bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-Initiated Multidisciplinary Teams: Addressing Complex Care Challenges and Enhancing Daily Life – A Qualitative Study
Authors: Aagaard Mikkel , Møller Trine Boje , Pedersen Steen Bønløkke , Kamronn Terese Matthesen , Pedersen Charlotte Gjørup
Published: May 2024

Background
Patients with multimorbidity often encounter complex care needs. Steno Diabetes Center Aarhus introduced a novel approach: enabling patients to initiate Multidisciplinary Team (MDT) conferences with specialists. This study explores daily challenges in complex care and compares them between MDT initiators and non-initiators.
Methods
Qualitative interviews were conducted with 14 MDT initiators and 28 non-initiators between 2022 and 2023. Out of 4189 patients from the diabetes clinic, invitations were extended to initiate the intervention. The research methodology employed Interpretive Description Methodology, with Aaron Antonovsky's Sense of Coherence theory as the theoretical lens.
Results
Few patients initiated the MDT, with most non-initiators considering it irrelevant. MDT initiators expressed greater concerns about polypharmacy and experienced more pronounced symptoms of fatigue, physical pain, and psychological distress. However, no significant differences were found in physical limitations and perceived well-being between the two groups. Both faced challenges managing chronic illnesses and uncoordinated schedules.
Conclusions
Significant differences exist between MDT initiators and non-initiators, with initiators demonstrating heightened awareness of daily care complexities. This suggests promising results for patients with complex care needs to engage with a multidisciplinary team, discuss a coordinated care plan, and improve self-management. Addressing low uptake requires systematic approaches to identify patients needing additional support. Further research is essential to accurately target those most likely to benefit from such interventions.
The association between physical activity and cognitive function in women with high parity: the chain-mediating effects of nutritional status and depression
Authors: Chen Xiaotong , Wei Kai , Peng Shanshan , Liu Na , He Leqi , Wu Biying , Shi Meifang , lin yong
Published: May 2024

Background
It has been reported that the cognitive responses to physical activity (PA) in postmenopausal women vary by parity status, and women with higher parity show a significant association between PA and cognitive function. However, the potential pathways mediating the relationship between PA and cognitive function in women with higher parity remain unclear. The objective of this study was to examine this association in Chinese cohort and further investigate the mediating pathways.
Methods
A total of 2296 postmenopausal women were enrolled from the Baoshan District, from April to December 2020. All participant details were collected by interviewer-administered questionnaires, including personal information, medical history, lifestyle body mass index (BMI), cognitive function, nutritional status, and. In this cross-sectional study, generalized linear regression models and the chain-mediation analysis were used to examine the relationship between PA and cognitive function and the mediating pathways.
Results
There was a significant relationship between PA and cognitive function in the high-parity group (≥ three births). In the fully adjusted generalized linear regression model, PA was significantly associated with cognitive function [β: 0.795, 95% confidence interval (CI): 0.251–1.340, P < 0.05]. The chain-mediation analysis showed that depression and nutritional status were two significant mediators, contributing 37.96% of the indirect effect of the overall effect.
Conclusions
Our findings suggest that PA is beneficial for women at a higher risk of cognitive decline, especially those with more than two births, and these benefits are mediated by depression and nutritional status.
Molecular & Morphological Identification of Entomopathogenic Fungus Purpureocillium lilacinum Isolated From Soil, Balakot Tehsil, Khaber Pakhtunkhwa, Pakistan
Authors: Sial Muhammad Amir
Published: May 2024

Purpureocillium lilacinum plays a crucial role as a natural biological control agent and serves as a valuable source for fungicides used in managing pests across various insect orders worldwide. The primary aim of this research was to isolate and identify P. lilacinum fungi from the soil of different forests and parks in the Balakot Tehsile. A total of 30 soil samples were collected, and fungal isolation was performed via the soil dilution technique. The isolated colonies were identified by the morphological characteristics of the colonies and conidia at the micro- and macro-levels by using scanning electron microscopy and also at the molecule-level standard molecular techniques, including nucleic acid extraction, ITS region ribosomal DNA amplification, and DNA sequence analysis. The fungal species isolated from the Balakot soil had 98.84–99.07% similarity with the related fungi recorded in GenBank, where they were deposited from different countries. This is the first effort to isolate P. lilaacinum from soil in Pakistan. In the future, it may have great economic value as a biocontrol agent in industry due to its entomopathogenic properties.
Advancements in Anomaly Detection: A Review of Machine Learning Applications in Cyber-Physical System Networks
Authors: Ahmed Asma
Published: May 2024

