bluuebunny/crossref_metadata_2025 huggingface dataset:
Technology-based interventions to improve adherence to antihypertensive medications – An evidence-based review
Authors: Chun-Yun Kang Gary
Published: May 2022

Background

Poor adherence to anti-hypertensive medications leads to poorly controlled blood pressure which is associated with worse cardiovascular outcomes. Emerging technologies may be utilised advantageously in interventions to improve adherence and reduce morbidity and mortality from poorly controlled hypertension.

Objective

To determine the efficacy of technology-based interventions in improving adherence to antihypertensive medications.

Methods

PubMed and EMBASE databases were searched using keywords and MeSH terms. Included studies met the following criteria: randomized controlled trial (RCT); adults ≥ 18 years old taking anti-hypertensives; intervention delivered by or accessed using a technological device or process; intervention designed to improve adherence.

Results

12 papers met inclusion criteria for the current review: 5 studies significantly improved adherence when compared to usual care; of these 5 studies, 2 had corresponding significant improvement in blood pressure. Successful interventions were: electronic medication bottle cap with audio-visual reminder; short message service (SMS) containing educational information (2 studies); reporting of self-measured blood pressure to a telephone-linked computer system; sending a video of every drug ingestion to obtain monetary rewards.

Conclusion

RCTs on technological interventions to improve adherence and those showing significant effect are rare. Some of the interventions show potential to be applied to other populations, especially if targeted at patients with poor adherence at baseline.
Assessing the performances of a chatbot to collect real-life data of patients suffering from primary headache disorders
Authors: Chaix Benjamin , Bibault Jean-Emmanuel , Romain Rolland , Guillemassé Arthur , Neeral Mikaël , Delamon Guillaume , Moussalli Julien , Brouard Benoît
Published: May 2022

Background

There are many scales for screening the impact of a disease. These scales are generally used to diagnose or assess the type and severity of a disease and are carried out by doctors. The chatbot helps patients suffering from primary headache disorders through personalized text messages. It could be used to collect patient-reported outcomes.

Objective

The aims of this study were (1) to study whether the collection and analysis of remote scores, without prior medical intervention, are possible by a chatbot, (2) to perform suggested diagnosis and define the type of headaches, and (3) to assess the patient satisfaction and engagement with the chatbot.

Method

Voluntary users of the chatbot were recruited online. They had to be over 18 and have a personal history of headaches. A questionnaire was presented (1) by text messages to the participants to evaluate migraines (2) based on the criteria of the International Headache Society. Then, the Likert scale (3) was used to assess overall satisfaction with the use of the chatbot.

Results

We included 610 participants with primary headache disorders. A total of 89.94% (572/610) participants had fully completed the questionnaire (eight items), 4.72% (30/610) had partially completed it, and 5.41% (33) had refused to complete it. Statistical analysis was performed on 86.01% (547/610) of participants. Auto diagnostic showed that 14.26% (78/547) participants had a tension headache, and 85.74% (469/547) had a probable migraine. In this population, 15.78% (74/469) suffered from migraine without probable aura, and 84.22% (395/469) had migraine without aura. The patient’s age had a significant incidence regarding the auto diagnosis ( P = .008<.05). The evaluation of overall satisfaction shows that a total of 93.9% (599/610) of users were satisfied or very satisfied regarding the timeliness of responses the chatbot provides.

Conclusion

The study confirmed that it was possible to obtain such a collection remotely, and quickly (average time of 3.24 min) with a high success rate (89.67% (547/610) participants who had fully completed the IHS questionnaire). Users were strongly engaged through chatbot: out of the total number of participants, we observed a very low number of uncompleted questionnaires (6.23% (38/610)). Conversational agents can be used to remotely collect data on the nature of the symptoms of patients suffering from primary headache disorders. These results are promising regarding patient engagement and trust in the chatbot.
Effect of temperature on color changes and mechanical properties of poplar/bismuth oxide wood alloy during warm-press forming
Authors: Yan Jin , Zhang Liqiang , Li Xianjun , Wu Qingding , Liu Jianan
Published: May 2022

Binderless poplar/bismuth oxide wood alloy is prepared using the warm-press forming technology. The effect of the forming temperatures on color changes and mechanical properties of the poplar/bismuth oxide wood alloy is studied. The results show that the surface color of the specimen gradually darkened as the forming temperature increased. There is the most obvious change from 140 to 160 °C. The CIE lightness color coordinate L* and chroma coordinate b* decrease with the increase of the forming temperature, while chroma coordinate a* decreases initially, but later increases with treatment severity. The static bending strength (MOR), the elastic modulus (MOE) and the surface hardness (HV) increase first and then decrease with the increase of the forming temperature. The X-ray diffraction (XRD) analysis shows that the wood underwent carbonization at 180 °C, resulting in a decrease in the density and mechanical properties of poplar/bismuth oxide wood alloy, and a deepening of the surface color. The Fourier transform infrared spectroscopy (FTIR) analysis reveals that the pyrolysis of cellulose and hemicellulose, as well as the pyrolysis and condensation of lignin led to the color of poplar/bismuth oxide wood alloy deepening. The hydroxyl groups between the cellulose molecular chains are reduced and hydrogen bonds are formed at 140 °C, which improve the mechanical properties of poplar/bismuth oxide wood alloy. However, the massive degradation of hemicellulose weakens binding strength with cellulose and lignin at 160 °C above. It greatly reduces the mechanical properties of specimen.
Gallbladder-preserving polypectomy for gallbladder polyp by embryonic-natural orifice transumbilical endoscopic surgery with a gastric endoscopy
Authors: He Xiao-Jian , Chen Zhi-Ping , Zeng Xiang-Peng , Jiang Chuan-Shen , Liu Gang , Li Dong-Liang , Li Da-Zhou , Wang Wen
Published: May 2022

