Objective: : Posterior endoscopic cervical foraminotomy (PECF) is a minimally invasive surgical technique for treating cervical radiculopathy. Traditionally, PECF is performed under general anesthesia in the prone position, but concerns over anesthesia-related complications have led to the exploration of local anesthesia in the lateral decubitus position as an alternative. This study aims to compare the clinical outcomes, safety, and efficacy of PECF performed under local anesthesia in the lateral decubitus position versus general anesthesia in the prone position. Methods: : We conducted a retrospective analysis of 13 patients who underwent PECF under local anesthesia in the lateral decubitus position. The outcomes were compared with data from 357 patients across eight studies who underwent PECF under general anesthesia in the prone position. Outcomes measures included Visual analog scale (VAS) pain scores, Oswestry disability index (ODI), length of stay (LOS), minimally clinically important difference (MCID), and complications. Results: : Patients in the local anesthesia group demonstrated significant reductions in neck pain (VAS-N : 4.93±1.32 to 1.49±0.52, p<0.001) and arm pain (VAS-A : 8.69±0.75 to 1.85±1.46, p<0.001), achieving a mean pain reduction of 78.8%. These improvements were comparable to the general anesthesia group (VAS-N : 4.80 to 1.28; VAS-A : 6.71 to 1.23). Functional outcomes improved significantly in both groups, with ODI scores improving from 54.76% to 9.82% locally and from 39.92% to 9.62% in the general group. Although LOS was slightly longer for the local anesthesia group (5.85±3.20 vs. 4.81±2.17 days, p=0.18), post-procedure monitoring time was significantly shorter (3.2 vs. 7.4 hours, p<0.001). The local anesthesia group reported zero complications (0%; 95% confidence interval [CI], 0–22.8%) compared to an 8.68% complication rate (95% CI, 5.8–11.6%) in the general anesthesia cohort (p=0.612). Conclusion : PECF under local anesthesia in the lateral decubitus position provides comparably effective pain relief and functional improvement comparable to general anesthesia, though the difference in complication rates was not statistically significant and requires larger studies for confirmation. This technique may be particularly advantageous for patients at higher risk for anesthesia-related complications. Further research is warranted to validate these findings in larger, prospective studies.

Poly(ADP-ribose) polymerase 1 (PARP1) is a multifunctional protein involved in diverse cellular functions, notably DNA damage repair. Pharmacological inhibition of PARP1 has therapeutic benefits for various pathologies. Despite the increased use of PARP inhibitors, challenges persist in achieving PARP1 selectivity and effective blood-brain barrier (BBB) penetration. The development of a PARP1-specific positron emission tomography (PET) radioligand is crucial for understanding disease biology and performing target occupancy studies, which may aid in the development of PARP1-specific inhibitors. In this study, we leverage the recently identified PARP1 inhibitor, AZD9574, to introduce the design and development of its ¹⁸F-isotopologue ([¹⁸F]AZD9574). Our comprehensive approach, encompassing pharmacological, cellular, autoradiographic, and in vivo PET imaging evaluations in non-human primates, demonstrates the capacity of [¹⁸F]AZD9574 to specifically bind to PARP1 and to successfully penetrate the BBB. These findings position [¹⁸F]AZD9574 as a viable molecular imaging tool, poised to facilitate the exploration of pathophysiological changes in PARP1 tissue abundance across various diseases.

