findings show an interplay between individual and organisational factors that HCWs faced while working in the NHS, underlining the need for wide-ranging intervention strategies. Since the HCWs’ original interviews in 2021, a secondary betrayal has developed, emphasising the need for interventions that can restore trust in the system.
Activity-based therapy (ABT) delivers intensive, repetitive sensorimotor stimulation to enhance neuroplasticity after spinal cord injury. ABT has demonstrated synergistic benefits with cervical transcutaneous spinal cord stimulation (tSCS) for motor recovery particularly in individuals with chronic cervical spinal cord injury. However, its efficacy in subacute cases remains an emerging area of research. Accordingly, this study aims to determine the efficacy of an adjunctive ABT paired with cervical tSCS compared with ABT alone on upper limb function in people with cervical spinal cord injury receiving in-patient rehabilitation.
This study is a single-centre, double-blind, two-arm randomised controlled trial. We will enrol 40 individuals with cervical spinal cord injury receiving in-patient rehabilitation (20/group). Participants will be randomly assigned to an intervention group (ABT+tSCS) or a control group (dose-matched ABT+sham stimulation). Both groups will receive 45 min of ABT+active or sham tSCS in addition to usual care for 20 sessions, 3 times per week. The primary outcome measures will be the Upper Extremity Motor Score of the International Standards for Neurological Classification of Spinal Cord Injury. Secondary measures will include clinical measures of upper limb impairments and activity limitations and neurophysiological measures (transspinal, motor and somatosensory-evoked potentials). All measures will be taken pre-intervention, post-intervention and at a 1-month follow-up.
This study was approved by the Research Ethics Committee en réadaptation et en déficience physique of Santé Québec Centre-Sud-de-l’Île-de-Montréal - Universitaire (MP-2024-2080). All procedures will be conducted in accordance with the principles of the Declaration of Helsinki.
Psychoses are among the most severe disorders in children and adolescents, representing the second leading cause of years lost due to disability worldwide. Evidence suggests that early intervention in psychosis may improve outcomes, and there is increasing consensus among clinicians to initiate treatment as soon as sustained positive psychotic symptoms emerge. Within this early intervention framework, intervening during the clinical high risk for psychosis (CHR-P) phase may mitigate, delay or even prevent the onset of a full psychotic disorder.
Recent psychological, clinical and neuroscientific studies underscore that socioemotional difficulties are critical determinants of clinical and functional outcomes in CHR-P individuals. Mentalising, or the ability to think about mental states, is refined during adolescence and has proven to be critical to adult social adaptation, notably playing a crucial role in maintaining good mental health and role functioning. Mentalisation-based treatment (MBT), a highly effective psychotherapeutic model for addressing chronic socioemotional difficulties, has been recently adapted for youth at CHR-P.
This trial will include 212 patients aged 14–30 years with a CHR-P state, as defined by the Structured Interview for Psychosis-Risk Syndromes criteria, randomly assigned to either the intervention group with MBT and need-based clinical intervention (NBCI) or the control group with NBCI alone. The MBT intervention consists of 24 weekly individual psychotherapy sessions, supplemented by monthly mentalisation-based family therapy sessions. Control intervention will consist of routine care based on NBCI. We will evaluate participants at baseline, 12 weeks, 24 weeks and 48 weeks. Impact of intervention on psychotic transition rates and symptom severity, as well as functioning, will be tested. Several potential mediators/moderators, including childhood trauma and schizotypal traits, will also be examined.
This trial was approved by the Swiss National Fund and the cantonal Ethics committee (CER-VD). A lay summary of the results will be published online for the general public and detailed results will be reported in future study publications, and presented during national and international conferences.
To evaluate the feasibility and acceptability of an online research capacity-building (RCB) education programme for the health and care workforce and explore its preliminary outcomes.
Mixed-methods pilot study incorporating quantitative survey data and a qualitative group interview.
Single Health Innovation organisation in England’s North West region.
Staff working in research, evaluation and innovation-related roles.
16 one-hour online RCB education sessions, informed by the Research Capacity and Culture Tool (individual domain), were delivered weekly via Microsoft Teams between February 2024 and October 2024.
The primary outcomes were feasibility and acceptability of the programme, assessed through attendance and a participant group interview. The secondary outcome was change in behaviour intention measured pre–post education sessions using the Continuing Professional Development Reaction (CPD-R) questionnaire.
Attendance per RCB education session ranged from 2 to 11 participants. Post-session CPD-R completion was low, limiting matched pre–post analysis, but median scores were generally higher post-session across most constructs. Four themes and eight sub-themes were identified from qualitative data. The four core themes were: establishing a common ground for research capacity building; creating pathways for meaningful involvement; translating knowledge within organisational contexts; and bridging individual development and collective momentum. The online format was received well for its accessibility and convenience, fitting within busy working schedules. Participants also reported increased confidence and perceived skill development.