In the practical world, Cyber-Physical Systems have integrated physical systems and software management in the cyber-world, with networks responsible for information interchange. CPSs are key technologies for various industrial domains, including intelligent medical systems, transport systems, and smart grids. The advancements in cybersecurity have surpassed the rapid growth of CPS, with new security challenges and threat models that lack an integrated and cohesive framework. The review methodology includes the search strategy along with the inclusion and exclusion criteria of fifteen studies conducted in the past ten years. The studies specific to the relevant topic have been added, while the others have been excluded. According to the results, Machine Learning (ML) algorithms and systems can synthesize data. It is employed in cyber-physical security to alleviate concerns regarding the safety and reliability of the findings. ML offers a solution to complex problems, enhancing computer-human interaction and enabling problem-solving in areas where custom-built algorithms are impractical. A comprehensive overview of the application of ML across various domains, such as smart grids, smart vehicles, healthcare systems, and environmental monitoring, has been included. However, a few challenges are associated with implementing ML techniques in CPS networks, including feature selection complexity, model performance, deployment challenges, algorithm biases, model mismatches, and the need to foster a robust safety culture. Overall, integrating ML techniques with CPS networks holds promise for enhancing system safety, reliability, and security but requires ongoing refinement and adaptation to address existing limitations and emerging threats.
Targeting the JAK1 /STAT3 Signaling Pathway: Entinostat as a Promising Treatment for Nasopharyngeal Carcinoma
Authors: Li CaiHong , Shao Jingjing , Zeng Jincheng , Wu Dongfang , Shao Zheng , Ding Hang
Published: May 2024

Background
In various cancer types, entinostat (MS275) inhibits histone deacetylase (HDAC) selectively and exhibits anti-tumor activity. Our study aims to investigate the effects of MS-275 on nasopharyngeal carcinoma (NPC) cells.
Methods
CNE-2 and HONE-1 cell lines were used to carry out the experiments. CCK-8, clone formation assay, DAPI staining, mitochondrial membrane potential (MMP), flow cytometry, wound healing, transwell assay and western blot analyses were used to assess MS-275's effects on NPC cells.
Results
MS-275 inhibited NPC cells from proliferating in a dose-and time-dependent manner. The G2 phase DNA proportion obviously increased with the MS-275 concentration increase (P < 0.05). MS-275 can induce apoptosis of nasopharyngeal carcinoma cells and then cause the decrease of mitochondrial membrane potential. In addition to inhibiting NPC invasion, MS-275 can also suppress cell migration. With increasing drug concentration, the phosphorylation of JAK1 and STAT3 was significantly prevented, while their expression remained unchanged. This is consistent with the immunofluorescence and confocal laser-scanning microscopy result. The metastasis-relevant MMP-2, Snail, anti-apoptotic protein Bcl-xL and Bcl-2 were all downregulated, while the metastasis-relevant E-cadherin, pro-apoptotic protein Bax and cyclin dependent kinase inhibitors p27 and p21 were significantly increased.
Conclusion
The present data demonstrates that MS-275 has the ability to induce apoptosis and suppress NPC proliferation and migration by affecting the JAK1/STAT3 signaling pathway. Therefore, MS-275 may present as a promising therapeutic agent for intractable NPC.
SFRP4 promotes autophagy and blunts FSH responsiveness through inhibition of AKT signaling in ovarian granulosa cells
Authors: Bérubé Michael , Abedini Atefeh , Lapointe Evelyne , Gusscott Samuel , Brind’Amour Julie , Zamberlam Gustavo , Boerboom Derek
Published: May 2024

Background
Secreted frizzled-related proteins (SFRPs) comprise a family of WNT signaling antagonists whose roles in the ovary are poorly understood. Sfrp4-null mice were previously found to be hyperfertile due to an enhanced granulosa cell response to gonadotropins, leading to decreased antral follicle atresia and enhanced ovulation rates. The present study aimed to elucidate the mechanisms whereby Sfrp4 antagonizes FSH action.
Methods
Primary cultures of granulosa cells from wild-type mice were treated with FSH and/or SFRP4, and effects of treatment on gene expression were evaluated by RT-qPCR and RNAseq. Bioinformatic analyses were conducted to analyse the effects of SFRP4 on the transcriptome, and compare them to those of FSH or a constitutively active mutant of FOXO1. Additional granulosa cell cultures from wild-type or Sfrp4-null mice, some pretreated with pharmacologic inhibitors of specific signaling effectors, were used to examine the effects of FSH and/or SFRP4 on signaling pathways, autophagy and apoptosis by western blotting and TUNEL.
Results
Treatment of cultured granulosa cells with recombinant SFRP4 was found to decrease basal and FSH-stimulated mRNA levels of FSH target genes. Unexpectedly, this effect was found to occur neither via a canonical (CTNNB1-dependent) nor non-canonical WNT signaling mechanism, but was found to be GSK3β-dependent. Rather, SFRP4 was found to antognize AKT activity via a mechanism involving AMPK. This lead to the hypophosphorylation of FOXO1 and a decrease in the expression of a portion of the FSH and FOXO1 transcriptomes. Conversely, FSH-stimulated AMPK, AKT and FOXO1 phosphorylation levels were found to be increased in the granulosa cells of Sfrp4-null mice relative to wild-type controls. SFRP4 treatement of granulosa cells also induced autophagy by signaling via AKT-mTORC1-ULK1, as well as apoptosis.
Conclusions
This study identifies a novel GSK3β-AMPK-AKT signaling mechanism through which SFPR4 antagonizes FSH action, and further identifies SFRP4 as a novel regulator of granulosa cell autophagy. These findings provide a mechanistic basis for the phenotypic changes previously observed in Sfrp4-null mice, and broaden our understanding of the physiological roles of WNT signaling processes in the ovary.
Successful Treatment of MDR Acinetobacter baumannii Meningitis in a Young Adult Patient with Intraventricular and Intravenous Polymyxin B-Tigecycline Based Combinations
Authors: Rahim Md Abdur , Biswas Himel Kumar , Zilani Md Abdul Kader
Published: May 2024