Background and aims

Cholecystectomy is performed for most gallbladder polyps (GPs). However, cholecystectomy results concerning complications in some patients. For benign GPs, adoption of gallbladder-preserving surgery is worth to recommend. We describe our experiences performing gallbladder-preserving polypectomy for GPs by embryonic-natural orifice transumbilical endoscopic surgery (E-NOTES) with a gastric endoscopy.

Methods

This is a retrospective study of patients with GPs who underwent gallbladder-preserving polypectomy by E-NOTES with a gastric endoscopy from April 2018 to September 2019 in our hospital. The operative time, intraoperative hemorrhage, intraoperative and postoperative complications, gallbladder emptying function were obtained and analyzed.

Results

The procedure was performed successfully in all 12 patients with 5 cases of single polyp and 7 cases of multiple polyps. The range of GPs size was 2 mm to 15 mm. The mean operation time was (95.33 ± 23.08) minutes (55–135 min). There were no adverse events including heavy bleeding, mortality and conversion to open surgery during operation. All patients were discharged in 4–5 days after surgery without postoperative complications such as delayed bleeding, fever, peritonitis, intra-abdominal abscess and abdominal wall incisional hernia. All patients were followed up at 1, 3, 6, and 12 months postoperation who had almost no visible incision on the umbilical region, no recurrent GPs. The gallbladder emptying function decreased one month after surgery, and gradually improved 3, 6 and 12 months after surgery.

Conclusion

E-NOTES gallbladder-preserving polypectomy is a safe and effective option for patients with GPs and is close to scar-free surgery which can be performed in routine clinical practice.
Determinants of associated events following AZD1222 (Covishield) vaccination in a high-risk population in Nepal
Authors: Poudel Kapil Madi , Shah Neha , Prakash Manab , Deo Santosh Kumar , Bhandari Sunita , Poudel Tika Ram
Published: May 2022

Background

Vaccination is the most effective method to prevent the spread of infectious diseases and helps reduce mortality rate and economic costs associated with the pandemic. Despite these advantages, misinformation on vaccine safety and efficacy can lead to increased hesitation towards vaccination. This study reports the incidence of adverse events following Covishield vaccination, their associated factors, medication used for their management, and attitudes about vaccine safety.

Methods

A cross-sectional study was conducted from the sample of Covishield-vaccinated individuals from a secondary hospital, two primary health centres, and 36 health posts in eastern Nepal. Individuals (n = 602) were randomly sampled from a population (n = 1013) who had received the first dose of Covishield, namely frontline workers and other high-risk populations. The second-round follow-up had 516 participants. Association of incidence and severity of post-vaccination events with socio-demographic variables, comorbidity status, and medication use were estimated.

Results

Among the 79.9% of participants who reported adverse events after receiving the first dose, two-thirds of complaints were mild (67.4%, 95% CI 63.2–71.6) with the most common complaint being pain at the injection site (86.5%). Paracetamol or its combination with NSAIDs were used in the majority of cases (95.2%). After the second dose, only 31.2% (95% CI 27.2–35.2) reported adverse events, the overwhelming majority of which were mild (95.7%) and required a lower frequency of medication (7.5% vs. 26.0%). Adverse event following immunization were significantly associated with being 18–30 years old (χ2 = 16.9, df = 3, p < 0.001) and female gender (χ2 = 5.2, df = 1, p < 0.05). Prior to the first dose, 86.0% of participants (95% CI 83.3–88.8%) perceived the vaccine to be safe, and 96.0% recommended the vaccine post-vaccination, while 96.8% were interested in receiving the second dose. AEFI severity was negatively associated with vaccine recommendation to the peers (odds-ratio 0.062, p < 0.05) following the first dose, whereas, the optimistic pre-vaccination perception was associated with positive vaccine recommendation post-vaccination (odds-ratio 28.658, p < 0.01).

Conclusions

Overall, vaccination-associated events were mild and majority were managed with paracetamol or its combination. Effective counselling about adverse events before vaccination should be prioritized to reduce hesitation and fear.
Comparison of the clinical presentation across two waves of COVID-19: a retrospective cohort study
Authors: Buttenschøn Henriette Nørmølle , Lynggaard Vibeke , Sandbøl Susanne Gundersborg , Glassou Eva Natalia , Haagerup Annette
Published: May 2022

Background

Only a few studies have performed comprehensive comparisons between hospitalized patients from different waves of COVID-19. Thus, we aimed to compare the clinical characteristics and laboratory data of patients admitted to the western part of Denmark during the first and second waves of COVID-19 in 2020. Furthermore, we aimed to identify risk factors for critical COVID-19 disease and to describe the available information on the sources of infection.

