Multimodal Prehabilitation and Rehabilitation for Men Undergoing Robot-Assisted Radical Prostatectomy

Conditions: Erectile Dysfunction Following Radical Prostatectomy; Prostate Cancer; Urinary Incontinence Following Surgical Procedure

Interventions: Drug: Tadalafil 5 mg; Behavioral: Pelvic Floor Muscle Training (PFMT); Behavioral: Aerobic Exercise Program; Behavioral: Nutritional Recommendations; Behavioral: Psychological and Wellbeing Strategies; Behavioral: Standard Perioperative Care

Sponsors: Surgical Outcomes Research Centre (SOuRCe); Generic Health; National Health and Medical Research Council, Australia; Sydney Local Health District

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Macrophages Use Cell Volume Changes to Sense Danger and Amplify Inflammation

Macrophages are often described as the immune system’s first responders, but new work suggests they are also remarkably attuned to the physical state of their environment. A study published in the Journal of Cell Biology titled “Disruption of macrophage cell volume drives inflammatory responses and type I interferon signaling” reveals that shifts in cell volume act as a previously underappreciated danger signal—one that can rewire macrophage gene expression, heighten antiviral defenses, and intensify inflammatory responses.

The research, led by Jack Green, PhD, and colleagues at the University of Manchester, centers on the Volume‑Regulated Anion Channel (VRAC), a protein complex that helps cells maintain osmotic balance. When VRAC is missing, macrophages lose the ability to correct swelling under hypo‑osmotic stress. “Cell volume disruption induced type I interferon signaling through a DNA- and TBK1-dependent mechanism, but independent of cGAS and 2′3′-cGAMP transport,” the authors wrote. That loss of control, the team found, is far more consequential than a simple biophysical hiccup. It fundamentally alters how macrophages interpret threats.

Green noted that although earlier studies hinted at a connection between cell volume and inflammatory signaling, the underlying biology remained murky. “Despite the reported indications that cell volume and VRAC are involved in inflammatory signaling, the basic biological mechanisms of how the regulation of cell volume shapes inflammation were unknown,” he said. To probe that gap, the team examined VRAC‑deficient macrophages exposed to mild osmotic stress.

The swelling triggered broad reprogramming of gene expression, including the induction of antiviral and proinflammatory pathways. Many of the most strongly upregulated genes belonged to type I interferon signaling cascades or nucleic acid–sensing systems. First author James Cook frames the finding succinctly: “Together, these findings suggest that cell volume acts as an additional layer of danger sensing in macrophages that shapes and tunes the nature of immune responses to pathogens.”

That prediction held up in functional assays. When challenged with Influenza A virus, VRAC‑deficient macrophages mounted a more potent antiviral response than their wild‑type counterparts. The heightened sensitivity extended beyond viral infection. In mouse models of systemic hyperinflammation, animals lacking VRAC showed elevated levels of a key inflammatory mediator, indicating that dysregulated cell volume can exacerbate cytokine‑driven pathology in vivo.

Rather than responding solely to biochemical cues, these cells appear to fold physical perturbations—such as osmotic imbalance—into their danger‑sensing logic. Green argued that this perspective may help explain why inflammatory diseases can escalate unpredictably when tissue conditions shift. “Understanding disruptions in the tissue microenvironment leading to alterations in cell volume is therefore an important consideration in our understanding of inflammation and disease pathogenesis,” he concluded, adding that “future studies will reveal the potential for regulating VRAC‑dependent cell volume changes in macrophages in disease.”

The post Macrophages Use Cell Volume Changes to Sense Danger and Amplify Inflammation appeared first on GEN – Genetic Engineering and Biotechnology News.

Fraudulent citations, blamed on AI hallucinations, are becoming more common in research papers

Citations in academic papers are intended to ground research in the work that preceded it, over time creating something of a family tree explaining the roots of ideas, protocols, and studies. 

But a growing number of these citations lead to dead ends. “Fabricated” citations that do not reference real papers are spreading in the literature, polluting the public record of science, a new study published Thursday in the Lancet shows. Tools using generative AI are likely to blame, say the Columbia University researchers who authored the paper.

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Barriers and Facilitators in the Implementation of the Systematic Medical Appraisal, Referral, and Treatment (SMART) Mental Health Digital Intervention in Rural India: Mixed Methods Process Evaluation Study

<strong>Background:</strong> An estimated 150 million people have mental health care needs in India, but only 15% are able to access care. Depression and anxiety contribute to a large proportion of mental morbidity. The Systematic Medical Appraisal, Referral, and Treatment (SMART) Mental Health trial used a mobile-based clinical decision support system for primary care doctors and community health workers (CHWs) to identify and treat people at risk of depression, anxiety disorders, and self-harm. A community-based antistigma campaign was also delivered. The intervention led to improved remission rates for depression and anxiety and lower stigma scores. <strong>Objective:</strong> A process evaluation assessed (1) implementation fidelity, barriers, and facilitators; (2) perceptions of doctors and CHWs on the use of SMART Mental Health; and (3) the causal pathways that led to trial outcomes. <strong>Methods:</strong> A mixed methods evaluation combining backend program data and qualitative data was conducted. A total of 38 focus group discussions and 37 key informant interviews were conducted with primary doctors, CHWs, government officials, local community leaders, and research project staff. The data were coded and analyzed using a framework analysis approach based on the UK Medical Research Council guidance on process evaluations and the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. <strong>Results:</strong> The intervention had high implementation fidelity. Across clusters, the median proportion of participants with at least 1 CHW follow-up was 98% (IQR 96.6%-100%). The referral rate for a psychiatrist was low (224/1697, 13.2%), and only 23.6% (53/224) of those referred visited the psychiatrist. The median exposure to antistigma audiovisual content was 84% (IQR 65.7%-95.9%). At the community level, key implementation barriers included cultural inhibitions in seeking mental health care and the unavailability of patients due to competing demands. Proximity and tight social connections between CHWs and their communities were important facilitators in seeking medical help. Doctor and CHW training, mentoring, and feedback provided by program staff were important facilitators to support the use of the digital health components by the health workforce. <strong>Conclusions:</strong> A complex intervention that included both community-based antistigma and clinical digital health interventions achieved high implementation fidelity. Key areas to consider for maintenance of such interventions include (1) the need for sustained community-based strategies to address stigma and other cultural barriers; (2) health workforce strengthening policies, including supportive supervision for CHWs and doctors to increase capability in the use of mental health digital health tools; and (3) strategies to improve access to specialist care for those with more complex care needs. <strong>Trial Registration:</strong> Clinical Trial Registry India CTRI/2018/08/015355; https://tinyurl.com/5r63suxp