Out of the boxes,out of the silos: The need of interdisciplinary collaboration to reduce poor-quality medical products in the supply chain

In this paper, we argue that understanding and addressing the problem of poor-quality medical products requires a more interdisciplinary approach than has been evident to date. While prospective studies based on rigorous standardized methodologies are the gold standard for measuring the prevalence of poor-quality medical products and understanding their distribution nationally and internationally, they should be complemented by social science research to unpack the complex set of social, economic, and governance factors that underlie these patterns. In the following sections, we discuss specific examples of prospective quality surveys and of social science studies, highlighting the value of cross-sector partnerships in driving high-quality, policy-relevant research in this area.     

The role of exosomes in metastasis and progression of melanoma

The mechanisms of melanoma metastasis have been the subject of extensive research for decades. Improved diagnostic and therapeutic strategies are of increasing importance for the treatment of melanoma due to its high burden of mortality in the advanced stages of the disease. Intercellular communication is a critical event for the progression of cancer. Collective evidence suggests that exosomes, small extracellular membrane vesicles released by the cells, are important facilitators of intercellular communication between the cells and the surrounding environment. Although the emerging field of exosomes is rapidly gaining traction in the scientific community, there is limited knowledge regarding the role of exosomes in melanoma. This review discusses the multifaceted role of melanoma-derived exosomes in promoting the process of metastasis by modulating the invasive and angiogenic capacity of malignant cells. The future implications of exosome research and the therapeutic potential of exosomes are also discussed.     

Addiction Mindsets and Psychological Processes of Quitting Smoking

Background: Lay belief systems about the malleability of human attributes have been shown to impact behavior change in multiple domains. Addiction mindset—i.e., beliefs about the permanence (vs. malleability) of addiction — may affect cigarette smokers’ ability to quit, but this has never been examined. Objectives: The aims of the present research were to develop a measure of addiction mindset (study 1) and examine its associations with various psychological aspects of quitting smoking (study 2). Methods: In Study 1, using factor analysis of current smokers’ and nonsmokers’ (n?=?600) responses to 22 items designed to measure addiction mindset, we developed a reliable six-item Addiction Mindset Scale (AMS). In Study 2, adult smokers (n?=?200) completed the AMS, and measures of a number of psychological processes related to smoking. Results: Higher scores on the AMS, indicative of the belief that addiction is malleable (referred to as a growth mindset), were positively and significantly associated with greater motivation to quit, greater commitment to quitting, greater self-efficacy to abstain, less attribution of failure to lack of ability to change addiction, and fewer self-reported barriers to cessation (all p’s < .05). Conclusions: The results of this study show a relationship between the beliefs about the permanence of addiction and psychological processes relevant to quitting smoking. The findings underscore the potential of future research exploring how addiction mindsets relate to successful smoking cessation as well as other types of addictive behavior and how they can be applied to change people’s behavior.     

Trends in HIV sexual prevention: Attitudinal beliefs and behavioral intention in Spanish young people over the past two decades (1999–2020)

Despite preventive efforts, HIV exposure is still a concern for public health. The current prevalence is related to unsafe sex, which is based on socio-cognitive variables. Therefore, information about these variables is required to verify whether the past preventive strategies have been effective and improve the future ones. However, there is not updated information to adjust future preventive interventions. For this reason, this study analyzes trends by gender in Spanish young people over the past two decades in perceived susceptibility to HIV, severity perceived to HIV, condom confidence and the intention of condom use, from 1999 to 2020. For this purpose, 11,665 Spanish young people (from 17 to 40 years old) completed the AIDS Prevention Questionnaire in each year. Following our results, in general, the socio-cognitive variables have revealed an unsatisfactory trend: a low perceived susceptibility to HIV and a behavioral intention that have remained stable or even declined slightly over the past years. Particularly, men are more likely to report a riskier level in socio-cognitive variables although, in the latest evaluations, women would decrease condom use intention largely than men. In general, regarding age, young adult would report better levels of condom confidence, but early youth would get higher results in perceived severity, as well as better scores in the latest evaluations of condom use intention. Considering these results, policies should make an effort in HIV prevention programs, and emphasize the attention to attitudinal beliefs and behavioral intention to improve their effectiveness.     

免疫检查点抑制剂应用于晚期胃癌治疗的研究进展

我国属胃癌高发国家,且以进展期胃癌为主。以手术和化疗为主的多学科治疗无法有效改善晚期胃癌患者的预后。近年来,免疫检查点抑制剂类药物的疗效在诸多癌症中得到了证实,因此,该类药物在胃癌中的治疗效果也受到了广泛的关注。本文对近年来的相关研究成果进行综述,全面介绍了免疫检查点抑制剂类药物在胃癌治疗中的临床应用情况、联合用药情况以及不良反应。对于其他治疗均失败的晚期胃癌患者,PD-1抑制剂是一个可行的治疗选项,其代表药物派姆单抗是目前唯一被美国食品药品监督管理局批准应用于胃癌治疗的免疫抑制剂类药物,而我国国家食品药品监督管理总局尚未批准任何此类药物应用于胃癌的临床治疗。如何进一步提高治疗的客观缓解率,将会是后续临床和基础研究的一大焦点。     

An off-the-shelf plasma-based material to prevent pacemaker pocket infection

Bacterial infection of subcutaneous “pockets” housing cardiovascular implantable electronic devices is a significant clinical complication. In this study, pacemakers encapsulated in a blood plasma-based material (PBM) composited with antibiotics were investigated for use as prophylactics against such infections. PBMs, which are made from pooled allogeneic plasma and platelets, are off-the-shelf biomaterials that can be manufactured in the form of complex 3D shapes, extrudable putties, or injectable pastes. In vitro studies with PBM pastes formulated with rifampicin and minocycline demonstrated antibiotic release over 6 days, activity against Escherichia coli, and reduced cytotoxic effects of the antibiotics on fibroblasts. The materials were also evaluated in vivo in a rabbit model in which pacemaker pockets were inoculated with methicillin-resistant Staphylococcus aureus (S. aureus) strain and examined 1 week later. The pockets containing the pacemaker plus S. aureus were grossly purulent and culture positive, whereas pockets into which PBM with antibiotics were injected around the pacemaker were free of purulence and culture negative (p < 0.001). None of the pockets into which PBM without antibiotics were placed demonstrated purulence, but 60% were culture positive. These results demonstrate the potential of PBMs to deliver antibiotics to diminish the incidence of pocket infections for pacemakers and other implantable devices.