Correction: Beyond Newton's law of cooling in evaluating magnetic hyperthermia performance: a device-independent procedure.

[This corrects the article DOI: 10.1039/D4NA00383G.].

The pathologies of migrants who travel by boat documented on imaging.

The migration phenomenon is increasingly common worldwide. It is essential for radiologists to be aware of the endemic diseases of the migrant's country as well as the characteristics of the journey to be able to understand and interpret radiological findings when admitted to our centre. This article aims to use imaging from our centre to describe the most common pathologies that migrant patients present with after long journeys by boat.

Beyond Newton's law of cooling in evaluating magnetic hyperthermia performance: a device-independent procedure.

Accurate knowledge of the heating performance of magnetic nanoparticles (MNPs) under AC magnetic fields is critical for the development of hyperthermia-mediated applications. Usually reported in terms of the specific loss power (SLP) obtained from the temperature variation (ΔT) vs. time (t) curve, such an estimate is subjected to a huge uncertainty. Thus, very different SLP values are reported for the same particles when measured on different equipment/in different laboratories. This lack of control clearly hampers the further development of nanoparticle-mediated heat-triggered technologies. Here, we report a device-independent approach to calculate the SLP value of a suspension of magnetic nanoparticles: the SLP is obtained from the analysis of the peak at the AC magnetic field on/off switch of the ΔT(time) curve. The measurement procedure, which itself constitutes a change of paradigm within the field, is based on the heat diffusion equation, which is still valid when the assumptions of Newton's law of cooling are not applicable, as (i) it corresponds to the ideal scenario in which the temperature profiles of the system during heating and cooling are the same; and (ii) it diminishes the role of coexistence of various heat dissipation channels. Such an approach is supported by theoretical and computational calculations to increase the reliability and reproducibility of SLP determination. Furthermore, the new methodological approach is experimentally confirmed, by magnetic hyperthermia experiments performed using 3 different devices located in 3 different laboratories. Furthermore, the application of this peak analysis method (PAM) to a rapid succession of stimulus on/off switches which results in a zigzag-like ΔT(t), which we term the zigzag protocol, allows evaluation of possible variations of the SLP values with time or temperature.

Local therapy with combination TLR agonists stimulates systemic anti-tumor immunity and sensitizes tumors to immune checkpoint blockade.

Toll-like receptor (TLR) agonists are being developed as anti-cancer therapeutics due to their potent immunostimulatory properties. However, clinical trials testing TLR agonists as monotherapy have often failed to demonstrate significant improvement over standard of care. We hypothesized that the anti-cancer efficacy of TLR agonist immunotherapy could be improved by combinatorial approaches. To prevent increased toxicity, often seen with systemic combination therapies, we developed a hydrogel to deliver TLR agonist combinations at low doses, locally, during cancer debulking surgery. Using tumor models of WEHI 164 and bilateral M3-9-M sarcoma and CT26 colon carcinoma, we assessed the efficacy of pairwise combinations of poly(I:C), R848, and CpG in controlling local and distant tumor growth. We show that combination of the TLR3 agonist poly(I:C) and TLR7/8 agonist R848 drives anti-tumor immunity against local and distant tumors. In addition, combination of local poly(I:C) and R848 sensitized tumors to systemic immune checkpoint blockade, improving tumor control. Mechanistically, we demonstrate that local therapy with poly(I:C) and R848 recruits inflammatory monocytes to the tumor draining lymph nodes early in the anti-tumor response. Finally, we provide proof of concept for intraoperative delivery of poly(I:C) and R848 together via a surgically applicable biodegradable hydrogel.

Landscape crop diversity contributes to higher pollination effectiveness and positively affects rapeseed quality in Mediterranean agricultural landscapes.

Pollination is crucial for biodiversity and food security. Heterogeneous agricultural landscapes have a positive effect on pollinator abundance and enhance crop production and quality. In this study, we explored the effects of three landscape features (past crop diversity measured as the Equivalent Richness of crop functional Groups in the previous year [ERGp], semi-natural habitat percentage [SNH], and mean field size [MFS]) and pollinator densities (wild bees [WB] and honey bees [HB]) on pollination and seed quantity and quality in rapeseed crops. Surveying the pollinator density in 20 rapeseed fields revealed a positive relationship with ERGp in the landscape. A pollinator exclusion experiment compared bagged and open-pollinated self-compatible rapeseed plants and revealed insect pollination effectiveness (fruits per flower and number of seeds per pod) and seed quality (oil content). Seed parameters were evaluated in relation to pollinator density (WB-HB) and landscape characteristics. The ERGp emerged as a crucial landscape feature that positively impacted WB density. When insect pollinators were excluded, plants exhibited reduced pollination effectiveness and seed quality. Analysis of open-pollinated plants highlighted ERGp as the most influential variable, positively affecting both sets of parameters. The MFS and SNH showed different but important relationships. Total tocopherol and α-tocopherol were positively correlated with pollinator density in HB, whereas WB showed a positive correlation with γ-tocopherol levels. Increased ERGp positively affected pollinator density and pollination effectiveness, thereby improving oilseed rape production quantity and quality. This study provides new insights into agroecosystem management and pollinator-friendly practices.

