Saint Francis University

ABSTRACT By investigating the role of counterstorytelling in Multiple Family Narrative Therapy, this study significantly advances our understanding of positive family identity development for culturally marginalized Chinese families of children with dyslexia. 54 Hong Kong Chinese families were recruited for a multi-site randomized controlled trial, while 12 families participated in post-intervention semi-structured interviews were included in this study. Multimodal data were collected during and after the intervention to illustrate participants’ counternarratives. A thematic temporal sequence was found: “Revelation: Epiphany of a fresh journey,” “Reconnection: Revival of unity and collaboration,” “Determination: A new family” and “Perseverance: Lasting imprint of hope.”

Prospective, multicenter, single-blind, randomized, controlled pivotal study. To evaluate whether P-15L (PearlMatrix P-15 Peptide Enhanced Bone Graft) is noninferior in effectiveness to local autograft when applied in single-level instrumented transforaminal lumbar interbody fusion (TLIF). P-15L, an FDA-designated Breakthrough Drug-Device, is a composite drug-device combination bone graft containing P-15, a 15-amino acid polypeptide, which enhances cell binding, proliferation, and differentiation, resulting in bone formation. Skeletally mature patients, aged 22 to 80 years, with degenerative disc disease (DDD) were randomized 1:1 to P-15L (investigational) or to the local autograft (control) during single-level TLIF with a polyetheretherketone (PEEK) cage and supplemental pedicle screw fixation. The primary outcome was composite clinical success (CCS) at 24 months, defined as: no index level secondary surgical procedures; achievement of fusion; ≥15-point improvement in Oswestry low back pain disability questionnaire (ODI) from baseline; no new or worsening persistent neurological deficit relative to baseline; and no device-related serious adverse events (SAEs). A total of 290 patients were enrolled at 33 sites: 141 (48.6%) received P-15L, and 149 (51.3%) received local autograft. P-15L was noninferior ( P <0.0001) and superior ( P =0.002) to autograft with respect to CCS, with 55.5% of the investigational group achieving composite clinical success compared with 37.5% of the control group. P-15L had a 25.8% higher fusion rate as compared with autograft for the CCS at 24 months (84.3% vs. 58.5%, respectively). Device-related SAE rates were similar in both groups. P-15L was superior to local autograft in achieving clinical success at 24 months. Furthermore, P-15L produced a significantly higher fusion rate as compared with autograft. No meaningful clinical differences were found in the incidence of device-related SAEs. P-15L appears to be a safe and effective option for TLIF. Level I.

Study Design.Prospective, multicenter, single-blind, randomized, and controlled pivotal study.Objective.Compare time-to-fusion in patients treated with P-15L (PearlMatrixTM P-15 peptide enhanced bone graft) versus local autograft over 24 months and evaluate changes in pain and quality of life at 24 months relative to baseline.Summary of Background Data.P-15L, an FDA-designated breakthrough device, is a composite bone graft with P-15, a 15-amino acid polypeptide that promotes cellular adhesion, proliferation, and differentiation to support bone formation.Methods.Patients (22–80 y) with degenerative disc disease were randomized to the investigational (P-15L) or control (local autograft) group during single-level transforaminal lumbar interbody fusion (TLIF) with a PEEK cage and supplemental pedicle screw fixation. Fusion assessments occurred at 6, 12, and 24 months. Time-to-fusion was tested for superiority as compared with the control using Kaplan-Meier survival analysis. Back and leg pain were measured using the Visual Analog Scale (VAS) and quality of life was assessed using the Short Form Survey (SF-12).Results.The analysis included 290 patients from 33 sites; 141 (48.6%) received P-15L and 149 (51.3%) received local autograft. At randomization, at least one risk factor for pseudoarthrosis (obesity, nicotine use, or diabetes) was reported in 58.9% (83/141) of the investigational group and 60.4% (90/149) of the control group. More patients in the investigational group than the control group achieved fusion at 6 months (Kaplan-Meier fusion rates 57.6% vs. 26.9%, respectively), 12 months (68.8% vs. 41.5%, respectively), and 24 months (81.1% vs. 54.9%, respectively). P-15L was statistically superior to autograft for time-to-fusion (hazard ratio=1.87, 95% CI: 1.47–2.38; P < 0.0001). There was marked improvement in VAS and SF-12 relative to baseline in both groups at 24 months.Conclusion.P-15L promotes statistically superior earlier time-to-fusion than local autograft in instrumented TLIF. Both treatments resulted in clinically meaningful improvements in pain and quality of life at 24 months.Level of Evidence.Level I.

