Conectar
by Nour Aboalhaija, Hala Abulawi, Rania Hamed, Mohammad Alwahsh, Fatma Afifi, Heba Syaj, Elham Abusharieh, Ismail Abaza
Chiliadenus montanus (Vahl) Boiss. (Asteraceae) is a pharmacologically significant plant with different potent pharmacological properties. This study aimed to evaluate the phytochemical and anticancer activity of C. montanus, and to develop nanoemulsions (NEs) to enhance pulmonary delivery for lung carcinoma treatment. For that ethanol and water extracts, along with petroleum ether, chloroform, ethyl acetate, and methanol fractions, were assessed for total phenol and flavonoid contents, antioxidant activity, and cytotoxicity against H1299 and A549 lung cancer cell lines. The results showed that ethyl acetate fraction exhibited the highest phenol (47.94 ± 0.32 mg GAE/g of DW) and flavonoid (20.34 ± 1.48 mg rutin/g of DW) contents, while the ethanol extract showed the most potent antioxidant activity (IC₅₀ = 322.1 µg/mL) and selective cytotoxicity (IC₅₀ = 641.2 µg/mL) against H1299 cells. Nevadensin, chlorogenic acid, and sorbifolin were identified as the major constituents of the ethanol extract using liquid chromatography-mass spectrometry (LC-MS) analysis. Gas chromatography-mass spectrometry (GC-MS) analysis revealed α-phellandrene, 1,8-cineole, and α-cadinol as the lead volatile constituents. The major volatile compound of the aroma profile of the aerial parts, determined by solid phase micro extraction (SPME) was 1,8-cineole. Spontaneous emulsification was used to formulate ethanolic NE (S1-S4 NEs) with varying concentrations of ethanol extract, surfactant, cosurfactant, and oil phase. The optimal S4 NE demonstrated thermodynamic stability, appropriate pulmonary pH, and droplet sizes below 100 nm. These findings highlight the promising potential of C. montanus NE as a stable pulmonary drug delivery system for lung carcinoma therapy.To explore the enablers of and barriers to implementing advanced practice nursing in primary health care in Germany and Brazil.
A qualitative cross-country comparative study.
Nine focus groups were conducted: 4 in Brazil and 5 in Germany with 48 participants (23 primary health care policy stakeholders and 25 nurses practicing in primary health care and general practitioners) between May 2022 and June 2023. The data were analysed by content analysis using a deductive–inductive approach.
Our findings reveal a need for clarity around the concept, specific roles and responsibilities of advanced practice nurses in primary health care. Although there is still no regulation in place for practising advanced practice nursing in either country, clear drivers can be observed, with Germany strengthening community health nursing and Brazil following clinical protocols in nursing practice. Dialogue among stakeholders—at both the policy and practitioner levels—is essential to bridge communication gaps. Additionally, involving patients in the implementation process is crucial for the holistic integration of advanced nursing roles.
Political, organisational and financial barriers persist, such as the need to establish both legal foundations and regulatory frameworks, enhance political participation within the nursing profession, and involve stakeholders in dialogue and consensus-building efforts. Giving advanced practice nursing a higher priority on political and research agendas—with policy adjustments and input from practitioners—can help integrate advanced practice nursing into primary health care.
Our findings highlight that actively involving nursing as an equal partner in political discourse is seen by stakeholders as crucial to drive the implementation process forward sustainably.
This study addresses the lack of data on the enablers and barriers to implementing advanced practice nursing in primary health care in Germany and Brazil. It underscores the need for clearer definitions of advanced practice nursing in primary health care, as well as sufficient regulation and funding. Dialogue is essential to bridge gaps and foster mutual understanding. The findings support future practice development and research, especially in countries that have introduced advanced nursing practice roles in primary health care.
The COnsolidated criteria for REporting Qualitative research (COREQ).
No involvement of patient and public contribution.
Our study highlights the growing adoption of expanded nursing responsibilities even in countries that have not yet formally implemented advanced practice nursing roles.
Although flow cytometric analysis of peripheral blood neutrophil myeloperoxidase expression can accurately rule out myelodysplastic neoplasms (MDS), it lacks reliability and efficiency due to the practical limitations of laboratory-developed liquid reagent-based assays. This study aimed to quantify the agreement and comparative discriminatory accuracy between a single-use flow cytometric lyophilised reagent tube (BD Lyotube Stain 468) and its laboratory-developed liquid reagent counterpart.