Cultural stress among immigrants in the workforce.

OBJECTIVES: Previous research has investigated cultural stress and well-being among individuals such as Hispanic college students and immigrants from other countries. However, there is a need to explore the impact of cultural stress among immigrants with a focus on the workforce. METHOD: Drawing from cultural stress theory, we present a theoretical framework that considers workplace context while exploring strategies that may mitigate the impact of cultural stress in the workplace, such as promoting diversity and inclusion, addressing biases and discrimination, and supporting employee mental health. RESULT: We provide actionable steps that can guide leaders to work toward a workplace where individuals develop a sense of belonging. CONCLUSION: This article provides a novel perspective on workplace diversity and inclusion that emphasizes the importance of considering cultural context in understanding and addressing workplace stress, with implications for psychology in the workplace. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Increased plasma levels of N-terminal pro-B-type natriuretic peptide as biomarker for the diagnosis of cardioembolic ischaemic stroke.

BACKGROUND: Despite comprehensive study, the aetiology of stroke is not identified in 35% of cases. AIMS: We conducted a study to assess the diagnostic capacity of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the identification of ischaemic stroke of cardioembolic origin. The secondary purpose of the study was to evaluate the prognostic value of NT-proBNP for predicting 90-day all-cause mortality. METHODS: We designed a prospective observational study including patients hospitalised due to stroke between March 2019 and March 2020. Blood samples were collected on admission to the emergency department and serum NT-proBNP levels were determined. Statistical analysis was performed using a bivariate logistic regression model and receiver operating characteristic (ROC) and Kaplan-Meier curves. Statistical significance was established at p<.05. RESULTS: The study included 207 patients with first ischaemic stroke. Plasma NT-proBNP levels were significantly higher (p<.001) in the cardioembolic stroke group (2069pg/mL±488.5). ROC curves showed that NT-proBNP>499pg/mL was the optimum value for diagnosing cardioembolic ischaemic stroke (sensitivity, 82%; specificity, 80%). Moreover, plasma NT-proBNP levels>499pg/mL were independently associated with cardioembolic stroke (OR: 9.881; p=.001). Finally, NT-proBNP>1500pg/mL was useful for predicting 90-day mortality (sensitivity, 70%; specificity, 93%). CONCLUSIONS: NT-proBNP was independently associated with cardioembolic stroke and should be quantified in blood tests within 24h of stroke onset. High plasma levels (>499pg/mL) may indicate an underlying cardioembolic cause, which should be further studied, while NT-proBNP >1500pg/mL was associated with increased 90-day mortality.

Periodic table screening for enhanced positive contrast in MRI and in vivo uptake in glioblastoma.

The quest for nanomaterial-based imaging probes that can provide positive contrast in MRI is fueled by the necessity of developing novel diagnostic applications with potential for clinical translation that current gold standard probes cannot provide. Although interest in nanomaterials for positive contrast has increased in recent years, their study is less developed than that of traditional negative contrast probes in MRI. In our search for new magnetic materials with enhanced features as positive contrast probes for MRI, we decided to explore the chemical space to comprehensively analyze the effects of different metals on the performance of iron oxide nanomaterials already able to provide positive contrast in MRI. To this end, we synthesized 30 different iron oxide-based nanomaterials. Thorough characterization was performed, including multivariate analysis, to study the effect of different variables on their relaxometric properties. Based on these results, we identified the best combination of metals for in vivo imaging and tested them in different experiments. First, we tested its performance on magnetic resonance angiography using a concentration ten times lower than that clinically approved for Gd. Finally, we studied the capability of these nanomaterials to cross the affected blood-brain barrier in a glioblastoma model. The results showed that the selected nanomaterials provided excellent positive contrast at large magnetic field and were able to accumulate at the tumor site, highlighting the affected tissue.