The Christian doctrine of Purgatory (CDP) is resurgent across confessional divides. Many philosophers and theologians have endorsed the Sanctification Account of CDP, according to which Purgatory provides the post-mortem moral purification required for believers to enter Heaven. The Sanctification Account can be embraced by Protestant and Orthodox Christians, who have historically disavowed CDP. However, its proponents typically ignore or repudiate traditional Catholic explanations of Purgatory’s purpose. Consequently, despite claims that Catholic doctrine merely affirms the Sanctification Account, there is a fresh challenge to CDP’s ecumenical reception. In this paper, I offer a new understanding of Purgatory – the Application Account – which should prove acceptable to Catholics and non-Catholics alike. I further show how the Application Account can incorporate Eleonore Stump’s work on atonement to provide a theological development of Catholic teaching on Purgatory which avoids prominent criticisms of the latter.

In the age of social media, the rapid spread of misinformation and rumors has led to the emergence of infodemics, where false information poses a significant threat to society. To combat this issue, we introduce <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">TrumorGPT</i>, a novel generative artificial intelligence solution designed for fact-checking in the health domain. TrumorGPT aims to distinguish “trumors”, which are health-related rumors that turn out to be true, providing a crucial tool in differentiating between mere speculation and verified facts. This framework leverages a large language model (LLM) with few-shot learning for semantic health knowledge graph construction and semantic reasoning. TrumorGPT incorporates graph-based retrieval-augmented generation (GraphRAG) to address the hallucination issue common in LLMs and the limitations of static training data. GraphRAG involves accessing and utilizing information from regularly updated semantic health knowledge graphs that consist of the latest medical news and health information, ensuring that fact-checking by TrumorGPT is based on the most recent data. Evaluating with extensive healthcare datasets, TrumorGPT demonstrates superior performance in fact-checking for public health claims. Its ability to effectively conduct fact-checking across various platforms marks a critical step forward in the fight against health-related misinformation, enhancing trust and accuracy in the digital information age.

BackgroundMicrowave ablation is a well-established therapeutic option for percutaneous treatment of lung tumors, however transbronchial microwave ablation remains under investigation. Our study aims to evaluate the safety and feasibility of transbronchial microwave ablation for lung cancer using state of the art bronchoscopy and imaging platforms and a microwave ablation system featuring tumor permittivity feedback control.MethodsThis study is an investigator initiated multicenter prospective diagnose-stage-treat, then resect, trial designed to evaluate the safety and feasibility of bronchoscopic microwave ablation. Patients with surgically resectable, treatment-naïve primary lung cancer tumors ≤ 3.0 cm will undergo shape sensing robotic assisted bronchoscopy (ssRAB) with cone-beam CT imaging for diagnostic sampling. Following intraoperative pathologic verification of malignancy, transbronchial microwave ablation will be performed. Cone-beam CT imaging will be used for verification of microwave probe position and for evaluation of ablation zone. Dedicated CT chest will be performed two weeks post-ablation. Two to four weeks following ablation patients will undergo standard of care surgical resection. Post-resection histopathologic analysis will evaluate treatment effect.Enrollment began March 2024 as a single-center study. The study will transition to multi-center to increase recruitment and improve generalizability.DiscussionThis study will be a first of its kind using shape sensing robotic assisted bronchoscopy and cone-beam CT for transbronchial microwave ablation. Our treat and resect design will provide short-term clinical safety data and vital treatment effect data.Trial registrationThis trial is registered at ClinicalTrials.gov (Identifier: NCT05281237). This study was prospectively registered on March 15, 2022.

The aim of the study was to learn if participating in an education series about Fetal Alcohol Spectrum Disorder (FASD), the Building Circles of Support (BCS) series, changes participants’ (1) understanding of FASD, (2) understanding of child behavior, and (3) thoughts about themselves as caregivers. It also investigated participants’ impressions of the program. Participants were recruited across three consecutive BCS series. Participants were eligible for the study by attending at least one BCS session. Six caregivers and eight supporters of children with FASD and prenatal alcohol exposure (PAE) were recruited. Data were collected before and after the series. Participants reported enjoying and learning from the series. They suggested additional sessions on strategies, sleep, community resources, and time for connecting as attendees be included in future BCS series. There was not enough information to determine if caregivers’ understanding of child behavior and thoughts about themselves as caregivers changed after the series; however, there were promising results to indicate an improvement in a caregiver’s sense of competency post-series. This study highlighted that caregivers and supporters value an educational series about PAE and FASD, which may lead to improved caregiving. It also uncovered insights that can be used to improve the BCS series and future research studies.