Search Results (48)

Background: Family caregivers are a vital yet often under-recognized part of the healthcare system. They provide essential emotional, physical, and logistical support to individuals with illness, disability, or frailty, and their contributions improve continuity of care and reduce system strain. However, many healthcare and social service providers are not equipped to meaningfully engage caregivers as partners. In Alberta, stakeholders validated the Caregiver-Centered Care Competency Framework and identified the need for a three-tiered education model—Foundational, Advanced, and Champion—to help providers recognize, include, and support family caregivers across care settings. This paper focuses on the development and early evaluation of the Advanced Caregiver-Centered Care Education modules, designed to enhance the knowledge and skills of providers with more experience working with family caregivers. The modules emphasize how partnering with caregivers benefits not only the person receiving care but also improves provider effectiveness and supports better system outcomes. Methods: The modules were co-designed with a 154-member interdisciplinary team and grounded in the competency framework. Evaluation used the first three levels of the Kirkpatrick–Barr health workforce education model. We analyzed pre- and post-surveys from the first 50 learners in each module using paired t-tests and examined qualitative feedback and SMART goals through inductive content analysis. Results: Learners reported a high level of satisfaction with the education delivery and the knowledge and skill acquisition. Statistically significant improvements were observed in 53 of 54 pre-post items. SMART goals reflected intended practice changes across all six competency domains, indicating learners saw value in engaging caregivers as partners. Conclusions: The Advanced Caregiver-Centered Care education improved providers’ confidence, knowledge, and skills to work in partnership with family caregivers. Future research will explore whether these improvements translate into real-world practice changes and better caregiver experiences in care planning, communication, and navigation. Full article

The extensive environmental pollution caused by petroleum-based plastics highlights the urgent need for sustainable, economically viable alternatives. The practical challenge of enhancing polyhydroxybutyrate (PHB) production with cost-effective agro-industrial residues—rice-bran and corn-flour hydrolysates—has been demonstrated. Bacillus bingmayongensis GS2 was isolated from soil samples collected at the Pirana municipal landfill in Ahmedabad, India, and identified through VITEK-2 biochemical profiling and 16S rDNA sequencing (GenBank accession OQ749793). Initial screening for PHB accumulation was performed using Sudan Black B staining. Optimization via a sequential one-variable-at-a-time (OVAT) approach identified optimal cultivation conditions (36 h inoculum age, 37 °C, pH 7.0, 100 rpm agitation), resulting in a PHB yield of 2.77 g L⁻¹ (66% DCW). Further refinement using a central composite response surface methodology (RSM)—varying rice-bran hydrolysate, corn-flour hydrolysate, peptone concentration, and initial pH—significantly improved the PHB yield to 3.18 g L⁻¹(74% DCW), representing more than a threefold enhancement over unoptimized conditions. Structural validation using Fourier Transform Infrared spectroscopy (FTIR) and Proton Nuclear Magnetic Resonance spectroscopy (¹H-NMR) confirmed the molecular integrity of the produced PHB. That Bacillus bingmayongensis GS2 effectively converts low-cost agro-industrial residues into high-value bioplastics has been demonstrated, indicating substantial industrial potential. Future work will focus on bioreactor scale-up, targeted metabolic-engineering strategies, and comprehensive sustainability evaluations, including life-cycle assessment. Full article

Sphingosine 1 phosphate receptor (S1PR) modulators are the latest drug class to have received approval for the treatment of ulcerative colitis, and have brought a new mechanism of action to this landscape. They target immune cell trafficking, specifically the egress of lymphocytes from lymph nodes to the bloodstream, and have proven to be an efficacious and safe anti-inflammatory mechanism. This narrative review aims to distil the key trial data on the efficacy and safety of ozanimod and etrasimod, the two S1PR modulators currently licensed for use in UC. We discuss the higher response rates in the advanced therapy naive versus exposed subgroups. We summarise their safety profiles, taking into consideration open label extension data. Finally, we consider where this class of drugs may be best placed in the treatment landscape and also provide a practical guide for their use in clinical practice. Full article

