Search Results (26)

Shift work can have an adverse impact on sleep and wellbeing, as well as negative consequences for workplace safety and productivity. SleepShifters is a co-developed sleep management programme that aims to equip shift workers and employers with the skills needed to manage sleep from the onset of employment, thus preventing sleep problems and their associated consequences from arising. This paper describes the co-development process and resulting programme protocol of SleepShifters, designed in line with the Medical Research Council’s framework for the development and evaluation of complex interventions. Programme components were co-produced in partnership with stakeholders from four organisations across the United Kingdom, following an iterative, four-stage process based on focus groups and interviews. As well as a handbook containing guidance on shift scheduling, workplace lighting, and controlled rest periods, SleepShifters consists of five key components: (1) an annual sleep awareness event; (2) a digital sleep training induction module for new starters; (3) a monthly-themed sleep awareness campaign; (4) a website, hosting a digital Cognitive Behavioural Therapy for insomnia platform and supportive video case studies from shift-working peers; (5) a sleep scheduling app for employees. Future work will implement and assess the effectiveness of delivering SleepShifters in organisational settings. Full article

Heart failure (HF) is a well-known leading cause of mortality, associated with a high symptom burden in advanced stages, frequent hospitalizations, and increasing economic costs. HF is typically classified into three main subgroups, based on left ventricular ejection fraction (LVEF): HF with reduced ejection fraction (HFrEF), HF with mildly reduced ejection fraction (HFmrEF), and HF with preserved ejection fraction (HFpEF). Recently, two additional subgroups have been proposed: HF with improved ejection fraction (HFimpEF) and HF with supernormal ejection fraction (HFsnEF). These five phenotypes exhibit distinct risk factors, clinical presentations, therapeutic responses, and prognosis. However, the LVEF thresholds used to define these subgroups remain a subject of considerable debate, with significant differences in opinions among leading experts. A major criticism concerns the reliability of LVEF in accurately classifying HF subgroups. Due to substantial intra and interobserver variability, determining the appropriate therapy and prognosis can be challenging, particularly in patients with HFmrEF. Additionally, patients classified under HFpEF are often too heterogeneous to be effectively managed as a single group. This narrative review explores these issues, and suggests a possible need for a new approach to HF classification, one that involves revising the LVEF reference values for HF phenotypes and highlighting LVEF trajectories rather than relying on a single measurement. Moreover, in light of the relatively limited therapeutic options for patients with LVEF > 40%, a new, simplified classification may be proposed: HF with reduced EF (LVEF ≤ 40%), HF with below-normal EF (41% ≤ LVEF ≤ 55%), and HF with normal EF (LVEF > 55%). This mindset would better equip clinical cardiologists to manage the diverse spectrum of HF syndromes, always with the patient at the center. Full article

Photodynamic therapy (PDT) involves the topical application of a photosensitizer and its activation by visible light, leading to the generation of protoporphyrin IX (PpIX) and reactive oxygen species. Daylight photodynamic therapy (dPDT), a variant utilizing natural sunlight as the energy source, enhances procedural flexibility by eliminating the need for specialized equipment. dPDT has been effectively used in dermatology to treat various cutaneous disorders, including neoplastic and infectious diseases. Traditionally, skin preparation and photosensitizer application are performed by trained practitioners, limiting the accessibility of dPDT for broader populations. However, recent studies suggest that these preparatory steps can be managed by patients or caregivers, enabling fully self-applied, home-based dPDT protocols. This review systematically examines the current evidence on self-applied dPDT (SA-dPDT), emphasizing molecular mechanisms and its efficacy in managing premalignant and other cutaneous conditions. Full article