Cross-sectional diagnostic accuracy study of two index tests against a reference diagnosis.
A university hospital in France.
Consecutive adult patients with an indication for bone marrow aspiration due to suspected MDS and unexplained peripheral blood cytopenia.
MDS confirmed by cytomorphological evaluation of the bone marrow aspirate performed in duplicate by experienced haematopathologists blinded to the index test.
Of 103 participants enrolled between July 2020 and August 2021, 37 had MDS (prevalence, 36%). The median intra-individual robust coefficient of variation (RCV) for myeloperoxidase expression was 30.9% using the BD Lyotube Stain 468 and 31.2% using the laboratory-developed liquid reagent assay, with an intraclass correlation coefficient of 0.94 (95% CI 0.91 to 0.96). The areas under the receiver operating characteristic curves were 0.83 (95% CI 0.74 to 0.90) and 0.82 (95% CI 0.73 to 0.89), respectively. Using a prespecified threshold of 30.0%, the corresponding sensitivity estimates were 89% (95% CI 75% to 97%) and 95% (95% CI 82% to 99%).
BD Lyotube Stain 468 performs as well as its laboratory-developed liquid reagent counterpart for the quantification of myeloperoxidase expression by peripheral blood neutrophils. It may obviate the need for invasive bone marrow aspiration in up to 40% of patients with suspected MDS.
by Ayaulym Rakhmatulina, Shynar Kenenbay, Altynay Abuova, Maigul Kizatova, Akniyet Ibraikhan, Farrukh Makhmudov, Aitugan Mukashev, Aigerim Aitbaeva, Zhastalap Abilkaiyr, Galiya Ibadullayeva, Urishbay Chomanov, Akhmet Murzabulatov, Sanavar Azimova, Altyn Kulpiisova, Svetlana Bayantassova, Nurbek Aralbayev, Nurbibi Imanbayeva, Fatima Dikhanbayeva, Nadezhda Burambayeva, Nazgul Smagulova, Arman Issimov, Peter White
Camel milk has demonstrated robust immunomodulatory and anti-inflammatory properties in various clinical and experimental studies. However, no previous studies have characterized the cellular immunological effects of camel milk in the context of allergic asthma. Therefore, the present work aimed to evaluate the protective effects of camel milk in house dust mite induced asthma in mice, which emulate human pulmonary inflammation. Female BALB/c mice aged 8- to 10-week-old were intranasally sensitized with vehicle or HDM in 2.5 µl (5 µg) per nostril, 5 days a week for 3 weeks. On day 22, mice received an HDM challenge by a large volume but low dose into the lung (5 µg in 50µl) using intranasal inoculation. Using oral gavage technique, CM/HDM group mice received 0.5 ml of camel milk or vehicle five times a week, starting a day prior to sensitization. On day 23 following HDM challenge, mice were exposed to serial challenges with 10, 20, 40 and 100 mg/ml aerosolized methacholine to measure lung dynamics. Furthermore, BALF and whole lung samples were harvested to examine pulmonary inflammation. Camel milk effectively inhibited both HDM-induced infiltration of eosinophils and AHR. In addition to this, camel milk downregulates the number of pulmonary Th2 and Th17 cells and suppressed CCL17 expression in whole lung homogenates. Furthermore, camel milk reduced HDM-induced IL-4 and IL-13 expression following in vitro restimulation of pulmonary T cell subsets. Additionally, camel milk suppressed total concentrations of IL-5 and IL-13 in the lung. These results corroborate the asthma-preventive potential of camel milk and highlight the significance of diminished local concentrations of Th2- associated cytokines. In the present study, the observed downregulation of asthma progression by camel milk suggests its potential health benefits; however, further experimental and controlled clinical trials are needed before it can be considered a supplementary approach for allergic asthma management.The objective is to explore patients’ perceptions on the management of atrial fibrillation (AF) and associated comorbidities.
A descriptive qualitative study involving in-depth individual interviews, analysed using Braun and Clarke's approach to Reflexive Thematic Analysis.
Cardiology departments in teaching hospitals in five geographically diverse European countries—Belgium, Greece, Poland, Spain and the Netherlands.
30 adults aged 65 years or older, diagnosed with AF, with two or more confirmed comorbidities were interviewed.