Methods

We performed a retrospective study of medical records from 311 consecutive hospitalized patients, 157 patients from wave 1 and 154 patients from wave 2. The period from March 7 to June 30, 2020, was considered wave 1, and the period from July 1st to December 31, 2020, was considered wave 2. Data are presented as the total study population, as a comparison between waves 1 and 2, and as a comparison between patients with and without critical COVID-19 disease (nonsurvivors and patients admitted to the intensive care unit (ICU)).

Results

Patients admitted during the first COVID-19 wave experienced a more severe course of disease than patients admitted during wave 2. Admissions to the ICU and fatal disease were significantly higher among patients admitted during wave 1 compared to wave 2. The percentage of patients infected at hospital decreased in wave 2 compared to wave 1, whereas more patients were infected at home during wave 2. We found no significant differences in sociodemographics, lifestyle information, or laboratory data in the comparison of patients from waves 1 and 2. However, age, sex, smoking status, comorbidities, fever, and dyspnea were identified as risk factors for critical COVID-19 disease. Furthermore, we observed significantly increased levels of C-reactive protein and creatinine, and lower hemoglobin levels among patients with critical disease.

Conclusions

At admission, patients were more severely ill during wave 1 than during wave 2, and the outcomes were worse during wave 1. We confirmed previously identified risk factors for critical COVID-19 disease. In addition, we found that most COVID-19 infections were acquired at home.
The relationship between medication literacy and skin adverse reactions in non-small-cell lung cancer patients undergoing targeted EGFR-TKI therapy
Authors: Du Ruofei , Yang Huashan , Zhou Huiyue , Ma Lixia , Getu Mikiyas Amare , Chen Changying , Wang Tao
Published: May 2022

Background

High medication literacy is the basis of rational medication application and is essential for the management of severe adverse drug reactions. The objective of the present study was to assess the level of medication literacy and determine the association between medication literacy and skin adverse drug reactions in non-small-cell lung cancer (NSCLC) patients undergoing targeted epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy.

Methods

This is a cross-sectional study conducted from May to September 2020. In total, 296 NSCLC patients undergoing targeted EGFR-TKI therapy were recruited from hospitals in Henan, China. Structured questionnaires were used to evaluate skin adverse drug reactions and medication literacy. Pearson correlation analysis and binary logistic regression analysis were carried out to identify the correlations between medication literacy and the severity of skin adverse drug reactions in the recruited patients.

Results

The research sample consisted of 296 patients with a response rate of 92.5%. The mean score of skin adverse drug reactions and the mean score of medication literacy were 1.83 ± 0.91 and 6.54 ± 2.78, respectively. In total, 188 patients (63.5%) were considered to have moderate medication literacy. According to the binary logistic regression analysis, the following factors were associated with severe skin adverse drug reactions: age (B =  − 3.929, P = 0.000), sex (B = -4.062, P = 0.000), educational level (B = 2.712, P = 0.002), comorbidity (B = 3.297, P = 0.001), eczema history (B = 2.996, P = 0.001), nutritional status (B = -4.891, P = 0.000), blood interleukin-6 level (B = -2.143, P = 0.013), blood high-sensitivity C-reactive protein level (B = -4.015, P = 0.000), combination of drugs (B = -3.183, P = 0.048) and medication literacy (B =  − 1.503, P = 0.000). Subgroup analysis showed that in addition to medication literacy, some other factors including education level, comorbidity, nutritional status, blood interleukin-6 level and combined drug application were common factors that contributed to various adverse skin drug reactions in NSCLC patients under targeted EGFR-TKI therapy.

Conclusion

The low medication literacy of the investigated NSCLC patients undergoing targeted EGFR-TKI therapy was correlated with a high proportion of severe skin adverse drug reactions. In addition, factors other than medication literacy including education level, comorbidity, nutritional status, blood interleukin-6 level and the combinatorial application of drugs were also related to the severity of various adverse skin drug reactions. A comprehensive and targeted intervention may be beneficial to improve medication literacy and control severe skin adverse drug reactions in NSCLC patients.
Cystic fibrosis and alpha-1 antitrypsin deficiency: case report and review of literature
Authors: Jaspers Evi , Van Dijck Ine , Hoffman Ilse , Knops Noël , Stéphenne Xavier , Witters Peter , Proesmans Marijke
Published: May 2022

Background

This case report describes a child born with both cystic fibrosis (CF) and alpha-1 antitrypsin deficiency (A1ATD). Both are autosomal recessive inherited diseases, mainly affecting the lungs and the liver. The combination of both diseases together is rare and may lead to a fulminant disease with limited life span. To the best of our knowledge, no case has been reported of a patient born with both diseases.

