323,871 results match your criteria challenges

The Impact of COVID-19 on the Optimal Management of Osteoporosis.

J Bone Metab 2021 May 31;28(2):115-122. Epub 2021 May 31.

Department of Orthopedic Surgery, Ewha Womans University, College of Medicine, Mokdong Hospital, Seoul, Korea.

Osteoporosis does not take a break while Coronavirus disease 2019 (COVID-19) stunned and overtook everyone's lives. Medical resources were immediately shifted, self-isolation and telemedicine were expanded, ambulatory care services such as bone densitometry and osteoporosis-centered clinics came to a near halt. Progress with fracture prevention has been challenged because osteoporotic fracture with low energy injury is more prevalent even though restriction of people's movement. Read More

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Therapeutic review of cabotegravir/rilpivirine long-acting antiretroviral injectable and implementation considerations at an HIV specialty clinic.

Pharmacotherapy 2021 Jun 15. Epub 2021 Jun 15.

Indiana University Health, Indianapolis, Indiana, USA.

Cabotegravir/rilpivirine (CAB/RPV) was recently approved by the US Food and Drug Administration (FDA) as the first complete parenteral antiretroviral (ART) regimen for treatment of people living with HIV (PLWH). As a monthly intramuscular (IM) injection, this therapy constitutes a major departure from the traditional paradigm of oral therapy requiring (at least) daily administration that has defined HIV treatment for decades. Composed of a second-generation integrase inhibitor (INSTI) and nonnucleoside reverse transcriptase inhibitor (NNRTI), CAB/RPV has achieved high rates of sustained virologic suppression with a favorable safety profile for treatment-experienced PLWH following oral lead-in (OLI) during several clinical trials. Read More

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Adjuvant versus Neoadjuvant Immunotherapy for Hepatocellular Carcinoma: Clinical and Immunologic Perspectives.

Semin Liver Dis 2021 Jun 15. Epub 2021 Jun 15.

Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.

Advancement in systemic therapy, particularly immune checkpoint inhibitor (ICI)-based combination regimens, has transformed the treatment landscape for patients with advanced hepatocellular carcinoma (HCC). The advancement in systemic therapy also provides new opportunities of reducing recurrence after curative therapy through adjuvant therapy or improving resectability through neoadjuvant therapy. Improved recurrence-free survival by adjuvant or neoadjuvant ICI-based therapy has been reported in other cancer types. Read More

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Multimaterial bioprinting towards the fabrication of biomimetic tissues and organs.

Biofabrication 2021 Jun 15. Epub 2021 Jun 15.

UCLA, 570 Westwood Plaza, Los Angeles, California, 90095, UNITED STATES.

Tissue reconstruction requires the utilization of multiple biomaterials and cell types to replicate the delicate and complex structure of native tissues. Various three-dimensional (3D) bioprinting techniques have been developed to fabricate customized tissue structures; however, there are still significant challenges, such as vascularization, mechanical stability of printed constructs, and fabrication of gradient structures to be addressed for the creation of biomimetic and complex tissue constructs. One approach to address these challenges is to develop multimaterial 3D bioprinting techniques that can integrate various types of biomaterials and bioprinting capabilities towards the fabrication of more complex structures. Read More

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Anisotropic compliance of robot legs improves recovery from swing-phase collisions.

Bioinspir Biomim 2021 Jun 15. Epub 2021 Jun 15.

Mechanical and Aerospace Engineering, University of California San Diego, 9500 Gilman Dr, La Jolla, California, 92093, UNITED STATES.

Uneven terrain in natural environments challenges legged locomotion by inducing instability and causing limb collisions. During the swing phase, the limb releases from the ground and arcs forward to target a secure next foothold. In natural environments leg-obstacle collisions may occur during the swing phase which can result in instability, and may require contact sensing and trajectory re-planning if a collision occurs. Read More

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Computational models of the "active self" and its disturbances in schizophrenia.

Conscious Cogn 2021 Jun 12;93:103155. Epub 2021 Jun 12.

Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany. Electronic address:

The notion that self-disorders are at the root of the emergence of schizophrenia rather than a symptom of the disease, is getting more traction in the cognitive sciences. This is in line with philosophical approaches that consider an enactive self, constituted through action and interaction with the environment. We thereby analyze different definitions of the self and evaluate various computational theories lending to these ideas. Read More

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Removal of trace DNA toxic compounds using a Poly(deep eutectic solvent)@Biomass based on multi-physical interactions.

J Hazard Mater 2021 Jun 9;418:126369. Epub 2021 Jun 9.