Performance and healthcare analysis in elite sports teams using artificial intelligence: a scoping review.

Introduction: In competitive sports, teams are increasingly relying on advanced systems for improved performance and results. This study reviews the literature on the role of artificial intelligence (AI) in managing these complexities and encouraging a system thinking shift. It found various AI applications, including performance enhancement, healthcare, technical and tactical support, talent identification, game prediction, business growth, and AI testing innovations. The main goal of the study was to assess research supporting performance and healthcare. Methods: Systematic searches were conducted on databases such as Pubmed, Web of Sciences, and Scopus to find articles using AI to understand or improve sports team performance. Thirty-two studies were selected for review. Results: The analysis shows that, of the thirty-two articles reviewed, fifteen focused on performance and seventeen on healthcare. Football (Soccer) was the most researched sport, making up 67% of studies. The revised studies comprised 2,823 professional athletes, with a gender split of 65.36% male and 34.64% female. Identified AI and non-AI methods mainly included Tree-based techniques (36%), Ada/XGBoost (19%), Neural Networks (9%), K-Nearest Neighbours (9%), Classical Regression Techniques (9%), and Support Vector Machines (6%). Conclusions: This study highlights the increasing use of AI in managing sports-related healthcare and performance complexities. These findings aim to assist researchers, practitioners, and policymakers in developing practical applications and exploring future complex systems dynamics.

Analyzing ECG signals in professional football players using machine learning techniques.

Background: Football player's health is important, and preventing sudden cardiac arrest may be a critical issue. Professional football players have different ECG signals than the average population, yet there are considerable gaps in study whereas the general population has been extensively studied. Objectives: (a) Generate a reference and innovative resting 12-lead ECG database from 54 UEFA PRO level male football players from La Liga. This is a novel approach to cope the ECG and possible arrythmias in athletes. (b) Manage each XML athlete ECG data and develop a free-use program to visualize, denoise and filter the signal with the capacity to automate the labelling of the waves and save the reports. (c) Study the ECG wave shape and generate models through ML to analyse its utility to automate basic diagnosis. Methods: The dataset collection is based on a prospective observational cohort and includes 10 s, 12-lead ECGs and rhythm and condition labels for each athlete. Physiological sport arrhythmias, T-Wave shape and other findings were studied and labelled. ECG Visualizer was developed and used for 3 machine learning (ML) methods to automate sinus bradycardia arrhythmia diagnosis. Results: A dataset with 163 ECGs in XML format was collected comprising the Pro Football 12-lead Resting Electrocardiogram Database (PF12RED). "ECG Visualizer" software was developed, and ML was shown to be useful in detecting sinus bradycardia. Conclusions: The study demonstrates that AI and machine learning can detect simple arrhythmias with accuracy, also it provides a valuable dataset and a free software application.

A systematic review and meta-analysis of human population studies on the association between exposure to toxic environmental chemicals and left ventricular dysfunction (LVD).

BACKGROUND: Exposure to environmental chemicals has been associated with an elevated risk of heart failure (HF). However, the impact on early markers of HF, such as left ventricular dysfunction (LVD), remains limited. OBJECTIVE: To establish a foundation of evidence regarding early HF markers and their association with environmental pollutants, a systematic review and meta-analysis was conducted. METHODS: The search, conducted on October 13th, 2023, encompassed PubMed, Embase, and Web of Science without filters, focusing on observational studies reporting myocardial geometrical, structural, or functional alterations in individuals without a history of heart disease. This included the general adult population, workers, young people, and the elderly. The risk of bias was assessed using the ROBINS-I tool at both study and item levels. RESULTS: The systematic review included 17 studies involving 43.358 individuals exposed to air pollution and 2038 exposed to heavy metals. Approximately 41% of the effect measures of associations reported significant abnormalities in myocardial structure or function. The metanalyses by pollutants categories indicated positive associations between LV systolic and diastolic abnormalities and exposure to PM2.5 [-0.069 (-0.104, -0.033); -0.044 (-0.062, -0.025)] and PM10 [-0.055 (-0.087, -0.022); -0.030 (-0.050, -0.010)] and NO2 [-0.042 (-0.071, -0.013); -0.021 (-0.037, -0.004)], as well as positive associations between lead exposure and LV systolic abnormalities [-0.033 (-0.051, -0.016)]. CONCLUSIONS: Existing evidence shows that specific early markers of HF may be associated with exposure to chemical pollutants. It is recommended to include such endpoints in new longitudinal and case-control studies to confirm further risk associations. These studies should consider co-exposures, account for vulnerable groups, and identify cardiotoxic compounds that may require regulation. When examining the link between myocardial abnormalities and environmental exposure, it is also advisable to explore the supportive use of Adverse Outcome Pathway (AOP) approaches to confirm a causal relationship.