This pilot study demonstrates initial feasibility and acceptability of an online format for RCB education within the health and care workforce. The format has potential for delivery at scale, where time and service pressures limit access to face-to-face programmes. Session length and content support require refinement in future iterations. Further research should examine implementation across diverse settings with larger samples.
Guillain-Barré syndrome (GBS) is an autoimmune polyneuropathy manifested by progressive limb weakness. Anxiety and depression are significant yet under-recognised complications of GBS, particularly in low- and middle-income countries (LMICs). This study examined the proportion and progression of anxiety and depression in Bangladeshi GBS patients and their associations with clinical features, outcomes and quality of life (QoL).
A prospective cohort study.
National Institute of Neurosciences and Hospital, Dhaka, Bangladesh.
A total of 148 GBS patients aged ≥18 years diagnosed by National Institute of Neurological Disorders and Stroke criteria for GBS, were recruited within 2 weeks of symptom onset.
Anxiety and depression were evaluated as the primary outcome using the Hospital Anxiety and Depression Scale (HADS) at week 13 and week 26 post-GBS. Secondary outcomes included Medical Research Council sum score, GBS Disability Score, fatigue severity, pain intensity and EuroQol 5-Dimension 5-Level. Statistical analyses involved descriptive summaries, group comparisons, correlation tests and longitudinal assessments by analysis of variance.
A total of 111 patients with complete HADS data were analysed (median age 36 years; 71% male). At week 13, 45% had anxiety reducing to 36% at week 26. Depression was 53% at week 13 and 41% at week 26. Baseline bulbar involvement was significantly associated with week 13 depression and week 26 anxiety. Between week 13 and week 26, 27%–30% of patients had persistent symptoms and 13%–16% experienced worsening. Anxiety and depression mostly followed concordant patterns, though 28 patients showed discordant patterns. Elevated mood symptoms were associated with greater fatigue, pain and reduced QoL.
Anxiety and depression are common and persistent in GBS adversely affecting recovery and QoL. Mental health monitoring and targeted support should be integrated into GBS management, especially in LMIC settings.
by Lee Jia Hui, Nicole Lam Koh Yie, Justine Yap, Muhamad Nasrul, Ali Haider Mohammed, Bassam Abdul Rasool Hassan, Lee Jia Jia, Dinesh Sangarran Ramachandram, Ruth Sim, Angelina Lim, Juman Dujaili, Ali Blebil
BackgroundDespite advancements in cancer therapy, opportunistic infections remain a significant obstacle to successful patient outcomes. This highlights the necessity for research into the role of antimicrobial prophylaxis in preventing opportunistic infections within oncology care. Therefore, this study aims to develop and validate a questionnaire that assesses pharmacists’ knowledge and practices regarding antimicrobial prophylaxis in cancer patients.
MethodThe research was conducted in 2 phases. Phase I focused on questionnaire development, which included assessing content validity using face validity, Delphi technique, and pilot testing. An initial questionnaire comprising 53 items was generated. The questionnaire was then distributed, and the data were collected from Survey Monkey. Phase II involved the psychometric evaluation of the questionnaire’s validity and reliability. Data analysis was performed using Item Response Theory (IRT), Exploratory Factor Analysis (EFA), and Cronbach’s alpha to establish construct validity and reliability.
ResultThe finalized questionnaire consists of 43 items, comprising 29 knowledge and 14 practice items. IRT analysis was applied to knowledge items, with acceptable discrimination (≥0.25), difficulty (−3–3), and guessing (≤0.4) parameters. Eight items were removed from the knowledge domain based on IRT analysis. Furthermore, EFA has shown high correlation between items and their respective factor, with each receiving an acceptable factor loading of >0.4. However, one domain has a reliability value of Conclusion
The results of this study have validated that the developed questionnaire possesses exceptional psychometric qualities, confirming its accuracy and reliability to evaluate pharmacists’ knowledge and practice towards antimicrobial prophylaxis in oncology care. The validated tool enables future research and targeted educational interventions to improve pharmacists’ skills in managing infection risks for cancer patients.
by Lana Sallam, Lucie Rychlíková, Johan Mölne, Martin O. Bergo, Åsa Torinsson Naluai, Helene Seeman-Lodding, Nicklas Oscarsson, Daniel Giglio
BackgroundIrradiation of tumours in the pelvic area may lead to adverse effects such as vaginal fibrosis and dyspareunia. We investigated the radioprotective effects of hyperbaric oxygen (HBOT) and toll-like receptor 5 (TLR5) in epithelial cells.
