Empowering macrophages: the cancer fighters within the tumour microenvironment in mantle cell lymphoma.

In Mantle Cell Lymphoma (MCL), the role of macrophages within the tumour microenvironment (TME) has recently gained attention due to their impact on prognosis and response to therapy. Despite their low absolute number in MCL tumour tissue, recent findings reveal an association between the levels of macrophages and prognosis, consistent with trends observed in other lymphoma subtypes. M2-like macrophages, identified by markers such as CD163, contribute to angiogenesis and suppression of the immune response. Clinical trials with MCL patients treated with chemoimmunotherapy and targeted treatments underscore the adverse impact of high levels of M2-like macrophages. Immunomodulatory drugs like lenalidomide reduce the levels of MCL-associated CD163+ macrophages and enhance macrophage phagocytic activity. Similarly, clinical approaches targeting the CD47 "don't eat me" signalling, in combination with the anti-CD20-antibody rituximab, demonstrate increased macrophage activity and phagocytosis of MCL tumour cells. Cell-based therapies such as chimeric antigen receptor (CAR) T-cell have shown promise but various challenges persist, leading to a potential interest in CAR-macrophages (CAR-M). When macrophages are recruited to the TME, they offer advantages including phagocytic function and responsiveness to microenvironment alterations, suggesting their potential as a manipulable and inducible alternative when CAR T-cell therapies fails in the complex landscape of MCL treatment.

RIvER Clinic: Rethinking Incarceration and Empowering Recovery-An Innovative Postincarceration Care Delivery Model Implemented During the COVID-19 Pandemic.

The Rethinking Incarceration and Empowering Recovery (RIvER) Clinic was launched in June 2021 to address the health disparities experienced during and after incarceration. The RIvER Clinic's multidisciplinary, community-centered team engages patients during jail detention and after release via telehealth, collocated in community locations, on a mobile van, and in clinic. The clinic serves as a bridge between incarceration and the establishment of permanent health care and social services in the community. In 2022, a total of 479 visits were completed. The clinic provided multidisciplinary substance use support to all eligible patients, paying for 104 medication for opioid use disorder (MOUD) prescriptions for uninsured patients. Twenty-five percent of patients were transitioned to community-based care, and less than 5% of patients were reincarcerated. Despite some limitations, results demonstrate that the RIvER Clinic is successfully reintegrating a marginalized population into its community. The purpose of this article is to describe the implementation and preliminary outcomes of this postincarceration clinic.

Empowering Little Fighters: Post-Cardiotomy Pediatric ECMO and the Journey to Recovery.

INTRODUCTION: Extra Corporeal Membrane Oxygenation (ECMO) has long been used for cardiorespiratory support in the immediate post-paediatric cardiac surgery period with a 2-3% success as per the ELSO registry. Success in recovery depends upon the optimal delivery of critical care to paediatric patients and a comprehensive healthcare team. METHODOLOGY: The survival benefit of children placed on central veno arterial (VA) ECMO following elective cardiac surgeries for congenital heart disease (n = 672) was studied in a cohort of 29 (4.3%) cases from the period of Jan 2018 to Dec 2022 in our cardiac surgical centre. Indications for placing these patients on central VA ECMO included inability to wean from cardiopulmonary bypass (CPB), low cardiac output syndrome, severe pulmonary arterial hypertension, significant bleeding, anaphylaxis, respiratory failure and severe pulmonary edema. RESULTS: The mean time to initiation of ECMO was less than 5 h and the mean duration of ECMO support was 56 h with a survival rate of 58.3%. Amongst perioperative complications, sepsis and arrhythmia on ECMO were found to be negatively associated with survival. Improvements in the pH, PaO2 levels and serum lactate levels after initiation of ECMO were associated with survival benefits. CONCLUSION: The early initiation of ECMO for paediatric cardiotomies could be a beacon of hope for families and medical teams confronting these challenging situations. Improvement in indicators of adequate perfusion and ventricular recoveries like pH and serum lactate and absence of arrhythmia and sepsis are associated with good outcomes.