Multiple drug resistance to Acinetobacter baumannii infection treatment is a great challenge for neuro-intensivists due to poor drug penetration through the blood‒brain barrier (BBB). Therefore, the intraventricular administration of polymyxin-B and tigecycline is effective; nevertheless, there are few case reports demonstrating the effectiveness of such treatments. Here, we report the case of a 24-year-old male who presented with fever and neck rigidity after intracranial drainage following lung infection caused by MDR Acinetobacter baumannii. Due to the presence of turbid CSF, the administration of the intrathecal (ITH) route polymyxin-B and tigecycline is not possible. In this situation, the neuro-intensivist decided to start intraventricular tigecycline and polymyxin-B administration along with IV tigecycline and polymyxin-B via the intraventricular route, which was feasible because the patient had an external ventricular drain (EVD) due to obstructive hydrocephalus caused by the neurosurgeon after excision of the tumor.
Exploring Drug-Target Interactions through Network Pharmacology in Breast cancer: A Text Mining Approach
Authors: Tikhile Neha Sanjay
Published: May 2024

Breast cancer is the second largest cause of cancer mortality among women. Breast cancer develops in a multi-step process involving various cell types, and prevention remains a global challenge. One of the most effective ways to avoid breast cancer is to diagnose it early. Breast cancer patients in certain developed nations have a 5-year relative survival rate of more than 80% thanks to early detection and treatment. Network pharmacology is a powerful approach that integrates various disciplines such as pharmacology, systems biology, and network analysis to understand the complex interactions between drugs, targets, and diseases at a systems level through various software like uniprotkb, string, cytoscape. The protein-protein interaction (PPI) analysis was conducted using STRING and Cytoscape. The resulting genes' drug-gene interaction was then used to generate candidate drugs. Our text mining searches yielded 2,658 genes associated with breast cancer. 166 genes have been selected as being important to breast cancer. Gene enrichment analysis identified ten genes encoding 10 pathways, which potentially target ten proteins in total. In conclusion, network pharmacology offers a promising approach for understanding the complex molecular mechanisms underlying breast cancer and identifying potential therapeutic targets. By integrating multi-omics data and computational techniques, we can elucidate intricate drug-target interactions, biological networks, and signaling pathways involved in breast cancer progression and treatment response. This comprehensive approach enables the discovery of novel therapeutic candidates, facilitates drug repurposing strategies, and supports the development of personalized treatment regimens.
From optical perturbation to true control : all-optical voltage clamp in live animals
Authors:   , Bergs Amelie
Published: May 2024

This dissertation constitutes a series of successive research papers, starting with the characterization of various optogenetic tools up to the establishment of purely optical electrophysiology in living animals. Optogenetics has revolutionized neurobiology as it allows stimulation of excitable cells with exceptionally high spatiotemporal resolution. To cope with the increasing complexity of research issues and accompanying demands on experimental design, the broadening of the optogenetic toolbox is indispensable. Therefore, one goal was to establish a wide variety of novel rhodopsin-based actuators and characterize them, among others, with respect to their spectral properties, kinetics, and efficacy using behavioral experiments in Caenorhabditis elegans. During these studies, the applicability of highly potent de- and hyperpolarizers with adapted spectral properties, altered ion specificity, strongly slowed off-kinetics, and inverted functionality was successfully demonstrated. Inhibitory anion channelrhodopsins (ACRs) stood out, filling the gap of long-sought equivalent hyperpolarizing tools, and could be convincingly applied in a tandem configuration combined with the red-shifted depolarizer Chrimson for bidirectional stimulation (Bidirectional Pair of Opsins for Light-induced Excitation and Silencing, BiPOLES). A parallel study aimed to compare various rhodopsin-based genetically encoded voltage indicators (GEVIs) in the worm: In addition to electrochromic FRET-based GEVIs that use lower excitation intensity, QuasAr2 was particularly convincing in terms of voltage sensitivity and photostability in C. elegans. However, classical optogenetic approaches are quite static and only allow perturbation of neural activity. Therefore, QuasAr2 and BiPOLES were combined in a closed-loop feedback control system to implement the first proof-of-concept all-optical voltage clamp to date, termed the optogenetic voltage clamp (OVC). Here, an I-controller generates feedback of light wavelengths to bidirectionally stimulate BiPOLES and keep QuasAr’s fluorescence at a desired level. The OVC was established in body wall muscles and various types of neurons in C. elegans and transferred to rat hippocampal slice culture. In the worm, it allowed to assess altered cellular physiology of mutants and Ca2+-channel characteristics as well as dynamical clamping of distinct action potentials and associated behavior. Ultimately, the optogenetic actuators and sensors implemented in the course of this cumulative work enabled to synergistically combine the advantages of imaging- and electrode-based techniques, thus providing the basis for noninvasive, optical electrophysiology in behaving animals.
Storysign: aplicativo de inteligência artificial e realidade aumentada para leitura bilíngue língua portuguesa e libras
Authors: Schlosser Diego Fabricio , Silva Sani de Carvalho Rutz da , Herrera Cantorani José Roberto , Pilatti Luiz Alberto
Published: May 2024