The average age was 73 years, 37% were women and the most common comorbidity was hypertension (n=26, 87%), followed by hypercholesterolaemia (n=12, 40%), obesity (n=10, 33%), hypothyroidism (n=9, 30%) and diabetes (n=7, 23%). Three main themes were identified: (1) navigating the diagnosis path and adapting to life with AF, (2) normalising symptoms and treatment burden and (3) striving to build a therapeutic relationship.
Respondents had some knowledge about the relationship between comorbidities and AF but lacked understanding of how these comorbidities related to AF. Participants raised concerns regarding their medications, especially anticoagulants, with a desire to be given more information about them. Participants were motivated to make lifestyle adjustments but reported a lack of education and advice on how to implement and maintain these lifestyle changes. Overall, participants were very satisfied with their cardiology/AF teams, and they emphasised the importance of a person-centred approach. There was a perceived disjointedness to healthcare systems, with some reporting multiple appointments at different locations, leading to participants being frustrated and highlighting the lack of integrated care.
In-depth interviews provided an excellent platform to explore the perceptions and experiences of patients living with AF and associated comorbidities and highlighted the lack of an integrated approach to multimorbid AF management.
To determine caregiver knowledge of, attitudes towards, and perceptions of feeding practices for infants admitted to a tertiary referral hospital with severe pneumonia, and to identify community feelings about nasogastric tube feeding in Malawi.
The paediatric ward of a government tertiary referral hospital in Lilongwe, Malawi.
From March through April 2023, we conducted in-depth interviews with 14 mothers of infants 0–12 months of age hospitalised with severe pneumonia who had been enrolled in an observational study evaluating feeding and swallowing in breastfed infants. In-depth interviews assessed mothers’ attitudes towards hospital feeding practices including nasogastric tube feeding, along with community perceptions of nasogastric tubes. Data were analysed using a thematic analysis approach to assess themes and subthemes of transcripts.
Mothers understood that children with pneumonia are at risk of ‘choking’ during oral feeding; however, they had substantial worries about both withholding breastfeeding and providing nasogastric feeds to their infants through a nasogastric tube. Community perceptions of nasogastric tubes were widely negative and included beliefs that nasogastric tubes cause children to ‘choke’ and die and that medical providers want to harm children. Mothers held strong beliefs about the benefits of breastfeeding.
There are alarming misconceptions in the community around nasogastric tubes and the intentions of medical providers. This leads to maternal concerns about this hospital feeding practice, poor adherence to medical recommendations, and mistrust in the broader healthcare system. To improve hospital outcomes of children with severe pneumonia, caregiver and community education is needed.
We aimed to investigate the relationship between serum neurofilament light chain (NfL) and grip strength using data from the 2013–2014 US National Health and Nutrition Examination Survey (NHANES).
Secondary analysis of cross-sectional, population-based data.
NHANES sample, 2013–2014.
We studied 1925 participants aged 20–75 years.
We applied a multivariable generalised linear regression model, adjusted for several potential confounders, and restrictive cubic spline models to evaluate the association between serum NfL and grip strength. Subgroup analyses were conducted using stratified multivariable linear regression analysis.
We included 1925 participants (average age: 44.8±0.44 years) from the NHANES database. Participants with higher serum NfL levels had a significantly higher prevalence of medical conditions (hypertension, diabetes, cardiovascular disorder, chronic kidney disease (CKD) and cancer) compared with those with lower NfL levels (all p
Our study demonstrates a strong, negative and linear correlation between elevated serum NfL levels and grip strength. Notably, our findings indicate that individuals aged between 60 and 75 years, those with physical inactivity and those with CKD exhibit a more pronounced reduction in grip strength with increasing serum NfL levels.
The chronic venous disease covers a wide spectrum of venous disorders that are characterized by severely impaired blood return that primarily affects veins in the lower extremities. Morphological and functional abnormalities of the venous system led to chronic venous insufficiency (CVI), and present as leg heaviness/achiness, edema, telangiectasia, and varices. The term ‘chronic venous insufficiency’ (CVI) refers to a disease of greater severity. Venous dysfunction is associated with venous hypertension and is associated with venous reflux due to poorly functioning or incompetent venous valves, which ultimately reduces venous return, leading to a cascade of morphological, physiological, and histologic abnormalities such as blood pooling, hypoxia, inflammation, swelling, skin changes (lipodermatosclerosis), and in severe cases, venous leg ulcers (VLU). This review summarizes recent knowledge about the aetiology, risk factors, and pathophysiology of VLU and compared the possibilities of their treatment.
FreshRSS 