Peer and land-based approaches for fostering empowering and healthy relationships with Indigenous and northern young people in the Northwest Territories.

Indigenous and Northern women in Canada experience high rates of intimate partner violence (IPV), and this is particularly true in the Northwest Territories (NWT). Adolescents are also at increased risk of IPV, which has far-reaching, lifelong effects. Indigenous youth are particularly vulnerable to IPV due to ongoing effects of intergenerational trauma caused by colonialism, racism and residential school legacies. We explored attitudes towards IPV and the healthy relationship knowledge, skills, and experiences among participants of Fostering Open eXpression among Youth (FOXY) and Strength, Masculinities, and Sexual Health (SMASH) Peer Leader Retreats in the NWT. Multi-method approaches included quantitative surveys youth completed before and immediately following retreats. Quantitative analysis from retreats (2018-2021) included 240 participants aged 12-19 (mean age 14.5) who reported ever having an intimate partner. Most were from the FOXY program (64.2%), Indigenous (69.6%) and heterosexual (66.4%). Qualitative methods included Focus Group Discussions (FGD) (n = 69) conducted with peer leaders and apprentices (n = 311) and youth and adult staff (n = 14 FGDs, n = 165 participants). We thematically analysed FGDs to explore healthy relationship knowledge and skills, alongside paired t-tests to examine pre/post retreat changes in attitudes towards IPV. Qualitative findings suggest that leadership and embodied learning were effective in equipping youth with violence prevention and healthy relationship skills. While young women were committed to sharing knowledge and skills about healthy relationships in their communities, young men resonated with values of respect and appreciated support to identify and express emotions. Participants across programmes demonstrated their belief that healthy intimate relationships have communal, relational and intergenerational benefits. Quantitatively, we found a statistically significant reduction in attitudes accepting of IPV among young women, but no changes were noted among young men. Findings contribute to emergent evidence on strengths-based, culturally-responsive IPV prevention programming. Components of effective IPV prevention programming with young men merit further exploration.

Empowering patients in primary care: a qualitative exploration of the usability and utility of an online diabetes self-management tool.

BACKGROUND: Despite the potential advantages of Internet-based diabetes self-management education, its adoption was not widespread among Singapore's public primary care clinics (polyclinics). An interactive online tool was thus developed to help educate patients with Type 2 diabetes mellitus (T2DM), and was now ready for user testing before implementation. AIM: To explore the perceived utility and usability of the educational tool in patients with suboptimally-controlled T2DM in a Singapore primary care setting. METHODS: In-depth interviews were used to gather qualitative data from multi-ethnic Asian adults who had suboptimally-controlled T2DM. A total of 17 IDIs were conducted between April 2022 to March 2023, audio-recorded, transcribed, and analyzed to identify emergent themes via thematic analysis. RESULTS: Regarding utility, users found the educational tool useful because it provided them with information that was comprehensive, accessible, reliable, and manageable. Regarding usability, the majority of users reported that the educational tool was easy to use, and suggested ways to improve navigational cues, visual clarity, readability and user engagement. CONCLUSION: Participants generally found the educational tool useful and easy to use. A revised educational tool will be developed based on their feedback and implemented in clinical practice.

Empowering adult patients with diabetes for health educators' role within their family members: A cross-sectional study.

