An individually-controlled multi-tined expandable electrode using active-cannula-based shape morphing for on-demand conformal radiofrequency ablation lesions

Being minimally invasive and highly effective, radiofrequency ablation (RFA) is widely used for small size malignant tumors treatment. However, in clinical practice, a large number of tumors are found in irregular shape, while the current RFA devices are hard to control their morphologic appearance of RFA lesions on demand, which usually ends up excessively ablating the tissues and often brings excessively irreversible damage to the organs’ functions. Here, we introduce active cannulas for each of individually-controlled sub-electrodes to achieve an on-demand shape morphing and thus conformal RFA lesion. The shape as well as the length of inserted sub-electrode can be precisely controlled by tuning the expanded length of the active stylet and relative position of the active cannula. Furthermore, owing to independent movement and energy control of each sub-electrodes, our electrode is shown to be not only efficient enough to accomplish accurate trajectory to target tissue in a single insertion, but also adaptive enough to ablate target tissues with diverse morphologic appearances and locations. Potentially, our RFA electrode is a better choice in the future clinical practice for minimally invasive treatments of malignant tumors of which preferred treatment is conformal ablation. Corresponding author(s) Email: [email protected]

Bcl2 inhibitor venetoclax +/− Anti-CD20: what do deep remissions mean?

SummaryIn recent years, treatment of patients exhibiting chronic lymphocytic leukemia has changed extensively due to advances in the development of targeted therapies. The Bcl‑2 inhibitor venetoclax demonstrated outstanding results when used in mono- as well as combination therapy. Minimal residual disease (MRD) measurement has become an important endpoint in most studies and shows high prognostic potential. With upcoming combination strategies, the role of MRD measurement has also increased and is likely to become a routine marker in future clinical practice.

Minimal residual disease in multiple myeloma: why, when, where

Improvements in multiple myeloma therapy have led to deeper responses that are beyond the limit of detection by historical immunohistochemistry and conventional flow cytometry in bone marrow samples. In parallel, more sensitive techniques for assessing minimal residual disease (MRD) through next-generation flow cytometry and sequencing have been developed and are now routinely available. Deep responses when measured by these assays correspond with improved outcomes and survival. We review the data supporting MRD testing as well as its limitations and how it may fit in with current and future clinical practice.

Molecular Immune Mechanism of Intestinal Microbiota and Their Metabolites in the Occurrence and Development of Liver Cancer

Intestinal microorganisms are closely associated with immunity, metabolism, and inflammation, and play an important role in health and diseases such as inflammatory bowel disease, diabetes, cardiovascular disease, Parkinson’s disease, and cancer. Liver cancer is one of the most fatal cancers in humans. Most of liver cancers are slowly transformed from viral hepatitis, alcoholic liver disease, and non-alcoholic fatty liver disease. However, the relationship between intestinal microbiota and their metabolites, including short-chain fatty acids, bile acids, indoles, and ethanol, and liver cancer remains unclear. Here, we summarize the molecular immune mechanism of intestinal microbiota and their metabolites in the occurrence and development of liver cancer and reveal the important role of the microbiota-gut-liver axis in liver cancer. In addition, we describe how the intestinal flora can be balanced by antibiotics, probiotics, postbiotics, and fecal bacteria transplantation to improve the treatment of liver cancer. This review describes the immunomolecular mechanism of intestinal microbiota and their metabolites in the occurrence and development of hepatic cancer and provides theoretical evidence support for future clinical practice.

Mindfulness as a well-being initiative for future nurses: a survey with undergraduate nursing students