Tretinoin improves the anti-cancer response to cyclophosphamide, in a model-selective manner.

BACKGROUND: Chemotherapy is included in treatment regimens for many solid cancers, but when administered as a single agent it is rarely curative. The addition of immune checkpoint therapy to standard chemotherapy regimens has improved response rates and increased survival in some cancers. However, most patients do not respond to treatment and immune checkpoint therapy can cause severe side effects. Therefore, there is a need for alternative immunomodulatory drugs that enhance chemotherapy. METHODS: We used gene expression data from cyclophosphamide (CY) responders and non-responders to identify existing clinically approved drugs that could phenocopy a chemosensitive tumor microenvironment (TME), and tested combination treatments in multiple murine cancer models. RESULTS: The vitamin A derivative tretinoin was the top predicted upstream regulator of response to CY. Tretinoin pre-treatment induced an inflammatory, interferon-associated TME, with increased infiltration of CD8 + T cells, sensitizing the tumor to subsequent chemotherapy. However, while combination treatment significantly improved survival and cure rate in a CD4+ and CD8+ T cell dependent manner in AB1-HA murine mesothelioma, this effect was model-selective, and could not be replicated using other cell lines. CONCLUSIONS: Despite the promising data in one model, the inability to validate the efficacy of combination treatment in multiple cancer models deprioritizes tretinoin/cyclophosphamide combination therapy for clinical translation.

Could the aroma of spices produce a cross-modal enhancement of food saltiness and contribute to reducing salt intake?

BACKGROUND: As a result of its correlation with cardiovascular diseases, salt intake must be reduced. According to multi-sensory integration, aroma plays an important role in saltiness enhancement; this could enable a food's salt content to be reduced without losing acceptance. We therefore studied the effect of three spices, Curcuma longa, Laurus nobilis L. and Petroselinum crispum L., on saltiness enhancement through sensory tests on consumers. This was followed by olfactometric analysis with the aim of relating the effect to the spices' aromatic composition. RESULTS: According to the odour-induced salty taste enhancement (OISE) mean values, bay leaf and turmeric had the highest effect on saltiness enhancement, at a similar level to dry-cured ham aroma, wherwas parsley had a significantly lower OISE value. Only one odour-active compound (OAC), eugenol, showed a direct correlation with the spices' OISE values. Turmeric primarily had OACs with sweet aroma, whereas bay leaf had more OACs belonging to the spicy-aroma category. CONCLUSION: The three spices, turmeric, bay leaf and parsley, investigated in the present study appear to enhance the salty taste of mashed potato with a low salt content. The results suggest that an interaction effect among OACs with different aromatic ranges may exist. Therefore, when the global OAC modified frequency value, grouped according to aroma range, was considered, the sweet range appears to counteract the effect of the spicy aroma on saltiness. © 2024 Society of Chemical Industry.

A community-based intervention study involving family gardens with aromatic herbs on changes in dietary and urinary sodium.

OBJECTIVE: To measure dietary and urinary changes in sodium (Na) intake and excretion through the implementation of family gardens with aromatic herbs and workshops for cooking, using the herbs as a substitute for salt and seasoning powder. METHODS: Thirty-five participants from a neighborhood of Mexico City were included. A general questionnaire was administered to collect information on sociodemographic factors. At baseline and 3 months later, a dietary evaluation was conducted, and 24-hour urine samples were collected. Food items reported were classified according to the NOVA classification. Visits to participants´ houses were conducted to measure the amount of salt and seasoning powder added to food during the preparation of meals as well as a home food inventory. All participants were given a family garden with 6 aromatic herbs and a recipe book. The intervention included 7 cooking and 3 garden care workshops. Qualitative information on the experience was also collected. Linear regression models were run in order to estimate the contribution of each NOVA group, salt, and seasoning powder to total dietary Na intake. RESULTS: Participants were 44 years old on average and were mainly women (91.4%). The participation compliance in the workshops was 69.5%. After 3 months, there was a Na intake mean reduction of 976 mg. There was also a reduction in the excreted urinary Na of 325 mg per day. CONCLUSION: A positive level of involvement in this program had a direct influence on dietary habits to lower Na consumption.