BACKGROUND: Patient engagement as partners in diabetes prevention for family members/close relatives is a novel and underexplored approach. This paper aims to assess patients' willingness and confidence in their ability to succeed as health educators for their family members and investigate the influencing factors. METHODS: A cross-sectional descriptive study was conducted between January 2023 and April 2023. A newly developed and validated self-reported questionnaire, based on the Health Belief Model (HBM) and previous research, was administered to a convenient sample of 134 adult participants diagnosed with diabetes. These participants sought care at primary healthcare clinics at King Abdul-Aziz Medical City, Ministry of National Guard Health Affairs in Riyadh and Jeddah (MNGHA). The data was examined using statistical methods including descriptive analysis, ANOVA, Tukey's HSD (Honestly Significant Difference) Post Hoc tests, and Pearson's correlation coefficients. RESULTS: The majority of participants expressed a willingness to assume the role of health educators for their family members (n = 117, 87.31%) and reported a high level of willingness and confidence, as indicated by self-efficacy scores ranging from 12.00 to 25.00, with a mean of 21.12 (SD = 2.76). Participants' willingness to be health educators exhibited positive correlations with their perceptions of diabetes severity and susceptibility (r = .433, p < .01), perceived benefits and barriers (r = .451, p < .01), cues to action (r = .520, p < .01), self-efficacy (r = .789, p < .01), and the total score of the questionnaire (r = .640, p < .01). CONCLUSIONS: The majority of participants expressed their willingness to assume the role of health educators for their family members, and a significant portion reported confidence in their capacity to accomplish this objective. Healthcare providers should emphasize the importance of equipping patients with the skills and knowledge necessary to effectively convey health messages and serve as health educators within their communities. This expansion of the approach holds the potential to have a significant impact on public health strategies for diabetes prevention.

Cardiac Rehabilitation Using the Family-Centered Empowerment Model is Effective in Improving Long-term Mortality in Patients with Myocardial Infarction: A 10-year Follow-Up Randomized Clinical Trial.

INTRODUCTION: Cardiac rehabilitation (CR) play a critical role in reducing the risk of future cardiovascular events and enhancing the quality of life for individuals who have survived a heart attack. AIM: To assess the mortality rates and stability of the effects in myocardial infarction (MI) survivors after implementing a Family-Centered Empowerment Model (FCEM)-focused hybrid cardiac rehabilitation program. METHODS: This double-blind randomized controlled clinical trial, conducted at Shariati Hospital, an academic teaching hospital in Tehran, Iran (2012-2023), involved 70 MI patients and their families. Participants were randomly assigned to an FCEM intervention group or standard CR control group. The intervention commenced after the MI patient's safe discharge from the CCU and continued for the entire 10-year follow-up period. Various questionnaires were utilized to collect data on mortality rates and health-related quality of life (HRQoL). RESULTS: The 10-year follow-up period revealed lower mortality rates in the intervention group (5.7%, 11.4%, and 17.1% at 5, 7, and 10 years, respectively) compared to the control group (20%, 37.1%, and 48.9%). After adjusting for age, gender, and BMI, the control group had a four times higher mortality risk (HR: 4.346, 95% CI 1.671-7.307, P = 0.003). The FCEM-focused program demonstrated a significant and sustained positive impact on participants' quality of life for 48 months, with greater improvement compared to the control group. CONCLUSION: This study highlights the effectiveness of FCEM-based hybrid CR programs in enhancing long-term patient outcomes and reducing mortality rates among MI survivors. Further research is needed to explore the potential benefits in larger samples and diverse populations. TRIAL REGISTRATION: This study (Identifier: NCT02402582) was registered in the ClinicalTrials.gov on 03/30/2015.

Evaluating the Usability of an mHealth App for Empowering Cancer Survivors With Disabilities: Heuristic Evaluation and Usability Testing.