O presente estudo tem como objetivo avaliar a eficácia do StorySign como uma ferramenta de Tecnologia Assistiva (TA) no ensino e aprendizagem de pessoas surdas. O método do estudo consistiu na avaliação do aplicativo StorySign em um iPhone 13 Pro, com foco em análise prática de usabilidade e análise técnica seguindo a norma ABNT NBR ISO/IEC 9126-1: 2003, cobrindo funcionalidade, confiabilidade, eficiência, manutenibilidade e portabilidade. Realizada por dois pesquisadores independentes ao longo de sete dias, contou com a intervenção de um terceiro pesquisador em casos de divergência para assegurar a imparcialidade da avaliação. Constatou-se que o aplicativo StorySign apresenta aspectos positivos, como gratuidade, facilidade de uso e eficácia do avatar interativo, mas também desafios como a necessidade de um livro físico, limitação de títulos literários e dependência de Internet. O aplicativo demonstrou potencial para inclusão educacional e social dos surdos, enfrentando limitações técnicas, principalmente na manutenibilidade, devido à indisponibilidade do código-fonte. Conclui-se que StorySign apresenta um potencial significativo para promover a alfabetização bilíngue e a inclusão social e educacional de surdos e ouvintes.
Rational Q-systems at root of unity I. Closed chains
Authors: Hou Jue , Jiang Yunfeng , Miao Yuan
Published: May 2024

The solution of Bethe Ansatz equations for XXZ spin chain with the parameter q being a root of unity is infamously subtle. In this work, we develop the rational Q-system for this case, which offers a systematic way to find all physical solutions of the Bethe Ansatz equations at root of unity. The construction contains two parts. In the first part, we impose additional constraints to the rational Q-system. These constraints eliminate the so-called Fabricius-McCoy (FM) string solutions, yielding all primitive solutions. In the second part, we give a simple procedure to construct the descendant tower of any given primitive state. The primitive solutions together with their descendant towers constitute the complete Hilbert space. We test our proposal by extensive numerical checks and apply it to compute the torus partition function of the 6-vertex model at root of unity.
MOTION GRAPHICS: AN ENTERTAINING AND ACCESSIBLE LEARNING MEDIA FOR THE STUDENTS
Authors: Perdani Yella Dezas
Published: May 2024

In the Covid-19 pandemic, teachers and students must continue learning at home online. Online learning requires teachers to be more selective and creative in preparing teaching materials, including learning media. Learning media must be informative, contain all the material to be taught, and be interesting so students are interested in learning. One of the informative and interesting learning media that is currently widely used is video. Teachers must prepare videos that suit the material and students' abilities. Technology has been and is still being used on a large scale by teachers to assist teaching in the classroom. Both applications and products from these applications support the teaching and learning process and help students understand learning. One technological product currently widely used is video-based learning, and one type of VBL that can be used to create interesting learning media is Motion Graphic learning. MG is the process of designing, writing and moving images whose final product can be learning media. This Community Service Activity (PKM) is designed to educate teachers on the use of Motion Graphics as a learning medium for students. As a result, it is expected that this training will benefit teachers.
Palliative care for chronic heart failure: non-pharmacological methods of relieving the main symptoms
Authors: Shevcova V. I. , Pashkova A. A. , Kolpacheva M. G. , Salamatova V. N.
Published: May 2024

Chronic heart failure is one of the main causes of the increase in mortality and disability of the population around the world. In the final stages of chronic heart failure, when the debilitating symptoms of patients no longer respond to treatment, the issue of palliative care arises. To date, current clinical recommendations and guidelines do not contain data on palliative measures for this category of patients – in such conditions, doctors often do not understand what tactics of patient management they need to choose. Therefore, the importance of integrating palliative care into the treatment of chronic heart failure is increasing. Many symptoms associated with the terminal stages of chronic heart failure have a negative impact on the general condition and quality of life of patients. The main ones are shortness of breath, pain, manifestations of asthenia, as well as anxiety-depressive disorders. In order to maximize the possible improvement in the quality of life of such patients, palliative care should be comprehensive: regular pharmacotherapy prescribed in accordance with current clinical recommendations, combined with various non-drug methods for relieving the main symptoms. As such methods, the main cardiac rehabilitation measures can be considered, including regular physical training, training in compliance with the treatment regimen, stress management techniques, and psychological support. The relationship of patients and caregivers with medical professionals is important in the organization of palliative care. Adequate and timely communication is necessary to improve self-control and compliance with medication, prevent unplanned hospitalization, inform decision-making and, ultimately, ensure a safe death. The article discusses the basic concepts of organizing and providing palliative care to patients with chronic heart failure, as well as non-pharmacological palliative measures proposed by European, American, and Russian specialists.
Association between gut microbiota and thyroid dysfunction
Authors: Tulsky A. A. , Myrinova O. A. , Shchetinina A. O. , Martirosian N. S. , Goncharova E. V. , Kuzina I. A. , Telnova M. E. , Valeeva F. V. , Petunina N. A.
Published: May 2024