Methods and materialsEndothelial cells (HUVEC), urothelial cells (UROtsa), and cervical epithelial cells (HeLa) were irradiated with 6 Gy and subsequently underwent HBOT. Cells were counted and qPCR was performed on HeLa for the expressions of TLR5, downstream signalling molecules, oxidative stress, and cytokines. The effects of the TLR5 agonist flagellin and the TLR5 antagonist TH1020 on radiation-induced cell death and oxidative stress were assessed.
ResultsHBOT attenuated radiation-induced epithelial cell death. In HeLa, radiation reduced TLR5, TRIF, NRF2, HIF-α and catalase expression. HBOT reversed their expression. The TLR5 agonist flagellin protected against radiation-induced cell death in HeLa and the TLR5 antagonist TH1020 inhibited the radioprotective effects by flagellin.
ConclusionsHBOT antagonizes radiation-induced cell death and normalizes the expressions of antioxidants, TLR5 and connected downstream signalling transcripts. TLR5 signalling contributes to protection from radiation-induced epithelial cell death, which supports further exploration of combined HBOT-TLR5-targeted strategies for mucosal radioprotection.
by Sobia Siddiq, Saryia Adra, Kamel A. Samara, Batool Aldaher, Mohamad Emad Aldeen Mahfouz, Nour Sakan, Fathima Musfira, Roomiyah Riyaz Assadi, Ahlam Mohamed Almarzooqi, Hiba Jawdat Barqawi, Eman Abu-Gharbieh
BackgroundYoung-onset stroke represents a growing public health concern, yet data from the United Arab Emirates (UAE) remain limited. This study aimed to examine the risk factors and clinical outcomes associated with young-onset stroke in the UAE.
MethodsA retrospective chart review was conducted on 419 patients aged below 50 years who were admitted at Al Qassimi Hospital, Sharjah, UAE, with a diagnosis of stroke between 2016 and 2022. Data on demographics, comorbidities, stroke subtype, management, and outcomes were collected and analyzed using Python-based statistical libraries.
ResultsThe study population comprised predominantly of male individuals (78.28%), with most patients originating from South Asia (63.96%) and the Middle East and North Africa region (19.33%). Ischemic stroke was the most common subtype (50.12%), followed by intracerebral hemorrhage (27.21%) and non-traumatic subarachnoid hemorrhage (22.67%). Hypertension (45.45%) and diabetes mellitus (24.42%) were the most prevalent comorbidities. Only 0.24% of patients underwent mechanical thrombectomy, and 9.41% received intravenous thrombolysis. The overall mortality rate was 12.68%, with coronary artery disease significantly associated with death (p Conclusions
Young-onset stroke in the UAE is characterized by a high burden of modifiable cardiovascular risk factors, particularly hypertension and diabetes mellitus. Targeted preventive strategies and region-specific research are essential to reduce disease burden and improve patient outcomes.
by Kittipan Tharakhet, Eakachai Prompetchara, Chirayus Khawsang, Supichcha Saithong, Papatsara Kaewpang, Nongnaphat Yostrerat, Pachara Wangsoontorn, Jenjira Sontikun, Sawaros Tantratorn, Thidarat Khotprathum, Kieu Lam, James Heyes, Drew Weissman, Kiat Ruxrungtham, Chutitorn Ketloy
Dengue virus (DENV) remains a major global health burden, with four antigenically distinct serotypes (DENV-1–4) posing a significant challenge for vaccine development. Dengue non-structural protein 1 (NS1) has been associated with additional protection and reduced disease severity, supporting its inclusion in vaccine design. In this study, we designed a consensus NS1 (cNS1) antigen by integrating sequence elements from all four DENV serotypes (78–89% amino acid identity) to enhance cross-serotype antigenic coverage. The cNS1 sequence was encoded as a nucleoside-modified mRNA and formulated in lipid nanoparticles (mRNA–LNPs). Immunization of BALB/c mice with a low dose (0.2 µg) of cNS1 mRNA–LNP induced broadly reactive NS1-specific IgG responses that recognized NS1 proteins from all four serotypes. In addition, the vaccine elicited interferon-γ (IFN-γ)–producing T cell responses against peptide pools derived from multiple DENV serotypes, indicating the activation of cross-reactive cellular immunity. While broad immune recognition was achieved, this was accompanied by lower serotype-specific response magnitudes as a trade-off. In conclusion, the cNS1 mRNA vaccine induces cross-serotype humoral and cellular immune responses in mice, highlighting the potential of consensus antigen design to broaden immune recognition of DENV NS1. These findings support the further development of NS1-based immunogens as complementary components of next-generation dengue vaccines aimed at achieving broad and effective protection.
FreshRSS 