BACKGROUND: More than 18 million cancer survivors are living in the United States. The effects of cancer and its treatments can have cognitive, psychological, physical, and social consequences that many survivors find incredibly disabling. Posttreatment support is often unavailable or underused, especially for survivors living with disabilities. This leaves them to deal with new obstacles and struggles on their own, oftentimes feeling lost during this transition. Mobile health (mHealth) interventions have been shown to effectively aid cancer survivors in dealing with many of the aftereffects of cancer and its treatments; these interventions hold immense potential for survivors living with disabilities. We developed a prototype for WeCanManage, an mHealth-delivered self-management intervention to empower cancer survivors living with disabilities through problem-solving, mindfulness, and self-advocacy training. OBJECTIVE: Our study conducted a heuristic evaluation of the WeCanManage high-fidelity prototype and assessed its usability among cancer survivors with known disabilities. METHODS: We evaluated the prototype using Nielsen's 10 principles of heuristic evaluation with 22 human-computer interaction university students. On the basis of the heuristic evaluation findings, we modified the prototype and conducted usability testing on 10 cancer survivors with a variety of known disabilities, examining effectiveness, efficiency, usability, and satisfaction, including a completion of the modified System Usability Scale (SUS). RESULTS: The findings from the heuristic evaluation were mostly favorable, highlighting the need for a help guide, addressing accessibility concerns, and enhancing the navigation experience. After usability testing, the average SUS score was 81, indicating a good-excellent design. The participants in the usability testing sample expressed positive reactions toward the app's design, educational content and videos, and the available means of connecting with others. They identified areas for improvement, such as improving accessibility, simplifying navigation within the community forums, and providing a more convenient method to access the help guide. CONCLUSIONS: Overall, usability testing showed positive results for the design of WeCanManage. The course content and features helped participants feel heard, understood, and less alone.

Empowering precise advertising with Fed-GANCC: A novel federated learning approach leveraging Generative Adversarial Networks and group clustering.

In the realm of targeted advertising, the demand for precision is paramount, and the traditional centralized machine learning paradigm fails to address this necessity effectively. Two critical challenges persist in the current advertising ecosystem: the data privacy concerns leading to isolated data islands and the complexity in handling non-Independent and Identically Distributed (non-IID) data and concept drift due to the specificity and diversity in user behavior data. Current federated learning frameworks struggle to overcome these hurdles satisfactorily. This paper introduces Fed-GANCC, an innovative federated learning framework that synergizes Generative Adversarial Networks (GANs) and Group Clustering. The framework incorporates a user data augmentation algorithm predicated on adversarial generative networks to enrich user behavior data, curtail the impact of non-uniform data distribution, and enhance the applicability of the global machine learning model. Unlike traditional approaches, our framework offers user data augmentation algorithms based on adversarial generative networks, which not only enriches user behavior data but also reduces the challenges posed by non-uniform data distribution, thereby enhancing the applicability of the global machine learning (ML) model. The effectiveness of Fed-GANCC is distinctly showcased through experimental results, outperforming contemporary methods like FED-AVG and FED-SGD in terms of accuracy, loss value, and receiver operating characteristic (ROC) indicators within the same computing time. Experimental results vindicate the effectiveness of Fed-GANCC, revealing substantial enhancements in accuracy, loss value, and receiver operating characteristic (ROC) metrics compared to FED-AVG and FED-SGD given the same computational time. These outcomes underline Fed-GANCC's exceptional prowess in mitigating issues such as isolated data islands, non-IID data, and concept drift. With its novel approach to addressing the prevailing challenges in targeted advertising such as isolated data islands, non-IID data, and concept drift, the Fed-GANCC framework stands as a benchmark, paving the way for future advancements in federated learning solutions tailored for the advertising domain. The Fed-GANCC framework promises to offer pivotal insights for the future development of efficient and advanced federated learning solutions for targeted advertising.

'It is empowering and gives people dignity in a very difficult process': A multistage, multimethod qualitative study to understand the views of end users in the cultural adaptation of a dementia and driving decision aid.