The article is devoted to modern researches about the potential role of gut microbiota in the development of thyroid pathology. Gut microbiota plays a major role both in the formation and maintenance of human health and in the pathogenesis of a wide range of diseases. There is evidence of the relationship between the gut microbiota and the immune system, the risk of developing several malignant and autoimmune diseases. The article discusses the functions of the gut microbiota and the factors that determine its composition. Studies have shown a connection between the gut microbiota and the thyroid gland, which formed the basis for the formation of the theory of the gut-thyroid axis. It has been shown that the gut microbiota takes part in the metabolism of thyroid hormones and ensures their enterohepatic circulation. It is assumed that one of the links between the thyroid gland and gastrointestinal microorganisms is the immune system. The results of studies examining the taxonomic composition of the gut microbiota in patients with autoimmune thyroiditis and Graves’ disease are presented. It is hypothesized that the composition of the gut microbiota may influence the requirement for levothyroxine, especially in patients with subclinical hypothyroidism. On the other hand, levothyroxine, to a lesser extent, directly hypothyroidism as a result of autoimmune thyroiditis are associated with bacterial overgrowth syndrome despite the achievement of euthyroidism, and may affect the composition of the microbiota. Even though autoimmune thyroid diseases are quite common in the general population, little work has been done on this issue. More reliable basic and clinical researches are needed to identify specific relationships and mechanisms of development of thyroid pathology depending on changes in the composition of the gut microbiota, as well as to assess the potential for therapeutic use.
Possibilities of activation of mucociliary transport in patients with inflammatory diseases of the nose and paranasal sinuses
Authors: Gurov A. V. , Yushkina M. A. , Muzhichkova A. V.
Published: May 2024

Impaired mucociliary clearance is the main mechanism of pathogenesis of acute and chronic diseases of the nose and paranasal sinuses. Viral infections have a negative impact on the condition of the mucous membranes of the upper respiratory tract, increasing the secretion of mucus by goblet cells, increasing its viscosity and reducing the intensity of the beating of cilia, making it difficult to remove mucus from the lumen of the respiratory tract and sinuses. The article discusses approaches to the treatment of acute and chronic sinusitis from the perspective of improving the functioning of mucociliary transport. Up-to-date requirements for drug therapy of both acute and chronic diseases of the nose and paranasal sinuses first necessitate a reasonable, evidence-based approach to the prescription of antibacterial agents, as the bacterial diseases account for no more than 2% of clinical cases in the sinusitis pattern, and even in this group, antibiotic therapy can only be prescribed in case of chronic, severe or complicated course of the disease. However, as most episodes of inflammatory diseases of the nose and paranasal sinuses are directly or indirectly associated with viral infection and post-viral changes, the next challenge facing the clinician is the choice of optimal therapy targeting the main link in the pathogenesis of the disease – correction of impaired mucociliary clearance. And the third issue that needs to be solved in planning drug therapy is the effectiveness and safety of the prescribed drug with the aim to minimize the risk of side effects. The authors of the article point to the effectiveness of the use of the herbal medicine Respero Myrtol, which has a mucolytic, anti-inflammatory and antibacterial effect, in the treatment of acute and chronic sinusitis, as well as protracted forms of rhinitis
Priorities of self-monitoring of glycemia: an important component of successful diabetes management
Authors: Biryukova E. V. , Shinkin М. V.
Published: May 2024

Effective treatment of diabetes mellitus (DM) is modern medicine’s big challenge. Chronic hyperglycemia is a key factor in the pathogenesis of chronic diabetic complications that determine life prognosis. Achieving and maintaining optimal glycemic controli is crucial for the management of diabetes and minimizing the risk of the whole range of diabetic complications. The role of self-monitoring of glycemia (SMG) in the management of diabetes and in the prevention of diabetic complications is discussed. Stable compensation of DM can be achieved by using effective therapy and regular SMG, which provides accurate and timely information about carbohydrate metabolism status. Treatment of diabetes as a chronic disease is a lifelong processs, in which both the doctor and the patient must definitely participate. SMG involves patients in the treatment process, provides them with the opportunity to become its active full-fledged participant, and helps improve glycemic control. Lack of proper glycemic control is one of the reasons for unsatisfactory glycemic levels in many patients with diabetes. Findings from clinical studies and real-world clinical practice demonstrating an improvement in carbohydrate metabolism markers due to regular SMG are presented. HbA1c levels begin to improve significantly as soon as the patient improves the frequency of SCG, regardless of the type of DM or the type of glucose-lowering therapy. The modern understanding of SMG implies a certain frequency of routine measurements of glucose levels. Advanced technologies provide additional opportunities to achieve optimal and safe blood glucose levels in patients with DM using modern blood glucose meters. Compliance with standards of accuracy is the most important criterion for choosing a blood glucose meter that is convenient and easy to use.
Quantitative microbial risk assessment (QMRA) of the work of manual pit emptiers, commonly known as bayakous
Authors: Jean-Baptiste Davidson , Monette Frédéric
Published: May 2024