College of Pharmaceutical Science, Institute of Life Science and Green Development, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis of Ministry of Education, Hebei University, Baoding 071002, China. Electronic address:

DNA toxic compounds (DNA-T-Cs), even in trace amounts, seriously threaten human health and must be completely eliminated. However, the currently used separation media face great challenges in removing trace DNA-T-Cs. Based on the functional advantages of deep eutectic solvents (DESs) and the natural features of biomass (BioM), a series of Poly(DES)@BioMs functioning as adsorbents were prepared for the removal of aromatic/hetero-atomic DNA-T-Cs at the ppm level. Read More

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A novel organ-chip system emulates three-dimensional architecture of the human epithelia and the mechanical forces acting on it.

Biomaterials 2021 Jun 6;275:120957. Epub 2021 Jun 6.

Emulate Inc., 27 Drydock Avenue, 5th Floor, Boston, MA, 02210, USA. Electronic address:

Successful translation of in vivo experimental data to human patients is an unmet need and a bottleneck in the development of effective therapeutics. Organ-on-Chip technology aims to address this need by leveraging recent significant advancements in microfabrication and biomaterials, which enable modeling of organs and their functionality. These microengineered chips offer researchers the possibility to recreate critical elements of native tissue architecture such as in vivo relevant tissue-tissue interface, air-liquid interface, and mechanical forces, including mechanical stretch and fluidic shear stress, which are crucial to recapitulate tissue level functions. Read More

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Recent trends in bioresponsive linker technologies of Prodrug-Based Self-Assembling nanomaterials.

Biomaterials 2021 Jun 5;275:120955. Epub 2021 Jun 5.

Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada. Electronic address:

Prodrugs are designed to improve pharmaceutical properties of potent compounds and represent a central approach in drug development. The success of the prodrug strategy relies on incorporation of a reversible linkage facilitating controlled release of the parent drug. While prodrug approaches enhance pharmacokinetic properties over their parent drug, they still face challenges in absorption, distribution, metabolism, elimination, and toxicity (ADMET). Read More

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Refining the shit flow diagram using the capacity-building approach - Method and demonstration in a south Indian town.

J Environ Manage 2021 Jun 12;294:112971. Epub 2021 Jun 12.

Centre for Technology Alternatives for Rural Areas (CTARA), Indian Institute of Technology Bombay (IITB), India.

In cities of the Global South, faecal sludge management (FSM) has arisen as an acceptable and economical alternative for managing excreta. Shit flow diagram (SFD) has emerged as the preferred tool for the planning and advocacy of FSM services. Besides context-specific challenges, FSM planning, especially the use of SFD is impeded by the lack of data related to on-site sanitation systems (OSSs) and lack of capacity at the local level. Read More

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Interaction of nanoplastics with extracellular polymeric substances (EPS) in the aquatic environment: A special reference to eco-corona formation and associated impacts.

Water Res 2021 Jun 2;201:117319. Epub 2021 Jun 2.

Joint Laboratory of Guangdong Province and Hong Kong Region on Marine Bioresource Conservation and Exploitation, College of Marine Sciences, South China Agricultural University, Guangzhou 510641, China; Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou 510642, China. Electronic address:

Nanoplastics (NPs) are plastic particles with sizes ranging between 1 and 1000 nm, exhibiting exceptional qualities such as large surface area, lightweight, durability; therefore, are widely used in cosmetics, paints, electronics, etc. NPs are inevitability released into the aquatic environment where they tend to interact with both, the extracellular polymeric substances (EPS) and other fractions of natural organic matter (NOM), respectively secreted by organisms (e.g. Read More

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Analysis of neurosurgical cases before and during the COVID-19 pandemic from a tertiary care centre in India.

World Neurosurg 2021 Jun 12. Epub 2021 Jun 12.

Professor, Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi India.

Objective: We present the unique administrative issues as well as specific patient and surgeon related challenges and solutions implemented while treating neurosurgical cases during the COVID pandemic vis-à-vis the pre COVID times at our tertiary care center.

Methods: This is a retrospective study comparing the outcome of the neurosurgical patients treated from the beginning of lockdown in India on 25 March 2020 to 30 November 2020 with that of same period in the previous year, 2019.

Results: We had a total of 687 admissions under neurosurgery this year during the study period as compared to 2550 admissions in 2019. Read More

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Proteomic portraits reveal evolutionarily conserved and divergent responses to spinal cord injury.

Mol Cell Proteomics 2021 Jun 12:100096. Epub 2021 Jun 12.

Division of Neurosurgery, University of British Columbia, Vancouver, BC, Canada.