BACKGROUND: Decisions about driving for individuals living with dementia (ILWD) can be challenging. There are limited evidence-based person-centred interventions in the United Kingdom that support decisions about transitioning to not driving or guidelines for developing decision aids for ILWD. This study aimed to understand the important features of a decision aid through the cultural adaptation of Australian dementia and driving decision aid (DDDA) for ILWD residing in the United Kingdom. METHODS: This qualitative study was theoretically underpinned by a person-centred framework and conducted over three stages: (1) Development of a draft UK-specific DDDA; (2) semistructured interviews with ILWD and an online survey with stakeholders to obtain their views on a draft UK DDDA and (3) content analysis and synthesis of qualitative data to inform the final version of the decision aid. RESULTS: Eleven ILWD and six of their spouses participated in interviews, and 102 stakeholders responded to an online survey. The four broad features identified as important to include in a decision aid for drivers living with dementia were: a structured and interactive format; positive and supportive messaging and presentation; relevant and concise content and choice-centred. The perceived benefits of the decision aid were identified as supporting conversations, enhancing collaborative decision making and enabling agency with decisions about driving and future mobility options. CONCLUSIONS: Decision aids that are underpinned by interactive choice-driven questions enhance a person-centred approach to decisions about driving. Positively framing decision aids through the presentation and content can facilitate engagement with the decision-making process about driving. The findings have implications for the development of decision aids designed for ILWD on other important health and social topics. PATIENT AND PUBLIC INVOLVEMENT: Advocating for the development of a UK DDDA were ILWD. Healthcare professionals contributed to the development of a draft UK DDDA. Former and current drivers living with dementia, family members, healthcare professionals and other support networks of ILWD participated in interviews or an online survey which informed the final version of the UK DDDA.

Empowering Nurses for High-Value Healthcare: A Call for Legislative and Systemic Change.

ABSTRACT: Recognizing the positive impact of clinical data outcomes and patient care experiences, coupled with the growing preference for advanced practice RNs among patients, it is imperative that nurse leaders propel legislative reforms and infrastructure support from health systems. This strategic approach is crucial for maximizing the potential of nurses in improving patient care experience and outcomes, as well as increasing accessibility to healthcare in every community.

Empowering women in sustainable agriculture.

The agricultural and rural development policy seeks to facilitate the transition towards environmentally sustainable and climate-neutral agricultural practices, with a focus on human capital, knowledge, and innovation. Gender equality can play a significant role in promoting environmentally sustainable practices in the agricultural sector, particularly through the adoption and implementation of agri-environment-climate schemes (AECS) in the context of farm, agricultural, and rural development. We examine the presence of gender bias in the adoption intensity of AECS by utilising farm-level data from Slovenia. We find that women on Slovenian farms engage in the adoption of AECS and receive subsidies, despite the presence of a gender gap in various agricultural factor endowment variables that typically favour men. The results of this study provide evidence in favour of promoting greater involvement and empowerment of women in the fields of green technology applications and green entrepreneurship, particularly with AECS practices.

Empowering Voices: Inspiring Women in Medicinal Chemistry.

As we celebrate International Women's Day 2024 with the theme "Inspire Inclusion", the women of the ACS Medicinal Chemistry Division (MEDI) want to foster a sense of belonging, relevance, and empowerment by sharing uplifting stories of what inspired them to become medicinal chemists. In this editorial, we are featuring female medicinal chemistry scientists to provide role models, encouragement, and inspiration to others. We asked women medicinal chemists to contribute a brief paragraph about what inspired them to become medicinal chemists or what inspires them today as medicinal chemists. The responses and contributions highlight their passions and motivations, such as their love of the sciences and their drive to improve human health by contributing to basic research and creating lifesaving drugs.

Empowering Strategies for Lifestyle Interventions, Diet Modifications, and Environmental Practices for Uterine Fibroid Prevention; Unveiling the LIFE UP Awareness.

Uterine fibroids (UFs) are the most common prevalent benign tumor among women of reproductive age, disproportionately affecting women of color. This paper introduces an innovative management strategy for UFs, emphasizing the curbing of disease prevention and progression. Traditionally, medical intervention is deferred until advanced stages, necessitating invasive surgeries such as hysterectomy or myomectomy, leading to high recurrence rates and increased healthcare costs. The strategy, outlined in this review, emphasizes UF disease management and is named LIFE UP awareness-standing for Lifestyle Interventions, Food Modifications, and Environmental Practices for UF Prevention. These cost-effective, safe, and accessible measures hold the potential to prevent UFs, improve overall reproductive health, reduce the need for invasive procedures, and generate substantial cost savings for both individuals and healthcare systems. This review underscores the importance of a proactive UF management method, paving the way for future research and policy initiatives in this domain.

