Vanda Institute

Microneedling and PRX PLUS formulations are established strategies for enhancing multidimensional skin quality, yet their combined use has not been systematically investigated. This pilot prospective real-world study evaluated the clinical effectiveness, patient-reported outcomes, and tolerability of a combined microneedling and skin booster protocol. A prospective single-arm pilot study was conducted in an outpatient aesthetic practice, enrolling 15 women with signs of photoaging. All participants received three full-face treatment sessions at 21-day intervals. Assessments at baseline (T0) and 15 days after the final session (T1) included high-resolution imaging (VISIA® and Visioscope) to quantify key skin parameters, the validated FLO-11 questionnaire for patient-reported outcomes, and visual analogue scales for immediate tolerability. The combined protocol produced significant improvements across multiple skin-quality domains. VISIA analyses demonstrated notable reductions in texture irregularities (–26.2%, p=0.001), texture score (–25.8%, p=0.001), UV spots (–9.5%, p=0.027), pigmented spots (–14.1%, p=0.001), and redness (–32.6%, p=0.008). Visioscope findings further confirmed reductions in spots (–41.7%, p=0.001), pore visibility (–17.1%, p=0.001), sebum levels (–40.0%, p=0.005), and wrinkle severity (–12.4%, p=0.006). Patient-reported outcomes indicated improved skin smoothness (p=0.014), a less “stressed” appearance (p=0.015), and greater satisfaction with overall facial aesthetics (p=0.038). Tolerability was favorable, with only mild-to-moderate discomfort and no clinically relevant adverse events. This pilot study suggests that microneedling combined with skin booster provides early, multidimensional improvements in skin quality with excellent tolerability and patient satisfaction. Larger controlled studies are needed to validate these preliminary findings.

Nghiên cứu mô tả đặc điểm lâm sàng, cận lâm sàng của 99 trẻ dưới 15 tuổi mắc viêm phổi nhiễm Mycoplasma pneumoniae tại Bệnh viện Đại học Y Hà Nội từ tháng 6/2023 đến tháng 12/2024. Viêm phổi nhiễm M. pneumoniae ở trẻ em gặp nhiều nhất ở nhóm từ 24 tháng tuổi đến dưới 60 tháng tuổi (47,5%). Biểu hiện lâm sàng viêm phổi nhiễm M. pneumoniae, chủ yếu là ho (100%), sốt (67,7%), khò khè (31,3%), và nghe phổi có ran (84,8%). Viêm phổi nhiễm M. pneumoniae có thể có biến chứng suy hô hấp (7,1%). X-quang tim phổi hay gặp nhất là hình ảnh đông đặc thuỳ phổi (39,4%) và mờ 2 rốn phổi (43,4%). Tràn dịch màng phổi ít gặp (5,1%). Xét nghiệm máu cho thấy hầu hết các trường hợp có bạch cầu trong giới hạn bình thường và tăng CRPhs.

This paper is devoted to discussing new records of land molluscs from Sicily and the surrounding archipelagos (Italy) acquired during our survey in the field in the last twenty years (2004–2024). Monacha parumcincta, a species widespread in Kérkira Island (Greece) and Apennine Italy, is reported for the first time in northeastern Sicily; Sardovitrina polloneriana, up to now considered endemic to Sardinia Island (Italy), is recorded for the first time from Pantelleria Island and Linosa Island (Sicilian Channel); Aegopinella pura, a species with European distribution, is confirmed in Sicily on the summit part of the Madonie Mountains (northern Sicily); and Milax lopadusanus, recently described from Lampedusa Island (Pelagian Archipelago, Sicily), is here reported also for Marettimo Island (Aegadian Archipelago, Sicily). The species identification is based on morphological inspection of shells and genitalia. Taxonomy and biogeographic issues are discussed as well.