Despite the emergence of promising therapeutic approaches in preclinical studies, the failure of large-scale clinical trials leaves clinicians without effective treatments for acute spinal cord injury (SCI). These trials are hindered by their reliance on detailed neurological examinations to establish outcomes, which inflate the time and resources required for completion. Moreover, therapeutic development takes place in animal models whose relevance to human injury remains unclear. Read More

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Precision cancer medicine: What has translated into clinical use in Belgium?

Semin Cancer Biol 2021 Jun 12. Epub 2021 Jun 12.

Cancer Center, Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.

Rationale: In 2016, Belgium launched the Next Generation Sequencing (NGS) Roadbook, consisting in 10 Actions, across the health care system, to facilitate the uptake of NGS in routine clinical practice. We compiled feedback on deployment of the NGS Roadbook from governmental stakeholders and beneficiaries: health policy makers, insurance providers, pathologists, geneticists, and oncologists.

Main Findings: The Roadbook ensured the establishment of a Commission on Personalized Medicine and NGS testing guidelines. Read More

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A review on application of next-generation sequencing methods for profiling of protozoan parasites in water: Current methodologies, challenges, and perspectives.

J Microbiol Methods 2021 Jun 12:106269. Epub 2021 Jun 12.

Institute for Water and Wastewater Technology, Durban University of Technology, Durban 4000, South Africa. Electronic address:

The advancement in metagenomics techniques has provided novel tools for profiling human parasites in environmental matrices, such as water and wastewater. In this article, we review the current workflow methods and provide recommendations for the standardization of techniques. The current methods for sample collection, storage, concentration, extraction, sequencing DNA, and bioinformatic analysis are not fully adequate for the analysis of protozoans in environmental samples. Read More

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Stimuli-responsive surfaces for switchable wettability and adhesion.

J R Soc Interface 2021 Jun 16;18(179):20210162. Epub 2021 Jun 16.

Centre of Advanced Structural Ceramics, Department of Materials, Imperial College London, London SW7 2AZ, UK.

Diverse unique surfaces exist in nature, e.g. lotus leaf, rose petal and rice leaf. Read More

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An integrated platform to facilitate the calculation, validation and visualization of optical flow velocities in biological images.

J R Soc Interface 2021 Jun 16;18(179):20210248. Epub 2021 Jun 16.

Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore.

Optical flow algorithms have seen poor adoption in the biological community compared with particle image velocimetry for quantifying cellular dynamics because of the lack of proper validation and an intuitive user interface. To address these challenges, we present OpFlowLab, an integrated platform that integrates our motion estimation workflow. Using routines in our workflow, we demonstrate that optical flow algorithms are more accurate than PIV in simulated images of the movement of nuclei. Read More

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Pharmacogenetics-guided advances in antipsychotic treatment.

Clin Pharmacol Ther 2021 Jun 15. Epub 2021 Jun 15.

Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.

Pharmacogenetics (PGx) research over the past two decades has produced extensive evidence for the influence of genetic factors on the efficacy and tolerability of antipsychotic treatment. However, the application of these findings to optimize treatment outcomes for patients in clinical practice has been limited. This paper presents a meta-review of key PGx findings related to antipsychotic response and common adverse effects, including antipsychotic-induced weight gain (AIWG), tardive dyskinesia (TD) and clozapine-induced agranulocytosis (CIAG), and highlights advances and challenges in clinical implementation. Read More

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Resveratrol reduces drug resistance of SCLC cells by suppressing the inflammatory microenvironment and the STAT3/VEGF pathway.

FEBS Open Bio 2021 Jun 15. Epub 2021 Jun 15.

Department of Thoracic Surgery, Laizhou People's Hospital, Wuli Street, Laizhou City, Shandong, China, 261400.

DNA-damaging agents, such as adriamycin, are widely used for the treatment of small cell lung cancer (SCLC). However, drug resistance is one of the major challenges for treatment of SCLC. Herein, we investigated the mechanisms underlying drug resistance in SCLC cells and the effects of resveratrol (Res) on drug resistance. Read More

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Positioning the National Health Insurance for financial sustainability and Universal Health Coverage in Ghana: A qualitative study among key stakeholders.

PLoS One 2021 15;16(6):e0253109. Epub 2021 Jun 15.

Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra.

Introduction: The National Health Insurance Scheme (NHIS) was introduced in 2003 to reduce "out-of-pocket" payments for health care in Ghana. Over a decade of its implementation, issues about the financial sustainability of this pro-poor policy remains a crippling fact despite its critical role to go towards Universal Health Coverage. We therefore conducted this study to elicit stakeholders' views on ways to improve the financial sustainability of the operations of NHIS. Read More

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Non-pharmacological pain management practice and barriers among nurses working in Debre Tabor Comprehensive Specialized Hospital, Ethiopia.

PLoS One 2021 15;16(6):e0253086. Epub 2021 Jun 15.

Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Background: Pain is an unpleasant sensory and emotional experience associated with or resembling that actual or potential tissue damage. Different study findings show that about 55% to 78.6% of inpatients experience moderate-to-severe pain. Read More

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Development and psychometric properties of the Nursing Student Academic Resilience Inventory (NSARI): A mixed-method study.

PLoS One 2021 15;16(6):e0252473. Epub 2021 Jun 15.

Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran.

Introduction: Resilience has been proposed as a suitable solution to better deal with nursing students in cases of challenges but the complex and multidimensional nature of resilience has made its measurement challenging. This study aimed to develop and validate a new inventory theory-driven labeled Nursing Student Academic Resilience Inventory.

Methods: This study was performed with an exploratory sequential mixed-method design. Read More

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A Deep Probabilistic Transfer Learning Framework for Soft Sensor Modeling With Missing Data.

IEEE Trans Neural Netw Learn Syst 2021 Jun 15;PP. Epub 2021 Jun 15.

Soft sensors have been extensively developed and applied in the process industry. One of the main challenges of the data-driven soft sensors is the lack of labeled data and the need to absorb the knowledge from a related source operating condition to enhance the soft sensing performance on the target application. This article introduces deep transfer learning to soft sensor modeling and proposes a deep probabilistic transfer regression (DPTR) framework. Read More

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Quantification of Motor Function Post-stroke using Novel Combination of Wearable Inertial and Mechanomyographic Sensors.

IEEE Trans Neural Syst Rehabil Eng 2021 Jun 15;PP. Epub 2021 Jun 15.

Subjective clinical rating scales represent the gold-standard diagnosis of motor function following stroke, however in practice they suffer from well-recognized limitations including assessor variance, low inter-rater reliability and low resolution. Automated systems have been proposed for empirical quantification but have not significantly impacted clinical practice. We address translational challenges in this arena through: (1) implementation of a novel sensor suite combining inertial measurement and mechanomyography (MMG) to quantify hand and wrist motor function; and (2) introduction of a new range of signal features extracted from the suite to supplement predicted clinical scores. Read More

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Coproducing clinical curricula in undergraduate medical education: Student and faculty experiences in longitudinal integrated clerkships.

Med Teach 2021 Jun 15:1-11. Epub 2021 Jun 15.

Department of Medicine, Cambridge Health Alliance, Cambridge, MA, USA.

Purpose: Educational coproduction, in which learners partner with educators to create and improve their educational experiences, can facilitate student-centered medical education. Empirical descriptions of best practices for involving students in clinical curricular coproduction are needed. We aimed to understand faculty and student perspectives on methods, perceived benefits, and common barriers and solutions to clinical curricular coproduction. Read More

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Involvement of Jordanian Head Nurses' in Health Policy Development: A Cross-Sectional Study.

Policy Polit Nurs Pract 2021 Aug;22(3):230-238

Community and Mental Health Nursing Department, Jordan University of Science and Technology, Irbid, Jordan.

Background: Despite the importance of involving nurses in health policy, nurse's involvement faces many challenges. Literature showed that there is a low level of nurses' and nurse leaders' involvement in health policy development.

Aim: The aims of this study were to examine (a) the level of Jordanian head nurses' involvement in health policy development and their perceived benefits and barriers; (b) the relationships between level of knowledge, competence, and interest in health policy and the level of involvement in health policy development; and (c) the relationship between the level of self-efficacy (efficacy expectation and outcome expectation) and the level of involvement in health policy development. Read More

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Mass Spectrometry Imaging of Fibroblasts: Promise and Challenge.

Expert Rev Proteomics 2021 Jun 15. Epub 2021 Jun 15.

Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Bruker-MUSC Center of Excellence, Clinical Glycomics, Medical University of South Carolina, Charleston SC USA.

Introduction: Fibroblasts maintain tissue and organ homeostasis through output of extracellular matrix that affects nearby cell signaling within the stroma. Altered fibroblast signaling contributes to many disease states and the extracellular matrix secreted by fibroblasts has been used to stratify patient by outcome, recurrence and therapeutic resistance. Recent advances in imaging mass spectrometry allow access to single cell fibroblasts and their ECM niche within clinically relevant tissue samples. Read More

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Transanal Ileal Pouch: Is It Better?

J Laparoendosc Adv Surg Tech A 2021 Jun 14. Epub 2021 Jun 14.

Department of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the procedure of choice for patients with ulcerative colitis and select patients with Crohn's disease. Minimally invasive techniques have been increasingly adopted including the transanal approach. However there remains a dearth of comparative data assessing the technical advantages and outcomes of a transanal approach to the IPAA against other minimally invasive techniques. Read More

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