Empowering Young Women: A Qualitative Co-Design Study of a Social Media Health Promotion Programme.

Social media platforms may be promising intervention tools to address the nutrition literacy and associated health behaviours of young women. We aimed to co-design a lifestyle intervention on social media targeting eating, physical activity, and social wellbeing that is evidence-based, acceptable, and engaging for young women aged 18-24 years. The study used a participatory design framework and previously published iterative mixed methods approach to intervention development. Matrices for workshop objectives were constructed using expert discussions and insights were sought from young women in participatory workshops. A 10-step qualitative data analysis process resulted in relevant themes, which guided intervention development. The resulting intervention, the Daily Health Coach, uses multiple features of Instagram to disseminate health information. Co-created nutrition content considers themes such as holism, food relationships, and food neutrality and acknowledges commonly experienced barriers associated with social media use such as nutrition confusion, body image concerns, and harmful comparison. This study may guide other researchers or health professionals seeking to engage young women in the co-design of women's health promotion or intervention content on social media.

Empowering careers sessions at BVA Live.

Expert speakers will provide practical tips and advice to help you feel empowered and thrive in your business and career at this summer's BVA Live.

Empowering Persons with Autism Through Cross-Reality and Conversational Agents.

Autism Spectrum Disorder is a neurodevelopmental condition that can affect autonomy and independence. Our research explores the integration of Cross-Reality and Conversational Agents for Autistic persons to improve ability and confidence in everyday life situations. We combine two technologies of the Virtual-Real continuum. User experiences unfold from the simulation of tasks in VR to the execution of similar tasks supported by AR in the real world. A speech-based Conversational Agent is integrated with both VR and AR. It provides contextualized help, promotes generalization, and stimulates users to apply what they learned in the virtual space. The paper presents the approach and describes an empirical study involving 17 young Autistic persons.

MetaTron: advancing biomedical annotation empowering relation annotation and collaboration.

BACKGROUND: The constant growth of biomedical data is accompanied by the need for new methodologies to effectively and efficiently extract machine-readable knowledge for training and testing purposes. A crucial aspect in this regard is creating large, often manually or semi-manually, annotated corpora vital for developing effective and efficient methods for tasks like relation extraction, topic recognition, and entity linking. However, manual annotation is expensive and time-consuming especially if not assisted by interactive, intuitive, and collaborative computer-aided tools. To support healthcare experts in the annotation process and foster annotated corpora creation, we present MetaTron. MetaTron is an open-source and free-to-use web-based annotation tool to annotate biomedical data interactively and collaboratively; it supports both mention-level and document-level annotations also integrating automatic built-in predictions. Moreover, MetaTron enables relation annotation with the support of ontologies, functionalities often overlooked by off-the-shelf annotation tools. RESULTS: We conducted a qualitative analysis to compare MetaTron with a set of manual annotation tools including TeamTat, INCEpTION, LightTag, MedTAG, and brat, on three sets of criteria: technical, data, and functional. A quantitative evaluation allowed us to assess MetaTron performances in terms of time and number of clicks to annotate a set of documents. The results indicated that MetaTron fulfills almost all the selected criteria and achieves the best performances. CONCLUSIONS: MetaTron stands out as one of the few annotation tools targeting the biomedical domain supporting the annotation of relations, and fully customizable with documents in several formats-PDF included, as well as abstracts retrieved from PubMed, Semantic Scholar, and OpenAIRE. To meet any user need, we released MetaTron both as an online instance and as a Docker image locally deployable.