BACKGROUND: The FAVOR (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients with Coronary Artery Disease) III China trial demonstrated that percutaneous coronary intervention (PCI) lesion selection using quantitative flow ratio (QFR) measurement, a novel angiography-based approach for estimating fractional flow reserve, improved two-year clinical outcomes compared with standard angiography guidance. This study aimed to assess the cost-effectiveness of QFR-guided PCI from the perspective of the current Chinese healthcare system. METHODS: This study is a pre-specified analysis of the FAVOR III China trial, which included 3825 patients randomized between December 25, 2018, and January 19, 2020, from 26 centers in China. Patients with stable or unstable angina pectoris or those ≥72 hours post-myocardial infarction who had at least one lesion with a diameter stenosis between 50% and 90% in a coronary artery with a ≥2.5 mm reference vessel diameter by visual assessment were randomized to a QFR-guided strategy or an angiography-guided strategy with 1:1 ratio. During the two-year follow-up, data were collected on clinical outcomes, quality-adjusted life-years (QALYs), estimated costs of index procedure hospitalization, outpatient cardiovascular medication use, and rehospitalization due to major adverse cardiac and cerebrovascular events (MACCE). The primary analysis calculated the incremental cost-effectiveness ratio (ICER) as the cost per MACCE avoided. An ICER of ¥10,000/MACCE event avoided was considered economically attractive in China. RESULTS: At two years, the QFR-guided group demonstrated a reduced rate of MACCE compared to the angiography-guided group (10.8% vs . 14.7%, P <0.01). Total two-year costs were similar between the groups (¥50,803 ± 21,121 vs . ¥50,685 ± 23,495, P = 0.87). The ICER for the QFR-guided strategy was ¥3055 per MACCE avoided, and the probability of QFR being economically attractive was 64% at a willingness-to-pay threshold of ¥10,000/MACCE avoided. Sensitivity analysis showed that QFR-guided PCI would become cost-saving if the cost of QFR were below ¥3682 (current cost: ¥3800). Cost-utility analysis yielded an ICER of ¥56,163 per QALY gained, with a 53% probability of being cost-effective at a willingness-to-pay threshold of ¥85,000 per QALY gained. CONCLUSION: In patients undergoing PCI, a QFR-guided strategy appears economically attractive compared to angiographic guidance from the perspective of the Chinese healthcare system. TRIAL REGISTRATION ClinicalTrials.gov , NCT03656848.
Humans ; Cost-Benefit Analysis ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Angiography/methods* ; Middle Aged ; Aged ; Coronary Artery Disease/surgery* ; Quality-Adjusted Life Years ; Fractional Flow Reserve, Myocardial/physiology*

Background: Exposure to respirable dust (RES) and respirable crystalline silica (RCS) is common in mining operations and is associated with health effects such as pneumoconiosis, chronic obstructive pulmonary disease (COPD), interstitial pulmonary fibrosis, silicosis, lung cancer, and renal disease. Methods: This study used industry occupational exposure data for respirable dust from two surface lithium mines in Western Australia for the period between 2017 and 2023. A total of 1122 samples were collected in workgroups across four departments - administration and support, mining, crushing and processing, and maintenance. Results: The study found that the overall RES concentration did not exceed the exposure standard. However, Crusher Dry/Wet Plant Personnel (0.558 mg/㎥) and Workshop Boilermakers (0.842 mg/㎥) recorded elevated exposure to RES. The highest mean exposures for RCS over the seven-year study period were measured for Management Administration & Technical (0.068 mg/㎥), followed by Crusher Dry/Wet Plant Personnel (0.042 mg/㎥), exceeding the ES. Maximum results for both RES (15.00 mg/㎥) and RCS (2.50 mg/㎥) indicated exceedances. Conclusion The study demonstrated a decline in exposure to RES over the seven years of study from 0.472 mg/㎥ to 0.151 mg/㎥, with a slight increase in 2019 and 2022. A decline in the concentration of RCS was observed between 2019 -2021, followed by an increase after 2021. The mean concentration of RCS exceeded the exposure standard in 2023. Based on the study results and the established adverse health effects associated with exposure to silica, various control measuresto protect workers from RCS exposure should be considered.