Background/Objectives: The diagnosis and prognosis of arrested foveal development or foveal hypoplasia (FH) can be made using the Leicester grading system for FH and optical coherence tomography (OCT). In clinical practice, ophthalmologists and ophthalmic health professionals with varying experience consult patients with FH; however, to date, the FH grading system has only been validated amongst experts. We compare the inter-grader and intra-grade agreement of healthcare professionals against expert consensus across all grades of FH. Methods: Handheld and table-mounted OCT images (n = 341) were graded independently at a single centre by experts (n = 3) with over six years of experience and “novice” medical and allied health professionals (n = 5) with less than three years of experience. Sensitivity, specificity, and Cohen’s kappa scores were calculated for each grader, and expert vs. novice performance was compared. Results: All graders showed high sensitivity (median 97% (IQR: 94–99)) and specificity (median 94% (IQR: 90–95)) in identifying the presence or absence of FH. No significant difference was seen in specificity between expert and novice graders, but experts had significantly greater diagnostic sensitivity (median difference = 5.3%, H = 5.00, p = 0.025). Expert graders had the highest agreement with the ground truth and novice graders showed great variability in grading uncommon grades, such as atypical FH. The proposed causes of misclassification included macular decentring in handheld OCT scans in children. Conclusions: Ophthalmologists of varying experience and allied health professionals can accurately identify FH using handheld and table-mounted OCT images. FH identification and paediatric OCT interpretation can be improved in wider ophthalmic clinical settings through the education of ophthalmic staff. Full article

Background: Family caregivers provide most (75–90%) of the essential unpaid care and support for individuals living with chronic conditions, disabilities, and age-related needs in the community, with about half performing medical tasks traditionally performed by professionals. Caregivers also assist with 15 to 35% of the care in congregate care settings. Yet despite their critical contributions to patient care, caregivers face stress, declining well-being, and insufficient recognition in healthcare systems. Addressing these challenges requires innovative, person-centered approaches to training healthcare providers. Co-design or co-production are participatory research methods that involve individuals with lived experience to ensure relevance and impact. Objective: This study sought to understand how participatory co-design principles influenced learning, collaboration, and engagement among diverse participants in developing a caregiver-centered education program for healthcare providers. Actionable recommendations for optimizing co-design processes are provided. Methods: Eighty-five participants from a team of 155 collaborators, including caregivers, healthcare providers, educators, policymakers, and leaders, participated in ten focus group sessions conducted in Zoom breakout rooms. Interviews were transcribed verbatim and analyzed using Thorne’s interpretive description and Braun and Clarke’s reflexive thematic analysis. Results: Participants described the co-design process as fostering collaboration, inclusivity, and skill enhancement. Exposure to diverse perspectives expanded transformative understanding and prompted reflection on caregiver support within professional practices. Skilled facilitation ensured equitable engagement. Challenges included information overload and personal time constraints. Participants liked using breakout rooms to mitigate the dynamics of large group management. Still, they recommended pre-meeting materials, flexible scheduling, and expanding stakeholder diversity (e.g., rural, Indigenous, and immigrant caregivers). Conclusions: Co-design fosters meaningful, caregiver-centered education through collaboration and inclusivity. Addressing logistical challenges and representation gaps can further enhance the impact of co-design and empower multi-level, interdisciplinary partners to inform equitable healthcare education. Full article

Heat stress is a major concern for lactating dairy cows. This study evaluated the effects of heat stress on six Holstein-Friesian crossbred dairy cows exposed to three thermal conditions represented by the Temperature-Humidity Index (THI). These conditions included a baseline pre-treatment phase at THI-72, a heat stress treatment phase at THI-75 and THI-80, and a post-treatment recovery phase at THI-72. The duration of the heat stress treatment phase was 24 h. A total of four trials, each involving three cows, were conducted in an IoT-based climatic chamber to assess various physiological, hematological, biochemical, and production parameters across these phases. Compared to the baseline (THI-72), cows showed significant increases (p < 0.05) in rectal temperature (RT), heart rate (HR), respiration rate (RR), and water intake (WI) at both THI-75 and THI-80, with the highest elevations observed at THI-80 (RT: 5.1%, HR: 8.6%, RR: 23.5%, and WI: 19.1%). Feed intake declined significantly (p < 0.05) by 6.5% and 14.0%, and milk yield dropped by 5.3% and 14.7% at THI-75 and THI-80, respectively; milk fat and protein percentages decreased by 1.1-fold and 1.2-fold. Hemoglobin, platelet, and lymphocyte counts, along with biochemical parameters (excluding serum creatinine) also decreased significantly (p < 0.05). The different levels of THI influenced pairwise correlation patterns, with THI-75 showing intense interactions and THI-80 exhibiting greater variability. The findings highlight that Holstein-Friesian crossbred dairy cows are particularly vulnerable to heat stress, even with short-term exposure. This vulnerability can lead to economic losses for Bangladeshi dairy farmers rearing Holstein-Friesian crossbred cows. Full article

While rare, necrotizing pneumonia is a severe and potentially life-threatening manifestation of lung parenchyma infection. Initially documented in the 1940s, it was a significant contributor to mortality rates in both adults and children, with figures reaching up to 45%. Despite being a disease described in the literature for decades, data on the management of necrotizing pneumonia remain limited. Most available information comes from retrospective observational cohort studies. This article aims to provide a comprehensive summary of the existing literature on the subject. Full article