In Haiti, manual pit emptiers, known as bayakous, face significant health risks. They work by descending naked into latrine pits, exposing themselves to pathogens and contributing to environmental contamination. This study employs the quantitative microbial risk assessment (QMRA) method to evaluate the microbial risks associated with this practice, considering nine prevalent pathogens in Haiti. Three ingestion scenarios were developed: hand-to-mouth contact, ingestion while immersed in excreta, and a combination of both. A sensitivity analysis assessed the impact of input data on study outcomes. The results indicate a high probability of infection and illness during pit emptying operations annually for all scenarios and pathogens. Recommendations include adopting personal protective equipment (PPE) and using a manual Gulper waste pump to eliminate the need to descend directly into the pits, thereby reducing the risk of injury from sharp objects. The study proposes the establishment of intermediate disposal points approximately 5 km from collection sites to deter illegal dumping. National regulations and professionalization of the bayakou profession are suggested, along with awareness campaigns to promote PPE and Gulper pump usage. Addressing these issues is crucial for safeguarding the health of bayakou and public health in Haiti.
El paisaje arqueológico de Machuchoquequirao, Tambillo e Inkiltambo en la microcuenca de Cachimayo, Cusco-Perú
Authors: Cama Ttito Percy Alfredo , Farfán Hancco Alex Ronald , Mormontoy Atayupanqui Alfredo
Published: May 2024

Esta investigación se desarrolló desde una perspectiva arqueológica postprocesual, teniendo en cuenta los aportes metodológicos y teóricos de Criado y Hodder. Se estableció el análisis en las diferentes dimensiones (física, social y simbólica) siguiendo los lineamientos de la arqueología del paisaje; por medio del análisis formal se estableció las formas del espacio y se identificó en su totalidad el espacio construido, además, permitió identificar diferentes unidades geomorfológicas, reconocer su superficie, características, límites y predefinir sus usos potenciales. De esta manera lograr la reconstrucción y deconstrucción virtual para conocer el sentido del espacio.
Estudio interpretativo, histórico y virtual del Presidio de San Francisco de Conchos del Camino Real de tierra adentro en México
Authors: Carrillo Acosta Roberto
Published: May 2024

Es de vital importancia realizar estudios que permitan brindar conocimiento sobre la historia, ya que esta es la base para la interpretación y puesta en valor del patrimonio. En este caso, ante las escasas evidencias materiales relacionadas con el presidio de Conchos, fue necesario hacer una reconstrucción o interpretación en un nivel hipotético de su estructura y espacios, para entender mejor su funcionamiento, así como su papel en la defensa, sobre todo en el poblamiento de la Nueva Vizcaya. Se trabajó sobre la base de nuestra experiencia en el tema, revisando la historiografía y también mediante un análisis comparativo entre propuestas de interpretación, así como haciendo analogías con otras fortificaciones contemporáneas. Así, se logró una identificación y reconstrucción satisfactoria del bien, que permite brindar claridad sobre su historia y papel dentro de la ocupación y pacificación del norte de México colonial.
José María Gálvez Pérez
Authors: Beingolea del Carpio José Luis
Published: May 2024

José María Gálvez Pérez (1947-2023) perteneció a la tercera generación de restauradores (Hayakawa, 2010, p. 54) , su formación especializada (UNI 1968-1975) se inició con los cursos de Historia de la Arquitectura (Occidental y Nacional) y de restauración de monumentos que introducían al estudiante en ese ámbito disciplinar. Compartí con él algunos de los cursos y trabajos de Historia de la Arquitectura Peruana, observé de cerca su vocación, capacidad y experiencia, pues, paralelamente, estuvo en obra y realizó relevamientos de edificios patrimoniales.
Patrimonio y Crisis. Patrimônio e Crise
Authors: Abarca Ancori Amparo
Published: May 2024

En las diferentes realidades presentadas en el libro y desde distintos vértices, es unánime en los autores que América Latina es el escenario donde el patrimonio y la crisis se lucen sin precedentes, a nivel político, económico, social y sanitario, desde la pandemia del COVID-19. La frase “No son 30 pesos, son 30 años", expresada por manifestantes en el “estallido social” de Chile, podría englobar la esencia del malestar social frente a políticas gubernamentales, alejadas del progreso y sus beneficios, en el continente. Malestar que encuentra en el valor simbólico del patrimonio la oportunidad para desconocerlo y resignificarlo, consolidando su “valor de conflicto” en el siglo XXI.
Enhancing Therapist Courage: Feasibility and Changes in Distress Tolerance and Equanimity Following Martial Arts-Based Radically Embodied Compassion Workshops
Authors: Hiskey Syd , Clapton Neil
Published: May 2024