Mục tiêu: 1. Đánh giá kết quả điều trị thoái hóa khớp gối nguyên phát bằng collagen thủy phân trọng lượng phân tử thấp tiêm nội khớp. 2. Nhận xét các tác dụng không mong muốn của liệu pháp trên. Đối tượng và phương pháp nghiên cứu: Nghiên cứu được tiến hành trên 58 bệnh nhân được chẩn đoán thoái hóa khớp gối nguyên phát giai đoạn 2-3 theo Kellgren và Lawrence, được chia làm 2 nhóm: Nhóm 1 gồm 23 bệnh nhân tiêm Arthrys và nhóm 2 gồm 35 bệnh nhân tiêm Synolis, điều trị ngoại trú tại Bệnh viện Đại học Y Hà Nội từ tháng 8/2023 đến 7/2024. Nghiên cứu tiến cứu, can thiệp, theo dõi dọc có so sánh giữa 2 nhóm. Kết quả: Sau 12 tuần điều trị: ở nhóm tiêm Arthrys điểm VAS trung bình từ 6,02 tại thời điểm trước nghiên cứu (T0), giảm rõ ràng từ ngay tuần thứ 1 còn 4,52, tỉ lệ cải thiện 30% điểm VAS là 21,74% và tiếp tục cải thiện đến tuần thứ 12 điểm VAS còn 1,61, tỉ lệ cải thiện 30% điểm VAS là 82,61%; điểm WOMAC chung từ 35,26±3,54 (T0), cải thiện rõ rệt từ tuần thứ 4 giảm còn 21,09, tỉ lệ cải thiện 50% điểm WOMAC là 43,48%; tiếp tục giảm vào tuần thứ 8 và đến tuần thứ 12 còn 12,88±2,11, tỉ lệ cải thiện 50% điểm WOMAC là 78,26%; điểm LEQUESNE từ 11,32 tại thời điểm T0, giảm rõ từ tuần thứ 4 và giảm còn 2,44 tại thời điểm T12. Sự khác biệt về cải thiện điểm VAS, WOMAC, LEQUESNE giữa 2 nhóm Arthrys và Synolis là không có ý nghĩa thống kê (p>0,05). Tỉ lệ gặp tác dụng không mong muốn của liệu pháp tiêm Arthrys là 12,9%, trong đó có 2 trường hợp bị căng tức sau tiêm, 1 trường hợp bị đau kéo dài sau tiêm 24h và có tràn dịch khớp gối nhưng giảm đi nhanh chóng khi dùng NSAIDs. Có 91,3% bệnh nhân hài lòng và rất hài lòng với phương pháp điều trị này. Kết luận: Liệu pháp tiêm nội khớp collagen trọng lượng phân tử thấp điều trị thoái hóa khớp gối nguyên phát có tác dụng giảm đau ngay từ tuần thứ 1, cải thiện chức năng vận động khớp gối rõ từ tuần thứ 4 và kéo dài đến tuần thứ 12 thông qua việc giảm các thang điểm VAS, WOMAC, LEQUESNE (p<0,05).

Today, three of four US physicians are employed by hospitals, health systems or corporations. Forward-thinking healthcare leaders are looking for ways to leverage the intellectual capital of their employed and affiliated physicians and tighten physician–hospital integration as a means to improve care management and coordination, improve access and quality and reduce costs. Structured medical group governance is one such approach taken by healthcare leaders to enable meaningful and intentional physician–hospital joint decision making and better integration. Governance enables providers to unify and speak with one collective voice, influence the business side of clinical matters, build a unified brand and culture within the organisation and set policy or standards needed to be adopted at scale, to name just a few. Since 2019, Providence Health, a national not-for-profit Catholic Health System providing services across seven states with nearly 9,000 employed or affiliated physicians, has developed a multi-tiered medical group governance structure to coalesce on strategic direction and the major decisions that influence the clinical practice. This paper describes Providence Health’s journey in designing and maturing its medical group governance structure. In this case study, the authors describe the why, the what and the how of medical group governance and provide lessons learned and specific examples of the impact Providence Medical Group boards have had on clinician integration, engagement and alignment across the system.

We introduce a new instrument called the Golden Mean Inventory (GMI). Founded on the proposition that the evaluation of underuse or overuse of character strengths represents an important extension of the understanding and applied use of character strength concepts, the GMI was developed as a 72-item instrument addressing underuse/optimal use/overuse in each of the 24 VIA character strengths in three contexts: work/school, relationships, and goal pursuit. Four a priori hypotheses were largely supported. Relationships with demographic variables were generally negligible. We envision a number of benefits from the GMI, including a model that effectively integrates concepts of positive and negative functioning, idiographic assessment appropriate for applied settings, and context-specific patterns of strengths use. The evidence provided here raises important questions about whether high scores on measures of positive functioning combine individuals who are operating in a highly effective manner with others who are demonstrating “too much of a good thing.”