Plastic pollution is a pressing environmental challenge, necessitating the development of biodegradable alternatives like polyhydroxybutyrate (PHB). This study focuses on optimizing PHB production by Neobacillus niacini GS1, a bacterium isolated from a municipal dumping site. By utilizing agricultural residues such as corn flour, wheat bran, and peptone as substrates, we aimed to establish an eco-friendly method for biopolymer production, contributing to sustainable agricultural residue management and bioplastic innovation. The bacterium was identified using morphological, biochemical, and molecular techniques. The optimization process involved adjusting variables such as inoculum age, inoculum size, incubation time, agitation rate, incubation temperature, pH of the medium, carbon sources, and nitrogen sources. Response surface methodology (RSM) was employed to identify optimal conditions, with the highest PHB yield of 61.1% achieved under specific conditions: 37 °C, pH 7, and an agitation rate of 150 rpm. These findings underscore the potential of Neobacillus niacini GS1 in converting agro-industrial residues into valuable biopolymers, promoting sustainable bioplastic production, and advancing agricultural residue valorization efforts through the use of eco-friendly materials. Full article

Excess phosphorus (P) in agricultural runoff can cause eutrophication in nearby waterbodies. Therefore, it is crucial to remove P from agricultural runoff before it reaches aquatic environments. This study evaluated the P adsorption potential of adsorbents prepared via co-hydrothermal carbonization of multiple agricultural wastes, including dairy manure (DM), corn stover (CS), and eggshell (ES), followed by thermal activation. The performance of the prepared adsorbents was investigated by both batch and column experiments. The activated hydrochar (AHC) with a DM/CS/ES ratio of 1:0:1 showed the highest P adsorption capacity of 209 ± 0.6 and 65.97 ± 9.04 mg/g in batch and column experiments, respectively. The P adsorption mechanism was well described by the Langmuir isotherm model (R² > 0.8802) and the pseudo-second-order kinetics model (R² > 0.8989). The adsorbent indicated the longest breakthrough and exhaust time of 210 and 540 min, respectively, with an adsorbent dose of 1 g and an initial concentration of 25 mg P/L. The breakthrough curve was well described by the Thomas model (R² > 0.971). Thus, this study indicates that AHC with eggshell has high potential for use as an adsorbent for P removal from agricultural runoff. Full article

Background: The detection of lung nodules at their early stages may significantly enhance the survival rate and prevent progression to severe disability caused by advanced lung cancer, but it often requires manual and laborious efforts for radiologists, with limited success. To alleviate it, we propose a Multi-View Soft Attention-Based Convolutional Neural Network (MVSA-CNN) model for multi-class lung nodular classifications in three stages (benign, primary, and metastatic). Methods: Initially, patches from each nodule are extracted into three different views, each fed to our model to classify the malignancy. A dataset, namely the Lung Image Database Consortium Image Database Resource Initiative (LIDC-IDRI), is used for training and testing. The 10-fold cross-validation approach was used on the database to assess the model’s performance. Results: The experimental results suggest that MVSA-CNN outperforms other competing methods with 97.10% accuracy, 96.31% sensitivity, and 97.45% specificity. Conclusions: We hope the highly predictive performance of MVSA-CNN in lung nodule classification from lung Computed Tomography (CT) scans may facilitate more reliable diagnosis, thereby improving outcomes for individuals with disabilities who may experience disparities in healthcare access and quality. Full article

Background: We conducted a systematic literature review (SLR) to identify clinical evidence on treatments in advanced renal cell carcinoma (aRCC) after the failure of prior therapy with cytokines, tyrosine kinase inhibitors, or immune checkpoint inhibitors. Herein, we summarise the evidence for axitinib in aRCC after the failure of prior therapy with cytokines or sunitinib. Methods: This SLR was registered with PROSPERO (CRD42023492931) and followed the 2020 PRISMA statement and the Cochrane guidelines. Comprehensive searches were conducted in MEDLINE and Embase as well as for conference proceedings. Study eligibility was defined according to population, intervention, comparator, outcome, and study design. Results: Of 1252 titles/abstracts screened, 266 peer-reviewed publications were reviewed, of which 182 were included. In addition, 28 conference abstracts were eligible. Data on axitinib were reported in 55 publications, of which 16 provided efficacy and/or safety outcomes on axitinib after therapy with sunitinib or cytokines. In these patients, median progression-free and overall survival ranged between 5.5 and 8.7 months and 11.0 and 69.5 months, respectively. Conclusions: Axitinib is commonly used in clinical practice and has a well-characterised safety and efficacy profile in the treatment of patients with aRCC after the failure of prior therapy with sunitinib or cytokines. Full article