The work of psychotherapy demands much of those who engage in it. Compassion provisioned by therapists requires varying competencies, yet remains a highly embodied and enactive endeavour. Therapist skill can be cultivated in this area and enhanced through a variety of body-mind trainings, including various forms of therapist personal practice. However, much clinical training/continued professional development centres on education workshops, emphasising knowledge above skill. Given this we present feasibility data from two deliberate practice/procedural learning, martial arts-based radically embodied compassion workshops aimed at enhancing therapist courage. Our findings show that conducting such training is feasible, with those attending able to participate in each practice. Participant self-report suggests the workshops can result in significant personal benefit, are able to deepen attendee understanding of compassion focused therapy and lead to an enhanced sense of how to apply it. Via self-report pre, post and 3-month after the workshops, significant beneficial changes in overall total clinical distress tolerance as well as specifically in absorption (the level of attention absorbed by distressing emotions) were shown. Beneficial changes were also noted in experiential acceptance and in total general equanimity pre and post workshops. We discuss limitations of the current study and potential future work that could follow from it, before concluding that training in this way represents an important first step in delineating a novel approach to therapist self-development. Practices drawn from traditional martial arts may be well suited to providing the context, relational safety and necessary skills for therapist development, in terms of enhanced distress tolerance and management of the self, to occur.
Using Topic Modeling to Understand Patients’ and Caregivers’ Perspectives About Left Ventricular Assist Device: Thematic Analysis
Authors: Melnikov Semyon , Klein Stav , Shahar Moni , Guy David
Published: May 2024

Background

Heart failure (HF) is a significant global clinical and public health challenge, impacting 64.3 million individuals worldwide. To address the scarcity of donor organs, left ventricular assist device (LVAD) implantation has become a crucial intervention for managing end-stage HF, serving as a bridge to heart transplantation or as a destination therapy. Web-based health forums, such as MyLVAD.com, play a vital role as trusted sources of information for individuals with HF symptoms and their caregivers.

Objective

We aim to uncover the latent topics within the posts shared by users on the MyLVAD.com website.

Methods

Using the latent Dirichlet allocation algorithm and a visualization tool, our objective was to uncover latent topics within the posts shared on the MyLVAD.com website. Through the application of topic modeling techniques, we analyzed 459 posts authored by recipients of LVAD and their family members from 2015 to 2023.

Results

This study unveiled 5 prominent themes of concern among patients with LVAD and their family members. These themes included family support (39.5% weight value), encompassing subthemes such as family caregiving roles and emotional or practical support; clothing (23.9% weight value), with subthemes related to comfort, normalcy, and functionality; infection (18.2% weight value), covering driveline infections, prevention, and care; power (12% weight value), involving challenges associated with power dependency; and self-care maintenance, monitoring, and management (6.3% weight value), which included subthemes such as blood tests, monitoring, alarms, and device management.

Conclusions

These findings contribute to a better understanding of the experiences and needs of patients implanted with LVAD, providing valuable insights for health care professionals to offer tailored support and care. By using latent Dirichlet allocation to analyze posts from the MyLVAD.com forum, this study sheds light on key topics discussed by users, facilitating improved patient care and enhanced patient-provider communication.
Efficacy of Mobile App–Based Cognitive Behavioral Therapy for Insomnia: Multicenter, Single-Blind Randomized Clinical Trial
Authors: Shin Jiyoon , Kim Sujin , Lee Jooyoung , Gu Hyerin , Ahn Jihye , Park Chowon , Seo Mincheol , Jeon Jeong Eun , Lee Ha Young , Yeom Ji Won , Kim Sojeong , Yoon Yeaseul , Lee Heon-Jeong , Kim Seog Ju , Lee Yu Jin
Published: May 2024

Background

Cognitive behavioral therapy for insomnia (CBTi) is the first-line therapy for chronic insomnia. Mobile app–based CBTi (MCBTi) can enhance the accessibility of CBTi treatment; however, few studies have evaluated the effectiveness of MCBTi using a multicenter, randomized controlled trial design.

Objective

We aimed to assess the efficacy of Somzz, an MCBTi that provides real-time and tailored feedback to users, through comparison with an active comparator app.

Methods

In our multicenter, single-blind randomized controlled trial study, participants were recruited from 3 university hospitals and randomized into a Somzz group and a sleep hygiene education (SHE) group at a 1:1 ratio. The intervention included 6 sessions for 6 weeks, with follow-up visits over a 4-month period. The Somzz group received audiovisual sleep education, guidance on relaxation therapy, and real-time feedback on sleep behavior. The primary outcome was the Insomnia Severity Index score, and secondary outcomes included sleep diary measures and mental health self-reports. We analyzed the outcomes based on the intention-to-treat principle.

Results

A total of 98 participants were randomized into the Somzz (n=49, 50%) and SHE (n=49, 50%) groups. Insomnia Severity Index scores for the Somzz group were significantly lower at the postintervention time point (9.0 vs 12.8; t95=3.85; F2,95=22.76; ηp2=0.13; P<.001) and at the 3-month follow-up visit (11.3 vs 14.7; t68=2.61; F2,68=5.85; ηp2=0.03; P=.01) compared to those of the SHE group. The Somzz group maintained their treatment effect at the postintervention time point and follow-ups, with a moderate to large effect size (Cohen d=–0.62 to –1.35; P<.01 in all cases). Furthermore, the Somzz group showed better sleep efficiency (t95=–3.32; F2,91=69.87; ηp2=0.41; P=.001), wake after sleep onset (t95=2.55; F2,91=51.81; ηp2=0.36; P=.01), satisfaction (t95=–2.05; F2,91=26.63; ηp2=0.20; P=.04) related to sleep, and mental health outcomes, including depression (t95=2.11; F2,94=29.64; ηp2=0.21; P=.04) and quality of life (t95=–3.13; F2,94=54.20; ηp2=0.33; P=.002), compared to the SHE group after the intervention. The attrition rate in the Somzz group was 12% (6/49).