Unveiling the crystal and magnetic texture of iron oxide nanoflowers.

Iron oxide nanoflowers (IONF) are densely packed multi-core aggregates known for their high saturation magnetization and initial susceptibility, as well as low remanence and coercive field. This study reports on how the local magnetic texture originating at the crystalline correlations among the cores determines the special magnetic properties of individual IONF over a wide size range from 40 to 400 nm. Regardless of this significant size variation in the aggregates, all samples exhibit a consistent crystalline correlation that extends well beyond the IONF cores. Furthermore, a nearly zero remnant magnetization, together with the presence of a persistently blocked state, and almost temperature-independent field-cooled magnetization, support the existence of a 3D magnetic texture throughout the IONF. This is confirmed by magnetic transmission X-ray microscopy images of tens of individual IONF, showing, in all cases, a nearly demagnetized state caused by the vorticity of the magnetic texture. Micromagnetic simulations agree well with these experimental findings, showing that the interplay between the inter-core direct exchange coupling and the demagnetizing field is responsible for the highly vortex-like spin configuration that stabilizes at low magnetic fields and appears to have partial topological protection. Overall, this comprehensive study provides valuable insights into the impact of crystalline texture on the magnetic properties of IONF over a wide size range, offering a deeper understanding of their potential applications in fields such as biomedicine and water remediation.

Fertility in seasonal-calving pasture-based lactating dairy cows following timed artificial insemination or timed embryo transfer with fresh or frozen in vitro-produced embryos.

The objective was to compare pregnancy per service event (P/S) in lactating dairy cows following timed artificial insemination (AI) or timed embryo transfer (ET) using either fresh or frozen in vitro-produced embryos. Oocytes were collected once per week for up to 9 wk using transvaginal ovum pick-up from elite dairy donors (ET-DAIRY; n = 40; Holstein-Friesian and Jersey) and elite beef donors (ET-ELITE-BEEF; n = 21; Angus). Both ET-DAIRY and ET-ELITE-BEEF donors consisted of heifers and cows. In addition, oocytes were collected from the ovaries of beef heifers of known pedigree following slaughter at a commercial abattoir (ET-COMM-BEEF; n = 119). Following in vitro maturation and fertilization, presumptive zygotes were cultured in vitro to the blastocyst stage. Grade 1 blastocysts were either transferred fresh or frozen for on-farm thawing and direct transfer. A total of 1,106 recipient cows (all lactating, predominantly Holstein-Friesian) located on 16 herdlets were blocked based on parity, calving date, and Economic Breeding Index, and randomly assigned to receive AI (n = 243) or ET (n = 863) after estrous synchronization with a 10-d Progesterone-synch protocol. Cows assigned to ET were further randomized to receive fresh (n = 187) or frozen (n = 178) ET-ELITE-BEEF embryos, fresh (n = 169) or frozen (n = 162) ET-DAIRY embryos, or fresh (n = 80) or frozen (n = 87) ET-COMM-BEEF embryos. Pregnancy was diagnosed using transrectal ultrasound on d 32 to 35 after synchronized ovulation and confirmed on d 62 to 65, at which time fetal sex was determined. Pregnancy per service event at d 32 was not different between AI (48.8%) and ET (48.9%) and did not differ between dairy and beef embryos (50.3% vs. 48.1%, respectively). However, P/S was less on d 32 following transfer of frozen embryos (41.6%) compared with fresh embryos (56.1%). Pregnancy loss between d 32 and 62 was greater for ET (15.1%) compared with AI (4.7%), with greater losses observed for frozen beef (18.5%), fresh beef (17.3%), and frozen dairy (19.2%) compared with fresh dairy (6.0%) embryos. Serum progesterone (P4) concentration on d 7 was associated with P/S at d 32 and 62. Cows in the quartile with the least serum P4 concentrations (quartile 1) had less probability of being pregnant on d 32 (33.4%) compared with cows in the 3 upper quartiles for serum P4 (45.7%, 55.6%, and 61.2% for quartile 2, quartile 3, and quartile 4, respectively). Sex ratio (male:female) at d 62 was skewed toward more male fetuses following ET (61.1:38.9) compared with AI (43.2:56.8) and was consistent with the sex ratio among in vitro blastocysts (61.2:38.8). In conclusion, P/S was similar for AI and ET, although pregnancy loss between d 32 and 62 was greater for ET than for AI.

Predictive toxicological effects of Artemisia absinthium essential oil on hepatic stellate cells.