In this paper, we report on the measurement of the optical properties (absorption and scattering coefficients) of photoluminescent turbid media using a homemade integrating sphere setup equipped with a tunable monochromatic light source. The hemispherical reflectance and transmission data are analyzed with the radiative transfer equation using a Monte Carlo simulation-based lookup table to obtain the optical properties of the sample. The results are compared with the optical properties received from a classical integrating sphere setup equipped with a broadband white light source. The additional light of the photoluminescence generates artifacts within the optical properties, which are not present using a monochromatic light source. Additionally, a batch of samples with a broad range of scattering coefficients and dye concentrations were prepared and characterized with the aforementioned setup. The findings can help to generate a digital twin with the optical properties of the sample, which improves the physically based rendering and the design of, e.g., white-light LEDs. Dental restoration and photodynamic therapy also benefit from determination of the optical properties of photoluminescent turbid media. Full article

Raman spectroscopy is a technique which involves quantitative and qualitative molecular analysis based on the interaction between incident light and isolation of scattered wavelengths in generating a molecular fingerprint. It has a broad array of potential scientific applications, encompassing areas as diverse as food science and forensics. However, it may also be highly useful in clinical oncology. A recent focus of research in oncology has been in achieving the individualisation of care. Two important strategies to achieve a so-called “precision oncology” approach may include the detection of circulating tumour DNA (ctDNA) in more objectively evaluating treatment response and guiding de-escalation and intensification approaches in systemic therapy and therapeutic drug monitoring (TDM). Therapeutic drug monitoring involves the quantitation of plasma drug levels in order to tailor medication dosing in optimizing outcomes. The existing approaches to characterize small molecules, such as fluorescence-based and chromatographic strategies, may be limited by high costs, long turnaround times, and bulky equipment. Surface-enhanced Raman spectroscopy (SERS) may be deployed by utilizing a handheld device, with the potential for point of care, rapid turnaround, low-cost assessment of clinically relevant parameters, and prompt implementation of attendant changes in treatment. Although there is a growing body of data supporting the implementation of TDM and evaluation of ctDNA in achieving precision medicine, the uptake of such approaches remains relatively limited outside of clinical trials. As stated, the nature of existing analytical methodologies may prove to be a significant barrier to the routine clinic-based implementation of such approaches. Therefore, we provide the existing evidence for SERS in alleviating these barriers. We also provide insights into how SERS could contribute to clinical oncology. Full article

L-cone opsin expression by gene therapy is a promising treatment for blue cone monochromacy (BCM) caused by congenital lack of long- and middle-wavelength-sensitive (L/M) cone function. Eight patients with BCM and confirmed pathogenic variants at the OPN1LW/OPN1MW gene cluster participated. Optical coherence tomography (OCT), chromatic perimetry, chromatic microperimetry, chromatic visual acuity (VA), and chromaticity thresholds were performed with unmodified commercial equipment and/or methods available in the public domain. Adaptive optics scanning laser ophthalmoscope (AOSLO) imaging was performed in a subset of patients. Outer retinal changes were detectable by OCT with an age-related effect on the foveal disease stage. Rod and short-wavelength-sensitive (S) cone functions were relatively retained by perimetry, although likely impacted by age-related increases in the pre-retinal absorption of short-wavelength lights. The central macula showed a large loss of red sensitivity on dark-adapted microperimetry. Chromatic VAs with high-contrast red gratings on a blue background were not detectable. Color vision was severely deficient. AOSLO imaging showed reduced total cone density with majority of the population being non-waveguiding. This study developed and evaluated specialized outcomes that will be needed for the determination of efficacy and safety in human clinical trials. Dark-adapted microperimetry with a red stimulus sampling the central macula would be a key endpoint to evaluate the light sensitivity improvements. VA changes specific to L-opsin can be measured with red gratings on a bright blue background and should also be considered as outcome measures in future interventional trials. Full article