Case presentation

After an uneventful pregnancy, a male baby was born with meconium ileus. The suspected diagnosis of CF was confirmed based on the sweat test and genetic analysis. The child developed persisting cholestasis, too severe to be likely caused by CF alone and indicating an associated problem. The diagnosis of A1ATD was established based on clinical suspicion (persisting cholestasis), decreased serum alpha-1 antitrypsin and genetic analysis. Supportive therapy was started, however the boy evolved to rapidly progressive liver disease leading to liver failure which necessitated an infant liver transplantation.

Conclusions

This case illustrates the complexity of care in case of two severe inherited diseases as well as post solid organ transplant care.
Long-term functional outcomes of patients with Hirschsprung disease following pull-through
Authors: Gunadi  , Monica Carissa Theodora , Stevie  , Daulay Ezzah Fatmala , Yulianda Dicky , Iskandar Kristy , Dwihantoro Andi
Published: May 2022

Background

Hirschsprung disease (HSCR) is a common congenital disorder presenting with functional obstruction due to aganglionosis of the colon. There are numerous types of pull-through surgery for managing HSCR, such as transabdominal endorectal (Soave), Swenson, Duhamel, transanal endorectal pull-through (TEPT), and laparoscopic (Georgeson) approach. Here, we aimed to describe the long-term outcome of patients with HSCR who underwent transabdominal Soave, Duhamel, and TEPT in our institution.

Methods

We performed a cross-sectional analysis for patients who underwent Duhamel, Soave, and TEPT at our institution from January 2012 to December 2015. Long-term functional outcome was determined by bowel function score (BFS). The BFS was obtained by interviewing patients who had completed at least three years of follow-up.

Results

Twenty-five patients were included in this study who underwent transabdominal Soave (n = 8), Duhamel (n = 4), and TEPT (n = 13). There were 24 patients with short aganglionosis type. The median age of HSCR diagnosis was 10 (IQR = 1–39) months, while the median age of pull-through surgery was 17 (IQR = 7–47) months. The median follow-up of BFS level for HSCR patients after pull-through was 72 (IQR, 54–99) months. There were 11 patients with good BFS level and 10 patients with normal BFS level. Additionally, 50% of Duhamel patients had poor BFS level, while 50% of Soave patients had good BFS level, and 54% of TEPT patients had normal BFS level (p = 0.027). As many as 50% of Duhamel patients showed daily soiling and required protective aids, while 38.5% of TEPT had staining less than 1/week and no change of underwear required, and 50% of Soave patients revealed no soiling, respectively (p = 0.030). Furthermore, 75% of Duhamel patients had accidents, while 75% of Soave and 46.2% of TEPT patients had no accidents (p = 0.035).

Conclusion

Our study shows that the type of definitive surgery might affect the long-term bowel functional outcome; particularly, the TEPT approach might have some advantages over the transabdominal Soave and Duhamel procedures.
Findings from a pilot open-label trial of N-acetylcysteine for the treatment of pediatric mania and hypomania
Authors: Wozniak Janet , DiSalvo Maura , Farrell Abigail , Vaudreuil Carrie , Uchida Mai , Ceranoglu T. Atilla , Joshi Gagan , Cook Emmaline , Faraone Stephen V. , Biederman Joseph
Published: May 2022

Background

Pediatric bipolar disorder is a highly prevalent and morbid disorder and is considered a prevalent public health concern. Currently approved treatments often pose the risk of serious side effects. Therefore, this study assessed the efficacy and tolerability of N-acetylcysteine (NAC), in children and adolescents with bipolar spectrum disorder.

Methods

We conducted a 12-week open-label trial of NAC for treatment of mania and hypomania in children and adolescents ages 5–17 with bipolar spectrum disorder including participants with full and subthreshold manic symptoms, accepting those with and without mixed states with co-occurring depression, and Young Mania Rating Scale scores ≥ 20 and < 40. Symptoms of mania and depression were assessed using the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Children’s Depression Rating Scale (CDRS), and Clinical Global Impression (CGI) Severity (CGI-S) and Improvement (CGI-I) scales for mania and depression.

Results

This study had a high drop-out rate with only 53% completing all 12 weeks. There was a significant reduction in YMRS, HDRS, and CDRS mean scores from baseline to endpoint. Of the 24 exposed participants, 54% had an anti-manic response measured by a reduction in YMRS ≥ 30% and 46% had a CGI-I mania score ≤ 2 at endpoint. Additionally, 62% of participants had an anti-depressive response measured by a reduction in HDRS ≥ 30%, 31% had an anti-depressive response measured by a reduction in CDRS ≥ 30%, and 38% had a CGI-I depression score ≤ 2 at endpoint.

Conclusions

These pilot open-label findings in a small sample provide preliminary data supporting the tolerability and safety of NAC in a pediatric population. The findings of this pilot scale study indicating improvement in mania and depression are promising, but require replication with a monotherapy randomized placebo controlled clinical trial and larger sample.

