Hamedan University of Medical Sciences

This letter critically evaluates the methodology of Eva Hjort Telhede's qualitative study exploring insomnia experiences among nursing homes. While the study contributes valuable insights into subjective sleep challenges, its methodological rigour warrants scrutiny to inform future research.

The study employed a qualitative descriptive design with semi-structured interviews (n = 19 participants) and inductive content analysis. Data collection occurred in nine Swedish nursing homes, with purposive sampling based on insomnia criteria (ICD-10) and cognitive competence (S-MMSE ≥20). Analysis followed Graneheim and Lundman's qualitative content analysis framework.

Key methodological strengths included purposive sampling, data saturation, and reflexive practices. Limitations identified were single-researcher bias, lack of intercoder reliability checks, gender imbalance (4 men, 15 women), and exclusion of variables such as cognitive diagnoses and medication use. Environmental factors (e.g. noise and lighting) were self-reported without objective validation, and contextual transferability was constrained by limited demographic diversity.

The reliance on a single coder and absence of triangulation may compromise the depth of thematic analysis. Recommendations include: (1) multi-researcher collaboration to enhance credibility; (2) inclusive sampling of residents with dementia; (3) mixed-methods designs integrating objective sleep measures; and (4) staff training in sleep hygiene to address institutional barriers. Strengthening methodological transparency and addressing contextual factors could improve future interventions for insomnia in nursing homes.

Cancer, marked by uncontrolled cell growth, is a leading global cause of death. Conventional cancer treatments such as chemotherapy and radiation, for all their use, often come with severe side effects. This has really pushed the development of immunotherapies and cancer vaccines, which try to leverage the body's immune system to fight tumors. Effective delivery of therapeutic agents to immune cells or tumors is critical, and natural carriers such as exosomes, archaeosomes, virosomes, and dendritic cells offer promising solutions. These systems excel in biocompatibility, low toxicity, and immune activation compared to synthetic alternatives. This review examines their role in cancer vaccines and immunotherapy, highlighting challenges like production consistency and tumor heterogeneity. Future directions include personalized vaccines and combination therapies, advancing these natural carriers in the fight against cancer.

Nanovesicles derived from botanical sources have garnered significant attention in the medicine and pharmacology due to their straightforward and efficient scaling methods for isolation. Allium cepa (A. cepa), or common red onion, has a long history in traditional medicine, primarily for its anti-inflammatory and antioxidant effects. Despite the growing interest, the biological activity of red onion-derived exosome-like nanovesicles (RDNVs) remains inadequately explored. In this context we tried to prepare nanovesicles from red onion juice and their therapeutic potential in a full-thickness skin wound animal model.

Following isolation and characterization of RDNVs, their anti-oxidant capacity was assessed via 2,2-diphenyl-1-picrylhydrazyl (DPPH) and superoxide dismutase (SOD) activity assays. A single, full-thickness, circular wound was created on the backs of C57BL/6 mice. Thirty mice were randomly administrated with PBS (control), red onion ethanolic extract, and RDNV. Wound healing parameters such as re-epithelialization, antioxidant status, and inflammation were evaluated at Days 4 and 7 post-wounding. The cup-shaped RDNVs isolated from A. cepa showed significant antioxidant activity and effectively polarized M1 phenotype to M2 phenotype macrophages compared to control group. Furthermore, the pro-inflammatory genes expression was significantly reduced in both RDNV and onion extract-treated groups (p-value < 0.01). Histological analysis revealed improved granulation tissue formation and re-epithelialization, and significant reduction in inflammatory cells in RDNV-treated wounds.

The findings of this study support the idea that RDNVs shed new light on skin wound management through antioxidant and anti-inflammatory activity and accelerating wound healing.