Background: Exposure to respirable dust (RES) and respirable crystalline silica (RCS) is common in mining operations and is associated with health effects such as pneumoconiosis, chronic obstructive pulmonary disease (COPD), interstitial pulmonary fibrosis, silicosis, lung cancer, and renal disease. Methods: This study used industry occupational exposure data for respirable dust from two surface lithium mines in Western Australia for the period between 2017 and 2023. A total of 1122 samples were collected in workgroups across four departments - administration and support, mining, crushing and processing, and maintenance. Results: The study found that the overall RES concentration did not exceed the exposure standard. However, Crusher Dry/Wet Plant Personnel (0.558 mg/㎥) and Workshop Boilermakers (0.842 mg/㎥) recorded elevated exposure to RES. The highest mean exposures for RCS over the seven-year study period were measured for Management Administration & Technical (0.068 mg/㎥), followed by Crusher Dry/Wet Plant Personnel (0.042 mg/㎥), exceeding the ES. Maximum results for both RES (15.00 mg/㎥) and RCS (2.50 mg/㎥) indicated exceedances. Conclusion The study demonstrated a decline in exposure to RES over the seven years of study from 0.472 mg/㎥ to 0.151 mg/㎥, with a slight increase in 2019 and 2022. A decline in the concentration of RCS was observed between 2019 -2021, followed by an increase after 2021. The mean concentration of RCS exceeded the exposure standard in 2023. Based on the study results and the established adverse health effects associated with exposure to silica, various control measuresto protect workers from RCS exposure should be considered.

Background: Exposure to respirable dust (RES) and respirable crystalline silica (RCS) is common in mining operations and is associated with health effects such as pneumoconiosis, chronic obstructive pulmonary disease (COPD), interstitial pulmonary fibrosis, silicosis, lung cancer, and renal disease. Methods: This study used industry occupational exposure data for respirable dust from two surface lithium mines in Western Australia for the period between 2017 and 2023. A total of 1122 samples were collected in workgroups across four departments - administration and support, mining, crushing and processing, and maintenance. Results: The study found that the overall RES concentration did not exceed the exposure standard. However, Crusher Dry/Wet Plant Personnel (0.558 mg/㎥) and Workshop Boilermakers (0.842 mg/㎥) recorded elevated exposure to RES. The highest mean exposures for RCS over the seven-year study period were measured for Management Administration & Technical (0.068 mg/㎥), followed by Crusher Dry/Wet Plant Personnel (0.042 mg/㎥), exceeding the ES. Maximum results for both RES (15.00 mg/㎥) and RCS (2.50 mg/㎥) indicated exceedances. Conclusion The study demonstrated a decline in exposure to RES over the seven years of study from 0.472 mg/㎥ to 0.151 mg/㎥, with a slight increase in 2019 and 2022. A decline in the concentration of RCS was observed between 2019 -2021, followed by an increase after 2021. The mean concentration of RCS exceeded the exposure standard in 2023. Based on the study results and the established adverse health effects associated with exposure to silica, various control measuresto protect workers from RCS exposure should be considered.

Background: Exposure to respirable dust (RES) and respirable crystalline silica (RCS) is common in mining operations and is associated with health effects such as pneumoconiosis, chronic obstructive pulmonary disease (COPD), interstitial pulmonary fibrosis, silicosis, lung cancer, and renal disease. Methods: This study used industry occupational exposure data for respirable dust from two surface lithium mines in Western Australia for the period between 2017 and 2023. A total of 1122 samples were collected in workgroups across four departments - administration and support, mining, crushing and processing, and maintenance. Results: The study found that the overall RES concentration did not exceed the exposure standard. However, Crusher Dry/Wet Plant Personnel (0.558 mg/㎥) and Workshop Boilermakers (0.842 mg/㎥) recorded elevated exposure to RES. The highest mean exposures for RCS over the seven-year study period were measured for Management Administration & Technical (0.068 mg/㎥), followed by Crusher Dry/Wet Plant Personnel (0.042 mg/㎥), exceeding the ES. Maximum results for both RES (15.00 mg/㎥) and RCS (2.50 mg/㎥) indicated exceedances. Conclusion The study demonstrated a decline in exposure to RES over the seven years of study from 0.472 mg/㎥ to 0.151 mg/㎥, with a slight increase in 2019 and 2022. A decline in the concentration of RCS was observed between 2019 -2021, followed by an increase after 2021. The mean concentration of RCS exceeded the exposure standard in 2023. Based on the study results and the established adverse health effects associated with exposure to silica, various control measuresto protect workers from RCS exposure should be considered.