Trial Registration

ClinicalTrials.gov Identifier: NCT02357290. First Registration 06/02/2015.
How personalisation programs can exacerbate socio-economic inequities: findings from budget utilisation in the Australian National Disability Insurance Scheme
Authors: Malbon Eleanor , Weier Megan , Carey Gemma , Writer Thomas
Published: May 2022

Background

Researchers and policymakers are increasingly concerned that personalisation schemes in social and health care might be worsening social and health inequities. This has been found internationally, where better outcomes from such schemes have been found amongst those who have higher education and more household income.

Method

This study looks at one of the world’s largest personalisation schemes, the Australian National Disability Insurance Scheme. Using publicly available data we examine the allocation and utilisation of NDIS funds according to social gradient.

Results

We find that the rate at which people with disability ‘spend’ or effectively use their disability care funds follows a social gradient. That is, those in areas of higher socioeconomic disadvantage are not spending as much of their allocated budgets on care services across the year compared to people in areas of higher socioeconomic advantage. This represents a clear issue of equity in the use of public money to people with disability in Australia.

Conclusion

We argue that this points to the need to provide targeted supports for the use of disability care funds in areas of higher socioeconomic disadvantage. Without effective supports for fund use, the NDIS and other personalisation schemes may be positioned to worsen existing social inequalities.
A randomized, double-blind, placebo-controlled trial of vitamin D supplementation with or without calcium in community-dwelling vitamin D deficient subjects
Authors: Gariballa Salah , Yasin Javed , Alessa Awad
Published: May 2022

Background

Although vitamin D deficiency is highly prevalent in the Middle East, very few studies have attempted to measure its health impact.

Aims

We aimed to assess whether vitamin D3 and calcium, either alone or in combination, have health benefit.

Methods

In a 2 × 2 factorial design double-blind, placebo-controlled trial, Community free living adults living in the city of Al Ain, UAE were randomly assigned to receive daily 2000 IU oral vitamin D3 alone, 600 mg calcium alone, oral vitamin D3 (2000 IU per day) combined with 600 mg calcium, or a placebo for 6 months. Primary outcomes were self-rated health and bone turnover markers.

Results

Of the 545 randomized, 277 subjects completed 6 months follow up. 25(OH)D levels marginally increased in the two groups received vitamin D3 alone or combined with calcium compared to the decline seen in those who received calcium supplement alone or a placebo. Sub-group analysis revealed that parathyroid hormone (PTH) concentration decreased and Calcium/creatinine ratio increased significantly in the combined vitamin D and Calcium group compared to the vitamin D alone or Calcium alone in contrast to the increase seen in the placebo group [p < 0.05 for between group difference at 6 months]. There were no statistically significant differences between the supplement and placebo groups at the 6 months follow-up in body weight, body mass index (BMI), blood pressure, body pains and general health.

Conclusion

PTH concentration decreased and calcium/creatinine ratio increased in subjects who received vitamin D and Calcium together compared to those who received vitamin D alone.

Trial registration

NCT02662491, First registered on 25 January 2016 (https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S00060CE&selectaction=Edit&uid=U0001M6P&ts=3&cx=scu4cb, Last update: 05 August 2019.
Network pharmacology combined with molecular docking to explore the potential mechanisms for the antioxidant activity of Rheum tanguticum seeds
Authors: Wang Lingling , Xiong Feng , Zhao Shuo , Yang Yang , Zhou Guoying
Published: May 2022

Background

Rheum tanguticum (R. tanguticum) is an edible and medicinal plant that exhibits high antioxidant activity. The purpose of the present study was to investigate the bioactive components of its seeds and the potential mechanisms of antioxidant activity to provide a foundation for further developmental work on R. tanguticum seeds as a functional food.

Methods

In this study, the antioxidant activities of R. tanguticum seeds were measured using DPPH, ABTS and FRAP assays. LC-Q-TOF/MS was used to identify the active compounds in the seeds, and Swiss Target Prediction was used to identify their potential targets. The DisGENET, DrugBank, OMIM and GeneCard databases were used to search for antioxidant-related targets.

Results

The component–target–pathway network was constructed and included 5 compounds and 9 target genes. The hub genes included ESR1, APP, MAPK8, HSP90AA1, AKT1, MMP2, PTGS2, TGFB1 and JUN. The antioxidant activity signaling pathways of the compounds for the treatment of diseases were the cancer signaling pathway, estrogen signaling pathway, colorectal cancer signaling pathway, MAPK signaling pathway, etc. Molecular docking revealed that the compounds in R. tanguticum seeds could inhibit potential targets (AKT1, ESR1 and PTGS2).

Conclusion

Molecular docking studies revealed that the binding energy score between liriodenine and PTGS2 was the highest (8.16), followed by that of chrysophanol (7.10). This result supports the potential for PTGS2-targeted drug screening and design.
Can stoic training develop medical student empathy and resilience? A mixed-methods study
Authors: Brown Megan E. L. , MacLellan Alexander , Laughey William , Omer Usmaan , Himmi Ghita , LeBon Tim , Finn Gabrielle M.
Published: May 2022

Background

Empathic erosion and burnout represent crises within medicine. Psychological training has been used to promote empathy and personal resilience, yet some training useful within adjacent fields remain unexplored, e.g., Stoic training. Given recent research within psychology suggesting that Stoic training increases emotional wellbeing, exploring this type of training within health professions education is important. We therefore asked: What impact would a Stoicism informed online training package have on third year medical students’ resilience and empathy?