Over the past decade, research has prominently established neutrophils as key contributors to the intricate landscape of tumor immune biology. As polymorphonuclear granulocytes within the innate immune system, neutrophils play a pivotal and abundant role, constituting approximately ∼70% of all peripheral leukocytes in humans and ∼10–20% in mice. This substantial presence positions them as the frontline defense against potential threats. Equipped with a diverse array of mechanisms, including reactive oxygen species (ROS) generation, degranulation, phagocytosis, and the formation of neutrophil extracellular traps (NETs), neutrophils undeniably serve as indispensable components of the innate immune system. While these innate functions enable neutrophils to interact with adaptive immune cells such as T, B, and NK cells, influencing their functions, they also engage in dynamic interactions with rapidly dividing tumor cells. Consequently, neutrophils are emerging as crucial regulators in both pro- and anti-tumor immunity. This comprehensive review delves into recent research to illuminate the multifaceted roles of neutrophils. It explores their diverse functions within the tumor microenvironment, shedding light on their heterogeneity and their impact on tumor recruitment, progression, and modulation. Additionally, the review underscores their potential anti-tumoral capabilities. Finally, it provides valuable insights into clinical therapies targeting neutrophils, presenting a promising approach to leveraging innate immunity for enhanced cancer treatment. Full article

Hypothermia is a promising clinical therapy for acute injuries, including neural damage, but it also faces practical limitations due to the complexities of the equipment and procedures required. This study investigates the use of the A1 adenosine receptor (A1AR) agonist N6-cyclohexyladenosine (CHA) as a more accessible method to induce steady, torpor-like hypothermic states. Additionally, this study investigates the protective potential of CHA against LPS-induced sepsis and neuroinflammation. Our results reveal that CHA can successfully induce a hypothermic state by activating a neuronal circuit similar to the one that induces physiological torpor. This state is characterized by maintaining a steady core body temperature below 28 °C. We further found that this torpor-like state effectively mitigates neuroinflammation and preserves the integrity of the blood–brain barrier during sepsis, thereby limiting the infiltration of inflammatory factors into the central nervous system. Instead of being a direct effect of CHA, this protective effect is attributed to inhibiting pro-inflammatory responses in macrophages and reducing oxidative stress damage in endothelial cells under systemic hypothermia. These results suggest that A1AR agonists such as CHA could potentially be potent neuroprotective agents against neuroinflammation. They also shed light on possible future directions for the application of hypothermia-based therapies in the treatment of sepsis and other neuroinflammatory conditions. Full article

Radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) is the cornerstone of organ-sparing or adjuvant therapy for nearly all head and neck cancers. Unfortunately, aggressive RT or CCRT can result in severe late toxicities, such as osteoradionecrosis of the jaws (ORNJ). The incidence of ORNJ is currently less than 5–6% due to advances in dental preventive care programs, RT planning systems, and RT techniques. Although numerous patient-, tumor-, and treatment-related factors may influence the incidence rates of ORNJ, RT modality (equipment), technique, and dose-volume-related factors are three of the most influential factors. This is mainly because different RT equipment and techniques have different levels of success at delivering the prescribed dose to the focal volume of the treatment while keeping the “organ at risk” safe. ORNJ risk is ultimately determined by mandibular dose, despite the RT technique and method being known predictors. Regardless of the photon delivery method, the radiobiological effects will be identical if the total dose, dose per fraction, and dose distribution within the tissue remain constant. Therefore, contemporary RT procedures mitigate this risk by reducing mandibular dosages rather than altering the ionizing radiation behavior in irradiated tissues. In light of the paucity of studies that have examined the impact of RT modality, technique, and dose-volume-related parameters, as well as their radiobiological bases, the present review aims to provide a comprehensive overview of the published literature on these specific issues to establish a common language among related disciplines and provide a more reliable comparison of research results. Full article