Fibromyalgia, a chronic pain condition marked by abnormal pain processing, impacts a significant part of the population, leading to reduced quality of life and function. Hallmark symptoms include widespread persistent pain, sleep disturbances, fatigue, cognitive dysfunction, and mood changes. Through this updated review, we aim to contribute to the evolving understanding and management of fibromyalgia, offering insights into the diverse tools available to improve the lives of those affected by this challenging condition. Management begins with educating patients to ultimately relieve them of unnecessary testing and provide reassurance. Treatment emphasizes a comprehensive approach, combining nonpharmacological interventions such as aforementioned education, exercise, and psychotherapy, alongside pharmacologic management—namely duloxetine, milnacipran, pregabalin, and amitriptyline—which have consistent benefits for a range of symptoms across the spectrum of fibromyalgia. Notably, drugs like nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are generally not recommended due to limited efficacy and associated risks. Lastly, a variety of other medications have shown promise, including NMDA-receptor antagonists, naltrexone, and cannabinoids; however, they should be used with caution due to a small amount of evidence and potential for adverse effects. Full article

Cardiovascular diseases (CVDs) are the number one cause of mortality among non-communicable diseases worldwide. Expanded polytetrafluoroethylene (ePTFE) is a widely used material for making artificial vascular grafts to treat CVDs; however, its application in small-diameter vascular grafts is limited by the issues of thrombosis formation and intimal hyperplasia. This paper presents a novel approach that integrates a hydrogel layer on the lumen of ePTFE vascular grafts through mechanical interlocking to efficiently facilitate endothelialization and alleviate thrombosis and restenosis problems. This study investigated how various gel synthesis variables, including N,N’-Methylenebisacrylamide (MBAA), sodium alginate, and calcium sulfate (CaSO₄), influence the mechanical and rheological properties of P(AAm-co-NaAMPS)-alginate-xanthan hydrogels intended for vascular graft applications. The findings obtained can provide valuable guidance for crafting hydrogels suitable for artificial vascular graft fabrication. The increased sodium alginate content leads to increased equilibrium swelling ratios, greater viscosity in hydrogel precursor solutions, and reduced transparency. Adding more CaSO₄ decreases the swelling ratio of a hydrogel system, which offsets the increased swelling ratio caused by alginate. Increased MBAA in the hydrogel system enhances both the shear modulus and Young’s modulus while reducing the transparency of the hydrogel system and the pore size of freeze-dried samples. Overall, Hydrogel (6A12M) with 2.58 mg/mL CaSO₄ was the optimal candidate for ePTFE–hydrogel vascular graft applications due to its smallest pore size, highest shear storage modulus and Young’s modulus, smallest swelling ratio, and a desirable precursor solution viscosity that facilitates fabrication. Full article

We propose and study a nanoscale strong coupling effect between metamaterials and polymer molecular vibrations using metallic split-ring resonators (SRRs). Specifically, we first provided a numerical investigation of the SRR design, which was followed by an experimental demonstration of strong coupling between mid-infrared magnetic dipole resonance supported by the SRRs fabricated on a calcium fluoride substrate and polymethyl methacrylate molecular vibrations at 1730 cm⁻¹. Characterized by the anti-crossing feature and spectral splitting behaviors in the transmission spectra, these results demonstrate efficient nanoscale manipulation of light–matter interactions between phonon vibrations and metamaterials. Full article

Current optical tweezering techniques are actively employed in the manipulation of nanoparticles, e.g., biomedical cells. However, there is still huge room for improving the efficiency of manipulating multiple nanoparticles of the same composition but different shapes. In this study, we designed an array of high-index all-dielectric disk antennas, each with an asymmetric open slot for such applications. Compared with the plasmonic counterparts, this all-dielectric metasurface has no dissipation loss and, thus, circumvents the Joule heating problem of plasmonic antennas. Furthermore, the asymmetry-induced excitation of quasi-bound states in continuum (QBIC) mode with a low-power intensity (1 mW/µm²) incidence imposes an optical gradient force of −0.31 pN on 8 nm radius nanospheres, which is four orders of magnitude stronger than that provided by the Fano resonance in plasmonic antenna arrays, and three orders of magnitude stronger than that by the Mie resonance in the same metasurface without any slot, respectively. This asymmetry also leads to the generation of large optical moments. At the QBIC resonance wavelength, a value of 88.3 pN-nm will act on the nanorods to generate a rotational force along the direction within the disk surface but perpendicular to the slot. This will allow only nanospheres but prevent the nanorods from accurately entering into the slots, realizing effective sieving between the nanoparticles of the two shapes. Full article