Methods

24 third year medical students took part in 12 days of online training (SeRenE), based on Stoic philosophy, and co-developed with psychotherapists. A mixed-methods study was conducted to evaluate impact. Pre- and post-SeRenE students completed the Stoic Attitudes and Behaviours Scale (SABS), Brief Resilience Scale (BRS) and Jefferson Scale of Empathy (JSE). All students completed semi-structured interviews following training and 2 months post-SeRenE. Thematic analysis was employed to analyse qualitative data, whilst within subjects t-tests and correlational analyses were conducted on quantitative data.

Results

Quantitatively, stoic ideation, resilience and empathy increased post-training, with correlational analyses suggesting resilience and empathy increase in tandem. Qualitatively, four themes were identified: 1. Negative visualisation aids emotional and practical preparedness; 2. Stoic mindfulness encourages students to think about how they think and feel; 3. Stoic reflection develops the empathic imagination; and 4. Evaluating the accessibility of SeRenE.

Conclusions

Our data lend support to the ability of Stoic-based psychological training to positively influence resilience and empathy. Although, quantitatively, results were mixed, qualitative data offers rich insight. The practice of negative visualisation, promoted by SeRenE, encourages student self-efficacy and planning, domains of resilience associated with academic success. Further, this study demonstrates a connection between Stoic practice and empathy, which manifests through development of the empathic imagination and a sense of empathic bravery.
Combining rules and dialogue: exploring stakeholder perspectives on preventing sexual boundary violations in mental health and disability care organizations
Authors: Kröger Charlotte , van Baarle Eva , Widdershoven Guy , Bal Roland , Weenink Jan-Willem
Published: May 2022

Background

Sexual boundary violations (SBV) in healthcare are harmful and exploitative sexual transgressions in the professional–client relationship. Persons with mental health issues or intellectual disabilities, especially those living in residential settings, are especially vulnerable to SBV because they often receive long-term intimate care. Promoting good sexual health and preventing SBV in these care contexts is a moral and practical challenge for healthcare organizations.

Methods

We carried out a qualitative interview study with 16 Dutch policy advisors, regulators, healthcare professionals and other relevant experts to explore their perspectives on preventing SBV in mental health and disability care organizations. We used inductive thematic analysis to interpret our data.

Results

We found three main themes on how healthcare organizations can prevent SBV in mental health and disability care: (1) setting rules and regulations, (2) engaging in dialogue about sexuality, and (3) addressing systemic and organizational dimensions.

Conclusion

Our findings suggest that preventing SBV in mental health and disability care organizations necessitates setting suitable rules and regulations and facilitating dialogue about positive aspects of sexuality and intimacy, as well as about boundaries, and inappropriate behaviors or feelings. Combining both further requires organizational policies and practices that promote transparency and reflection, and focus on creating a safe environment. Our findings will help prevent SBV and promote sexual health in mental health and disability care organizations.
Access to primary and secondary health care services for people living with diabetes and lower-limb amputation during the COVID-19 pandemic in Lebanon: a qualitative study
Authors: Chaiban Lea , Benyaich Aicha , Yaacoub Sally , Rawi Haya , Truppa Claudia , Bardus Marco
Published: May 2022

Background

People living with chronic conditions and physical disabilities face many challenges accessing healthcare services. In Lebanon, in 2020, the COVID-19 pandemic and concomitant economic crisis further exacerbated the living conditions of this segment of the population. This study explored the barriers to accessing healthcare services among people living with diabetes and lower-limb amputation during the pandemic.

Methods

We conducted semi-structured, in-depth phone interviews with users of the Physical Rehabilitation Program, offered by the International Committee of the Red Cross. We used a purposive sampling technique to achieve maximum variation. Interviews were audio-recorded, transcribed, translated, and analyzed using thematic analysis following the “codebook” approach. Transcripts were coded and grouped in a matrix that allowed the development of themes and sub-themes inductively and deductively generated.

Results

Eight participants (7 males, 1 female) agreed to be interviewed and participated in the study between March and April, 2021. Barriers to healthcare services access were grouped according to five emerging themes: (1) economic barriers, included increasing costs of food, health services and medications, transportation, shortage of medications, and limited income; (2) structural barriers: availability of transportation, physical environment, and service quality and availability; (3) cultural barriers: marginalization due to their physical disabilities; favoritism in service provision; (4) personal barriers: lack of psychosocial support and limited knowledge about services; (5) COVID-19 barriers: fear of getting sick when visiting healthcare facilities, and heightened social isolation due to lockdowns and physical distancing.