Medicinal plants are important worldwide, considering their properties for treating diseases; however, few studies have evaluated their toxicological potential. Among them, Artemisia absinthium is frequently used to treat liver diseases, because its essential oil has several popular therapeutic properties. Based on this information, in the present study, we investigated molecular connectors of physiological effects of the Artemisia absinthium essential oil on human hepatic stellate cell line, LX-2, to explore the potential toxicity of the plant on liver cells. LX-2 is a cellular model to investigate mechanisms of liver fibrosis; then, to analyze the essential oil effects LX-2 was cultured under different conditions, treated or not with the essential oil at 0.4 µg/µL for 24 h. Next, fluorescence microscopy analyses, gene expression measurements, and biochemical approaches revealed that the essential oil reduced pro-fibrogenic markers; however, disrupt lipid metabolism, and cause cellular stress, by the activation of cellular detoxification and pro-inflammatory processes. In conclusion, the hepatic stellate cells incubated with the essential oil present an antifibrotic potential, supporting its popular use; however, the combined results suggest that the essential oil of Artemisia absinthium should be used with caution.

Workplace aggressions on hospital workers: A current and prevalent problem with a high demand for training.

BACKGROUND: Workplace aggressions on hospital workers is a very frequent and under-reported problem. OBJECTIVE: The novel objective of our study was to analyze the number of workplace aggressions per hospital worker. Other objectives of the study were to analyze the management knowledge and interest in receiving training on aggressions by hospital workers. METHODS: An anonymous survey was handed out among all professionals in a university hospital. RESULTS: A total of 1118 anonymous surveys were collected. The responders declared that throughout their working life they had suffered some sort of verbal aggression in the hospital in 766 cases (68.5%) and physical aggression in 393 cases (35.2%). Multiple logistic regression analyses found higher risk of receiving physical and verbal aggression in the nursing category and in the Emergency, Critical Care or Psychiatry Units, and a higher risk of receiving physical aggression in women. The score on the level of personal knowledge regarding the legal, physical, and psychological management of aggressions (score 0-10 for each of the 3 aspects) was 2.91±2.68 in legal management, 2.97±2.77 in psychological management and 2.91±2.76 in physical management. The opinion about the interest of receiving training (score from 0 to 10) on the legal management of hospital aggressions was 8.90±1.72, on psychological management was 8.85±1.78 and on physical management was 8.88±1.78. CONCLUSIONS: Workplace aggression on hospital workers mainly affects women, the nursing category and the Emergency, Critical Care or Psychiatry Units. Hospital workers showed little knowledge on the topic but a great interest in receiving training.

Can Achilles tendinosis be treated effectively with lidocaine and glucose infiltrations, and if so, is the effect lasting? A longitudinal, observational on 27 consecutive patients.

OBJECTIVE: Our aim was to add to the small but growing body of evidence on the effectiveness of ultrasound-guided Achilles intratendinous hyperosmolar dextrose prolotherapy and introduce a novel, preceding step of paratenon hydrodissection with lidocaine in patients with chronic Achilles tendinosis resistant to rehabilitation therapy. METHODS: We conducted a longitudinal, observational study on 27 consecutive patients diagnosed with Achilles tendinosis, in whom conservative treatment, ie, physiotherapy or shock wave therapy, had failed. A 2% lidocaine paratenon anesthesia and hydrodissection was followed by ultrasound-guided, intratendinous injections of 25% glucose every 5 weeks. Visual analogue scales (VAS) were used for pain assessment at rest, for activities of daily living, and after moderate exercise at the begining and at the end of the treatment. Moreover, tendon thickness and vascularisation were recorded at baseline and final treatment consultation. Effectiveness was estimated from scoring and relative pain reduction using a 95% CI. The non-parametric Wilcoxon test and a general linear model for repeated measures were applied. Statistical significance was established as p < 0.05. RESULTS: A median of 5 (1-11) injection consultations per patient were required. Pain scores decreased significantly in all three conditions (p < 0.001). Relative reductions were 75% in pain at rest (95% CI;61-93%), 69% in pain with daily living activities (95% CI; 55-83%), and 70% in pain after moderate exercise (95% CI; 57-84%). Tendon neo-vascularisation was significantly reduced (p < 0.001). We did not observe significant changes in tendon thickness (p = 0.083). CONCLUSIONS: Achilles tendinosis treatment with paratenon lidocaine hydrodissection and subsequent prolotherapy with hyperosmolar glucose solution is safe, effective, inexpensive, and virtually painless with results maintained over time.