Photodynamic therapy (PDT), a noninvasive method for cancer therapy, involves the generation of reactive oxygen species (ROS) by the photochemical excitation of photosensitizers (PSs) to induce cell death in cancer cells. A variety of PS including porphyrin derivatives and metal complexes such as iridium (Ir) complexes have been reported. In clinical trials, red-near infrared (NIR) light (650–900 nm) is preferred for the excitation of PSs due to its deeper penetration into tissues compared with visible light (400–500 nm). To overcome this limitation, we established a PDT system that uses cyclometalated iridium(III) (Ir(III)) complexes that are excited with blue light in the wireless power transmission (WPT) system. To achieve this, we developed a light-emitting diode (LED) light device equipped with a receiver coil that receives electricity from the transmitter coil through magnetic resonance coupling. The LEDs in the receiving device use blue light (470 nm) to irradiate a given Ir(III) complex and excite triplet oxygen (³O₂) to singlet oxygen (¹O₂) which induces cell death in HeLa S3 cells (human cervical carcinoma cells). The results obtained in this study suggest that WPT-based PDT represents a potentially new method for the treatment of tumors by a non-battery LED, which are otherwise difficult to treat by previous PDT systems. Full article

The extreme aggressiveness and lethality of many cancer types appeal to the problem of the development of new-generation treatment strategies based on smart materials with a mechanism of action that differs from standard treatment approaches. The targeted delivery of nanoparticles to specific cancer cell receptors is believed to be such a strategy; however, there are no targeted nano-drugs that have successfully completed clinical trials to date. To meet the challenge, we designed an alternative way to eliminate tumors in vivo. Here, we show for the first time that the targeting of lectin-equipped polymer nanoparticles to the glycosylation profile of cancer cells, followed by photodynamic therapy (PDT), is a promising strategy for the treatment of aggressive tumors. We synthesized polymer nanoparticles loaded with magnetite and a PDT agent, IR775 dye (mPLGA/IR775). The magnetite incorporation into the PLGA particle structure allows for the quantitative tracking of their accumulation in different organs and the performing of magnetic-assisted delivery, while IR775 makes fluorescent in vivo bioimaging as well as light-induced PDT possible, thus realizing the theranostics concept. To equip PLGA nanoparticles with targeting modality, the particles were conjugated with lectins of different origins, and the flow cytometry screening revealed that the most effective candidate for breast cancer cell labeling is ConA, a lectin from Canavalia ensiformis. In vivo experiments showed that after i.v. administration, mPLGA/IR775–ConA nanoparticles efficiently accumulated in the allograft tumors under the external magnetic field; produced a bright fluorescent signal for in vivo bioimaging; and led to 100% tumor growth inhibition after the single session of PDT, even for large solid tumors of more than 200 mm³ in BALB/c mice. The obtained results indicate that the mPLGA/IR775 nanostructure has great potential to become a highly effective oncotheranostic agent. Full article

Based on the modification of biological substances, either directly from the patient to be treated or from healthy donors, Advanced Therapy Medicinal Products (ATMPs) are promising therapeutic solutions (among others, CAR T-cells represent the current and best-known ATMPs). However, at a few hundred thousand USD per dose, these products suffer from their prohibitive price, limiting the number of treated patients. The reasons for this can be summarized as follows. The whole process takes place in sterile facilities and requires trained staff (as well as onerous equipment) who perform sampling for the numerous rounds of quality control performed throughout production. Production can last more than one week, and each round of sampling further increases the risk of contamination and the need to fight against them. Therefore, there exists a need for online control of the content of the bioreactor during production, especially focused on concentration measurements and quality assessments. Meanwhile, the real-time detection of possible contamination would allow production to be stopped as soon as a problem arises, hence saving days of useless cultures and reducing the cost of global production. In this conference, we present simple and real-time white-light spectroscopy to simultaneously monitor T-cell growth, estimate the production quality and detect contamination. The mathematical description of the absorption spectra shape allows us to achieve these goals. The contactless nature of white-light spectroscopy prevents sampling of the bioreactor’s content, and consequently, reduces the risk of concomitant contamination. The possible integration of such online methods in bioreactors is also proposed with the ulterior motive of democratizing the use of ATMPs for as many people as possible. Full article