Conclusion

The underlying economic crisis has worsened the conditions of people living with diabetes and lower-limb amputation. The pandemic has made these individuals more vulnerable to external and contextual factors that cannot be addressed only at an individual level. In the absence of a protective legal framework to mitigate inequalities, we provide recommendations for governments and nongovernmental institutions to develop solutions for more equitable access to healthcare for this segment of the population.
Spontaneous closure of an isolated congenital perimembranous ventricular septal defect in two dogs
Authors: van de Watering Anne , Szatmári Viktor
Published: May 2022

Background

Though spontaneous closure of isolated congenital ventricular septal defects in humans is very common, it has been rarely reported in dogs.

Case presentation

A 4 month old Havanese dog and a 4.5 month old Chihuahua x Jack Russell terrier cross were presented for murmur evaluation to the authors’ institution. Both puppies were clinically healthy and had a loud systolic murmur on the right hemithorax. Echocardiography in both dogs revealed a small, isolated, restrictive perimembranous congenital ventricular septal defect. No echocardiographic signs of left ventricular volume overload or pulmonary hypertension were present. Re-check auscultation in both dogs revealed the absence of a murmur, and echocardiography showed no flow through the interventricular septum. In the 9 kg Havanese dog and the 4 kg mixed breed dog, spontaneous closure occurred at 13–17 months and 12–30 months, respectively.

Conclusions

In both dogs the spontaneous closure of a congenital perimembranous ventricular septal defect took place in a young adult age. The mechanism of closure remains unclear.
Plasmodium knowlesi: the game changer for malaria eradication
Authors: Lee Wenn-Chyau , Cheong Fei Wen , Amir Amirah , Lai Meng Yee , Tan Jia Hui , Phang Wei Kit , Shahari Shahhaziq , Lau Yee-Ling
Published: May 2022

Plasmodium knowlesiis a zoonotic malaria parasite that has gained increasing medical interest over the past two decades. This zoonotic parasitic infection is prevalent in Southeast Asia and causes many cases with fulminant pathology. Despite several biogeographical restrictions that limit its distribution, knowlesi malaria cases have been reported in different parts of the world due to travelling and tourism activities. Here, breakthroughs and key information generated from recent (over the past five years, but not limited to) studies conducted onP. knowlesiwere reviewed, and the knowledge gap in various research aspects that need to be filled was discussed. Besides, challenges and strategies required to control and eradicate human malaria with this emerging and potentially fatal zoonosis were described.
The accumulation of Vγ4 T cells with aging is associated with an increased adaptive Vγ4 T cell response after foodborne Listeria monocytogenes infection of mice
Authors: Khairallah Camille , Chu Timothy H. , Qiu Zhijuan , Imperato Jessica N. , Yang Daniella , Sheridan Brian S.
Published: May 2022

Background

It is generally accepted that aging has detrimental effects on conventional T cell responses to systemic infections. However, most pathogens naturally invade the body through mucosal barriers. Although mucosal sites are highly enriched in unconventional immune sentinels like γδ T cells, little is currently known about the impact of aging on unconventional mucosal T cell responses. We previously established that foodborne infection with a mouse-adapted internalin A mutant Listeria monocytogenes (Lm) generates an adaptive intestinal memory CD44hi CD27neg Vγ4 T cells capable of co-producing IL-17A and IFNγ. Therefore, we used this model to evaluate the impact of aging on adaptive Vγ4 T cell responses elicited by foodborne infection.

Results

Foodborne Lm infection of female Balb/c and C57BL/6 mice led to an increased adaptive CD44hi CD27neg Vγ4 T cell response associated with aging. Moreover, Lm-elicited CD44hi CD27neg Vγ4 T cells maintained diverse functional subsets despite some alterations favoring IL-17A production as mice aged. In contrast to the documented susceptibility of aged mice to intravenous Lm infection, mice contained bacteria after foodborne Lm infection suggesting that elevated bacterial burden was not a major factor driving the increased adaptive CD44hi CD27neg Vγ4 T cell response associated with mouse age. However, CD44hi CD27neg Vγ4 T cells accumulated in naïve mice as they aged suggesting that an increased precursor frequency contributes to the robust Lm-elicited mucosal response observed. Body mass did not appear to have a strong positive association with CD44hi CD27neg Vγ4 T cells within age groups. Although an increased adaptive CD44hi CD27neg Vγ4 T cell response may contribute to foodborne Lm resistance of C57BL/6 mice aged 19 or more months, neither anti-TCRδ or anti-IL-17A treatment impacted Lm colonization after primary infection. These results suggest that γδTCR signaling and IL-17A are dispensable for protection after primary foodborne Lm infection consistent with the role of conventional T cells during the early innate immune response to Lm.