BackgroundCambodia aims to eliminate all forms of malaria by 2025. In 2020, 90% of all malaria cases were Plasmodium vivax. Thus, preventing P. vivax and relapse malaria is a top priority for elimination. 14-day primaquine, a World Health Organization-recommended radical cure treatment regimen, specifically targets dormant hypnozoites in the liver to prevent relapse. Cambodia introduced P. vivax radical cure with primaquine after glucose-6-phosphate dehydrogenase (G6PD) qualitative testing in 2019. This paper presents Cambodia’s radical cure Phase I implementation results and assesses the safety, effectiveness, and feasibility of the programme prior to nationwide scale up.MethodsPhase I implementation was carried out in 88 select health facilities (HFs) across four provinces. Males over 20kgs with confirmed P. vivax or mixed (P. vivax and Plasmodium falciparum) infections were enrolled. A descriptive analysis evaluated the following: successful referral to health facilities, G6PD testing results, and self-reported 14-day treatment adherence. P. vivax incidence was compared before and after radical cure rollout and a controlled interrupted time series analysis compared the estimated relapse rate between implementation and non-implementation provinces before and after radical cure.ResultsIn the 4 provinces from November 2019 to December 2020, 3,239 P. vivax/mixed infections were reported, 1,282 patients underwent G6PD deficiency testing, and 959 patients received radical cure, achieving 29.6% radical cure coverage among all P. vivax/mixed cases and 98.8% coverage among G6PD normal patients. Among those who initiated radical cure, 747 patients (78%) completed treatment. Six patients reported side effects. In implementation provinces, an average 31.8 relapse cases per month were estimated signaling a 90% (286 cases) reduction in relapse compared to what would be expected if radical cure was not implemented.ConclusionsPlasmodium vivax radical cure is a crucial tool for malaria elimination in Cambodia. The high coverage of radical cure initiation and adherence among G6PD normal patients demonstrated the high feasibility of providing radical cure at point of care in Cambodia. Incomplete referral from community to HFs and limited capacity of HF staff to conduct G6PD testing in high burden areas led to lower coverage of G6PD testing. Phase I implementation informed approaches to improve referral completion and patient adherence during the nationwide expansion of radical cure in 2021.

The evolving field of food technology is increasingly dedicated to developing functional foods. This study explored bioactive peptides from sunflower protein isolate (SPI), obtained from defatted flour, a by-product of the oil processing industry. SPI underwent simulated gastrointestinal digestion and the obtained peptide-enriched fraction (PEF) showed antioxidant properties in vivo, in zebrafish. Among the peptides present in PEF identified by mass spectrometry analysis, we selected those with antioxidant properties by in silico evaluation, considering their capability to interact with Keap1, key protein in the regulation of antioxidant response. The selected peptides were synthesized and evaluated in a cellular model. As a result, DVAMPVPK, VETGVIKPG, TTHTNPPPEAE, LTHPQHQQQGPSTG and PADVTPEEKPEV activated Keap1/Nrf2 pathway leading to Antioxidant Response Element-regulated enzymes upregulation. Since the crosstalk between Nrf2 and NF-κB is well known, the potential anti-inflammatory activity of the peptides was assessed and principally PADVTPEEKPEV showed good features both as antioxidant and anti-inflammatory molecule.

BackgroundScotland currently has the highest rates of drug-related deaths in Europe, so drug checking services are being explored due to their potential role in reducing these deaths and related harms. Drug checking services allow individuals to submit presumed psychoactive drug samples for analysis, and then receive individualised feedback and counselling. This paper explores participants’ views on the advantages and challenges of three hypothetical service models, to inform future service delivery in Scotland.MethodsSemi-structured interviews were conducted with 43 people: 27 professional stakeholders, 11 people with experience of drug use, and five family members across three cities. Vignettes were used to provide short descriptions of three hypothetical service models during the interviews. Interviews were audio-recorded, transcribed and analysed using thematic analysis.ResultsParticipants identified advantages and challenges for each of the three potential service models. The third sector (not-for-profit) model was favoured overall by participants, and the NHS substance use treatment service was the least popular. Participants also noted that multiple drug checking sites within one city, along with outreach models would be advantageous, to meet the diverse needs of different groups of people who use drugs.ConclusionsDrug checking services need to be tailored to local context and needs, with a range of service models being possible, in order to meet the needs of a heterogeneous group of people who use drugs. Addressing issues around stigma, accessibility, and concerns about the potential impact of accessing drug checking on access to and outcomes of drug treatment, are essential for successful service delivery.