Background Mindfulness can potentially positively impact well-being and resilience in undergraduate nursing students. The psychological well-being of such students undertaking clinical training is paramount to ensure optimal learning, and to equip them with skills to manage their wellbeing in future clinical practice. The aim of our study was to explore the views of undergraduate nursing students in relation to understanding and engaging with mindfulness, and how mindfulness could best be delivered within their university programme. Methods An online survey was administered via a cloud-based student response system to a convenience sample of first year undergraduate nursing students completing a Bachelor of Science (BSc) Honours (Hons) degree in nursing at a University in the United Kingdom. Data were analysed using descriptive statistics and thematic analysis. Results The survey achieved a response rate of 78% (n = 208). Seventy-nine percent of participants had heard of mindfulness and were interested in taking part in a mindfulness programme. Respondents reported that the ideal delivery of the programme would consist of weekly 45-min, in person group sessions, over a 6-week period. Respondents also indicated that a mobile application could potentially facilitate participation in the programme. Thematic analysis of open-ended comments, and free text, within the survey indicated 4 overarching themes: 1) Perceptions of what mindfulness is; 2) Previous mindfulness practice experiences; 3) Impact of mindfulness in nursing; 4) The need for a future well-being initiative for undergraduate nursing students. Conclusions Undergraduate nursing students perceived that a mindfulness programme has the potential to enhance well-being and future clinical practice. This student cohort are familiar with mindfulness and want more integrated within their undergraduate curriculum. Further research is required to examine the effectiveness of a tailored mindfulness intervention for this population that incorporates the use of both face-to-face and mobile delivery.

Students’ Perception towards the Usefulness and Satisfaction of Practical Biochemistry Skills in a Public University versus Private University in Khartoum, Sudan (2019)

Practical biochemistry skills (PBS) teaching sessions employ experiential learning techniques to promote medical students’ understanding and recall of essential concepts and basic clinical tests. Biochemistry Practical skill sessions constitute about 45% of the contact teaching hours and between 10% - 20% of the final assessment grades, in addition the students are unacquainted about the method of assessment used. This cross sectional institutional based study aimed to assess medical students’ perception towards the practical biochemistry skills (PBS). Medical students in one public (Al-Neelain) and one private (Al-Moughtarbeen) universities, in Khartoum State were involved. After ethical approval, the questionnaire was approved after using it in a pilot study. Data collected by a questionnaire were analyzed using (SPSS version 22).Private university students have more satisfaction (58% versus 18%, p<0.001), more positive perception with PBS (49.5% versus 15.1%, p<0.001) and are more convinced that it helps to retain knowledge (68.3% versus 12.9%, p<0.001). They are more satisfied with laboratory environment (p<0.001), PBS relation to theory (p<0.001) and more aware of PBS assessment and scores allocation (p≤0.002).Medical student satisfaction and engagement with Practical biochemistry skills is likely to be driven by the students’ awareness of the relevance of these sessions to other aspects of the curriculum, to their end-of-year assessment, and to their future clinical practice rather than the laboratory environment. In conclusion, we recommend updating Practical biochemistry skills contents and assessment methods and raising students’ awareness of its importance.

Adipose Tissue-Derived Microvascular Fragments From Male and Female Fat Donors Exhibit a Comparable Vascularization Capacity

Adipose tissue-derived microvascular fragments (MVF) represent effective vascularization units for tissue engineering. Most experimental studies exclusively use epididymal fat tissue of male donor mice as a source for MVF isolation. However, in future clinical practice, MVF-based approaches may be applied in both male and female patients. Therefore, we herein compared the vascularization capacity of MVF isolated from the epididymal and peri-ovarian fat tissue of male and female donor mice. Freshly isolated MVF from male and female donors did not differ in their number, length distribution, viability and cellular composition. After their assembly into spheroids, they also exhibited a comparable in vitro sprouting activity. Moreover, they could be seeded onto collagen-glycosaminoglycan matrices, which were implanted into full-thickness skin defects within mouse dorsal skinfold chambers. Repetitive intravital fluorescence microscopy as well as histological and immunohistochemical analyses revealed a comparable vascularization and incorporation of implants seeded with MVF of male and female origin. Taken together, these findings demonstrate that the vascularization capacity of MVF is not gender-specific.

The Emerging Roles and Therapeutic Potential of Extracellular Vesicles in Infertility

Infertility is becoming much more common and affects more couples. The past years witnessed the rapid development of the diagnosis and treatment upon infertility, which give numerous coupled more opportunities become parents. Extracellular vesicles are known as nano-sized membrane vesicles to play a major role in intracellular communication. In recent years, several basic and clinical studies have tried to investigate the correlation between the reproductive health/disorder and extracellular vesicles. However, the mechanism is still unclear. In this review, we reviewed the relationship between reproductive physiology and extracellular vesicles, and then collectively focused on the recent findings on the relationship between extracellular and infertility, and its consequent influence on the novel insight regarding the therapeutic strategies for infertility in the future clinical practice.