Conclusions

Lm-elicited adaptive Vγ4 T cells appear resistant to immunosenescence and memory Vγ4 T cells could be utilized to provide protective immune functions during enteric infection of aged hosts. As such, oral immunization might offer an efficient therapeutic approach to generate unconventional memory T cells in the elderly.
A novel chronic dural port platform for continuous collection of cerebrospinal fluid and intrathecal drug delivery in free-moving mice
Authors: Nakajima Tsuneo , Takeda Shuko , Ito Yuki , Oyama Akane , Takami Yoichi , Takeya Yasushi , Yamamoto Koichi , Sugimoto Ken , Shimizu Hideo , Shimamura Munehisa , Rakugi Hiromi , Morishita Ryuichi
Published: May 2022

Background

Cerebrospinal fluid (CSF) provides a close representation of pathophysiological changes occurring in the central nervous system (CNS); therefore, it has been employed in pathogenesis research and biomarker development for CNS disorders. CSF obtained from valid mouse models relevant to CNS disorders can be an important resource for successful biomarker and drug development. However, the limited volume of CSF that can be collected from tiny intrathecal spaces and the technical difficulties involved in CSF sampling has been a bottleneck that has hindered the detailed analysis of CSF in mouse models.

Methods

We developed a novel chronic dural port (CDP) method without cannulation for CSF collection of mice. This method enables easy and repeated access to the intrathecal space in a free-moving, unanesthetized mouse, thereby enabling continuous long-term CSF collection with minimal tissue damage and providing a large volume of high-quality CSF from a single mouse. When combined with chemical biosensors, the CDP method allows for real-time monitoring of the dynamic changes in neurochemicals in the CSF at a one-second temporal resolution in free-moving mice. Moreover, the CDP can serve as a direct access point for the intrathecal injection of CSF tracers and drugs.

Results

We established a CDP implantation and continuous CSF collection protocol. The CSF collected using CDP was not contaminated with blood and maintained physiological concentrations of basic electrolytes and proteins. The CDP method did not affect mouse’s physiological behavior or induce tissue damage, thereby enabling a stable CSF collection for up to four weeks. The spatio-temporal distribution of CSF tracers delivered using CDP revealed that CSF metabolism in different brain areas is dynamic. The direct intrathecal delivery of centrally acting drugs using CDP enabled real-time behavioral assessments in free-moving mice.

Conclusions

The CDP method enables the collection of a large volume of high-quality CSF and direct intrathecal drug administration with real-time behavioral assessment in free-moving mice. Combined with animal models relevant to CNS disorders, this method provides a unique and valuable platform for biomarker and therapeutic drug research.
“The climate itself must have hidden some medicines”: traditional veterinary medicine of indigenous and non-indigenous campesinos of the southern Andes
Authors: Olivares Fernanda , Marchant Carla , Ibarra José Tomás
Published: May 2022

Background

Traditional veterinary medicine (TVM) or ethnoveterinary medicine comprises knowledge, practices, and beliefs about farm animals. Its study serves to offer ecologically and culturally appropriate strategies for the management of animals and their health in a context marked by the increased use of synthetic pharmaceuticals, social–environmental degradation, pollution, and climate change. In this study, we examine the TVM that Mapuche and non-Mapuche campesinos in the southern Andes have about the management of animals and their health. In addition, we investigate the main factors influencing the current use of TVM.

Methods

Between December 2020 and March 2021, we undertook participant observation and conducted 60 semi-structured and informal interviews with Mapuche and non-Mapuche campesinos from the Pucón and Curarrehue municipal districts in the southern Andes of Chile.

Results

We identified a set of knowledge about cycles and manifestations of nature used in planning 14 animal management practices related to a Mapuche kosmos expressed in living with respect for and in dialogue with non-human elements. On health management, we recorded knowledge about 30 plant species, whose use for different categories of wounds and parasites has the highest informant consensus factors. The use of these plant species is governed by a kosmos associated with respect and reciprocity in their gathering. Nonetheless, 70% of the campesinos interviewed prefer to use synthetic pharmaceuticals. We found that the growing use of synthetic pharmaceuticals, the processes of reduction and change in the structure of land ownership, and climate change are perceived as the main factors behind processes of assimilation of new praxis and hybridization as well as the reduction and/or loss of the use of TVM.

Conclusion

Our results reveal the presence of ethnoveterinary knowledge, practices, and beliefs that are safeguarded by Mapuche and non-Mapuche campesinos in the southern Andes. However, in the context of different social–environmental changes, it is imperative to document, visibilize, and revitalize TVM since it provides new perspectives for bioculturally diverse and sustainable animal production.
Plant trait measurement in 3D for growth monitoring
Authors: Paturkar Abhipray , Sen Gupta Gourab , Bailey Donald
Published: May 2022

Background

There is a demand for non-destructive systems in plant phenotyping which could precisely measure plant traits for growth monitoring. In this study, the growth of chilli plants (Capsicum annum L.) was monitored in outdoor conditions. A non-destructive solution is proposed for growth monitoring in 3D using a single mobile phone camera based on a structure from motion algorithm. A method to measure leaf length and leaf width when the leaf is curled is also proposed. Various plant traits such as number of leaves, stem height, leaf length, and leaf width were measured from the reconstructed and segmented 3D models at different plant growth stages.

Results

The accuracy of the proposed system is measured by comparing the values derived from the 3D plant model with manual measurements. The results demonstrate that the proposed system has potential to non-destructively monitor plant growth in outdoor conditions with high precision, when compared to the state-of-the-art systems.

Conclusions

In conclusion, this study demonstrated that the methods proposed to calculate plant traits can monitor plant growth in outdoor conditions.