Background: Exposure to respirable dust (RES) and respirable crystalline silica (RCS) is common in mining operations and is associated with health effects such as pneumoconiosis, chronic obstructive pulmonary disease (COPD), interstitial pulmonary fibrosis, silicosis, lung cancer, and renal disease. Methods: This study used industry occupational exposure data for respirable dust from two surface lithium mines in Western Australia for the period between 2017 and 2023. A total of 1122 samples were collected in workgroups across four departments - administration and support, mining, crushing and processing, and maintenance. Results: The study found that the overall RES concentration did not exceed the exposure standard. However, Crusher Dry/Wet Plant Personnel (0.558 mg/㎥) and Workshop Boilermakers (0.842 mg/㎥) recorded elevated exposure to RES. The highest mean exposures for RCS over the seven-year study period were measured for Management Administration & Technical (0.068 mg/㎥), followed by Crusher Dry/Wet Plant Personnel (0.042 mg/㎥), exceeding the ES. Maximum results for both RES (15.00 mg/㎥) and RCS (2.50 mg/㎥) indicated exceedances. Conclusion The study demonstrated a decline in exposure to RES over the seven years of study from 0.472 mg/㎥ to 0.151 mg/㎥, with a slight increase in 2019 and 2022. A decline in the concentration of RCS was observed between 2019 -2021, followed by an increase after 2021. The mean concentration of RCS exceeded the exposure standard in 2023. Based on the study results and the established adverse health effects associated with exposure to silica, various control measuresto protect workers from RCS exposure should be considered.

Poland has a unique history of traditional Chinese medicine (TCM) dating back to the 17th century when Polish missionary Michael (Michał) Boym was a pioneer in the field. In the 20th century, his successor, Professor Zbigniew Garnuszewski, reintroduced acupuncture to medical practice in Poland. However, other methods of TCM and its holistic approach to patient care have not found their place in modern medicine in Poland. At present, the legal status of TCM in Poland remains unregulated, with TCM included in the broad spectrum of complementary and alternative medicine (CAM) practices. Few reports are available on the use of TCM methods among the Polish population. Integrative medicine combines conventional medicine with evidence-based CAM interventions and considers all aspects of a patient's health, including physical, emotional, mental, social, and environmental factors. An integrative healthcare model that incorporates TCM modalities and lifestyle recommendations as well as a whole person approach may provide a more sustainable solution for the constantly underfinanced Polish healthcare system, which faces challenges of multimorbidity in an aging society and limited access to care. The coronavirus disease 2019 pandemic, war in Ukraine, and ongoing climate crisis have underscored the need to strengthen the resilience of the Polish healthcare system and search for new solutions. A model of care that blends the best of biomedicine and TCM healing approaches may be a better option for both patients and the healthcare system in Poland. Please cite this article as: Rybicka M, Zhao J, Piotrowicz K, Ptasnik S, Mitka K, Kocot-Kępska M, Hui KK. Promoting whole person health: Exploring the role of traditional Chinese medicine in Polish healthcare. J Integr Med. 2023; 21(6): 509-517.
Humans ; Medicine, Chinese Traditional ; Poland ; Holistic Health ; Complementary Therapies/psychology* ; Delivery of Health Care

RNA viruses are critically dependent upon virally encoded proteases to cleave the viral polyproteins into functional proteins. Many of these proteases exhibit a similar fold and contain an essential catalytic cysteine, offering the opportunity to inhibit these enzymes with electrophilic small molecules. Here we describe the successful application of quantitative irreversible tethering (qIT) to identify acrylamide fragments that target the active site cysteine of the 3C protease (3C^pro) of Enterovirus 71, the causative agent of hand, foot and mouth disease in humans, altering the substrate binding region. Further, we re-purpose these hits towards the main protease (M^pro) of SARS-CoV-2 which shares the 3C-like fold and a similar active site. The hit fragments covalently link to the catalytic cysteine of M^pro to inhibit its activity. We demonstrate that targeting the active site cysteine of M^pro can have profound allosteric effects, distorting secondary structures to disrupt the active dimeric unit.