Conclusions

Somzz outperformed SHE in improving insomnia, mental health, and quality of life. The MCBTi can be a highly accessible, time-efficient, and effective treatment option for chronic insomnia, with high compliance.

Trial Registration

Clinical Research Information Service (CRiS) KCT0007292; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=22214&search_page=L
Using a Semiautomated Procedure (CleanADHdata.R Script) to Clean Electronic Adherence Monitoring Data: Tutorial
Authors: Bandiera Carole , Pasquier Jérôme , Locatelli Isabella , Schneider Marie P
Published: May 2024

Background

Patient adherence to medications can be assessed using interactive digital health technologies such as electronic monitors (EMs). Changes in treatment regimens and deviations from EM use over time must be characterized to establish the actual level of medication adherence.

Objective

We developed the computer script CleanADHdata.R to clean raw EM adherence data, and this tutorial is a guide for users.

Methods

In addition to raw EM data, we collected adherence start and stop monitoring dates and identified the prescribed regimens, the expected number of EM openings per day based on the prescribed regimen, EM use deviations, and patients’ demographic data. The script formats the data longitudinally and calculates each day’s medication implementation.

Results

We provided a simulated data set for 10 patients, for which 15 EMs were used over a median period of 187 (IQR 135-342) days. The median patient implementation before and after EM raw data cleaning was 83.3% (IQR 71.5%-93.9%) and 97.3% (IQR 95.8%-97.6%), respectively (Δ+14%). This difference is substantial enough to consider EM data cleaning to be capable of avoiding data misinterpretation and providing a cleaned data set for the adherence analysis in terms of implementation and persistence.

Conclusions

The CleanADHdata.R script is a semiautomated procedure that increases standardization and reproducibility. This script has broader applicability within the realm of digital health, as it can be used to clean adherence data collected with diverse digital technologies.
Evolution of Chatbots in Nursing Education: Narrative Review
Authors: Zhang Fang , Liu Xiaoliu , Wu Wenyan , Zhu Shiben
Published: May 2024

Background

The integration of chatbots in nursing education is a rapidly evolving area with potential transformative impacts. This narrative review aims to synthesize and analyze the existing literature on chatbots in nursing education.

Objective

This study aims to comprehensively examine the temporal trends, international distribution, study designs, and implications of chatbots in nursing education.

Methods

A comprehensive search was conducted across 3 databases (PubMed, Web of Science, and Embase) following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram.

Results

A total of 40 articles met the eligibility criteria, with a notable increase of publications in 2023 (n=28, 70%). Temporal analysis revealed a notable surge in publications from 2021 to 2023, emphasizing the growing scholarly interest. Geographically, Taiwan province made substantial contributions (n=8, 20%), followed by the United States (n=6, 15%) and South Korea (n=4, 10%). Study designs varied, with reviews (n=8, 20%) and editorials (n=7, 18%) being predominant, showcasing the richness of research in this domain.

Conclusions

Integrating chatbots into nursing education presents a promising yet relatively unexplored avenue. This review highlights the urgent need for original research, emphasizing the importance of ethical considerations.
Revolutionizing Care: Unleashing the Potential of Digital Health Technology in Physiotherapy Management for People With Cystic Fibrosis
Authors: Morrison Lisa , Saynor Zoe Louise , Kirk Alison , McCann Lisa
Published: May 2024

This viewpoint paper explores the dynamic intersection of physiotherapy and digital health technologies (DHTs) in enhancing the care of people with cystic fibrosis (CF), in the context of advancements such as highly effective modulator therapies that are enhancing life expectancy and altering physiotherapy needs. The role of DHTs, including telehealth, surveillance, home monitoring, and activity promotion, has expanded, becoming crucial in overcoming geographical barriers and accelerated by the recent pandemic. Physiotherapy, integral to CF care since 1946, has shifted toward patient-centered approaches, emphasizing exercise training and a physically active lifestyle. The reduction in inpatient admissions due to highly effective modulator therapies has led to increased home care and online or electronic consultations, and DHTs have revolutionized service delivery, offering flexibility, self-management, and personalized care options; however, there is a need to comprehensively understand user experiences from both people with CF and physiotherapists. This paper highlights the essential exploration of user experiences to facilitate clinician adaptation to the digital requirements of modern clinical management, ensuring equitable care in the “future hospitals” arena. Identifying research gaps, this paper emphasizes the need for a thorough evaluation of DHT use in CF physiotherapy education, training, and self-monitoring, as well as the experiences of people with CF with online or electronic consultations, self-monitoring, and remote interventions. Online group exercise platforms address historical challenges relating to infection control but necessitate comprehensive evaluations of user experiences and preferences. Future-proofing DHTs within the physiotherapy management of CF demands a shift toward full integration, considering stakeholder opinions and addressing barriers. While DHTs have the potential to extend physiotherapy beyond the hospital, this paper stresses the importance of understanding user experiences, addressing digital poverty, and working toward more equitable health care access. A flexible approach in the “future hospital” is advocated, emphasizing the need for a nuanced understanding of user preferences and experiences to optimize the integration of DHTs in CF care.