Shift work disrupts an otherwise normal circadian rhythm, which may result in sleepiness among night-shift workers. Artificial light has been shown to alter the light–dark cycle of shift workers and reset or phase shift the biological clock, improving nighttime alertness in workers. However, the effect of light therapy on improving sleepiness in nighttime workers has not been effectively confirmed in nursing clinical studies, and it is worth using relevant studies to provide the best evidence in any clinical setting. Systematic review and meta-analysis were used. The study was performed using PRISMA. Academic Search Complete, Embase, MEDLINE, the Cochrane Library, and CINAHL were searched, from the inception of each database to 27 December 2021. The Cochrane risk of bias tool was used to assess the methodological quality of each study. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were synthesized using a random-effects model to assess the efficacy of lighting intervention to improve sleepiness in night-shift workers. Sensitivity analysis followed by subgroup analysis was employed to examine heterogeneity. The meta-analysis was performed using Review Manager 5.4.1 software. A total of 14 studies from 7 countries were included. The overall result shows that lighting interventions significantly improved sleepiness. Further, the blue-enriched white light with a color temperature greater than 5000 Kelvin was effective in improving sleepiness of night-shift workers. This study unveils the emergent knowledge that light interventions with blue-enriched white were effective in improving sleepiness for night-shift workers, including nurses. This finding can be applied to ensure patient safety, reduce accidents, and improve work efficiency and job satisfaction. Nurses constitute the largest health professional workforce. We suggest that hospitals can insert blue-enriched white light equipment for night-shift healthcare providers. Several evidence-based suggestions are made for further consideration. Full article

The contact of blood with the bioincompatible membranes of the dialyzer, which is part of the extracorporeal circuit during hemodialysis (HD), causes upregulation of various cellular and non-cellular processes, including massive generation and release of reactive oxygen species (ROS), (which is one of the primary causes of anemia in chronic renal failure). We hypothesize that near-infrared (NIR) radiation possesses antioxidant properties and is considered to protect the red blood cell (RBC) membrane by enhancing its resilience to negative pressures. Our experimental setup consisted of an HD machine equipped with a dialyzer with a polyamide membrane; whole bovine blood was examined in vitro in blood-treated circulation. Blood samples were taken at 0, 5, 15, and 30 min during the HD therapy. We also assessed osmotic fragility, hematocrit, hemolysis, and oxidative stress as a concentration of reactive thiobarbituric acid substances (TBARS). Our results have shown that RBC membrane peroxidation increased significantly after 30 min of circulation, whereas the TBARS level in NIR-treated blood remained relatively steady throughout the experiment. The osmotic fragility of NIR-irradiated samples during dialysis was decreased compared to control samples. Our studies confirm that in vitro, blood photobiomodulation using NIR light diminishes oxidative damage during HD and can be considered a simultaneous pretreatment strategy for HD. Full article

Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) is a positive-sense single-stranded RNA coronavirus capable of causing potentially lethal pneumonia-like infectious diseases in mammals and birds. The main mechanisms by which SARS-CoV-2 spreads include airborne transmission (aerosols and droplets) and the direct exposure of tissues (conjunctival, nasal, and oral mucosa) to contaminated fluids. The aerosol formation is universal in dentistry due to the use of rotary instruments (handpieces), ultrasonic scalers, and air–water syringes. Several layers of infection control should protect key stakeholders such as dentists, dental staff, and patients. These include the utilization of personal protective equipment, high-volume evacuation systems, pre-procedural mouthwashes, rubber dam, and more recently, antimicrobial photodynamic therapy and intra-oral visible light irradiation. These non-specific light-based approaches are relatively simple, inexpensive, and effective against viruses, bacteria, and fungi. Therefore, the present perspective review discusses the current efforts and limitations on utilizing biophotonic approaches as adjunct infection control methods to prevent the transmission of SARS-CoV-2 in dental settings. In addition, the present perspective review may positively impact subsequent developments in the field, as it offers relevant information regarding the intricacies and complexities of infection control in dental settings. Full article