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Hong J, Sun J, Zhang L, Tan Z, Chen Y, Chen Q, Zhu Y, Liu Y, Zhu L, Zeng L, Kong Y, Li B, Liu L. Neurological mechanism and treatment effects prediction of acupuncture on migraine without aura: Study protocol for a randomized controlled trial. Front Neurol 2022; 13:981752. [PMID: 36158972 PMCID: PMC9492888 DOI: 10.3389/fneur.2022.981752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionAcupuncture is an effective treatment in migraine without aura (MWoA), but the neurological mechanism has not been investigated using multimodal magnetic resonance imaging (MRI). This trial will combine functional MRI, structural MRI, and diffusion tensor imaging to explore the potential neural mechanism of acupuncture on MWoA, and will use machine learning approach to predict acupuncture treatment effects.MethodsIn this multimodal neuroimaging randomized controlled trial, a total of 60 MWoA participants will be randomly allocated to two groups: the real acupuncture treatment group and the sham acupuncture control group. This trial will include a 4-week baseline phase, a 4-week treatment phase, and a 12-week follow-up phase. Participants will undergo 12 acupuncture or sham acupuncture sessions during the treatment phase. The Headache Diary, Migraine-Specific Quality of Life Questionnaire, Headache Impact Test, Beck Depression Inventory-II, and Beck Anxiety Inventory will be utilized to evaluate the clinical efficacy. Multimodal MRI scans will be employed to investigate the mechanism of acupuncture at baseline, at the end of treatment, and after follow-up. Multimodal MRI data will be used to predict acupuncture treatment effects using machine learning technology.DiscussionThis study hypothesized that acupuncture therapy may treat MWoA by restoring the neuropathological alterations in brain activity. Our finding should provide valuable scientific proof for the effects of acupuncture and demonstrate the usefulness of acupuncture in the treatment of MWoA. Moreover, acupuncture response prediction might decrease healthcare expenses and time lags for patients.Trial registration number[ChiCTR2100044251].
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Affiliation(s)
- Jiahui Hong
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Jingqing Sun
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Liping Zhang
- Department of Radiology, Dong Zhimen Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Zhongjian Tan
- Department of Radiology, Dong Zhimen Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Ying Chen
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Qiuyi Chen
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Yupu Zhu
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuhan Liu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Liying Zhu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Lin Zeng
- Peking University Third Hospital, Research Centre of Clinical Epidemiology, Beijing, China
| | - Yazhuo Kong
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Bin Li
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
| | - Lu Liu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing, China
- *Correspondence: Lu Liu
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Arkam J, Azhar S, Khan KS, Aman A. Patient safety attitudes of frontline healthcare workers in Lahore: A multicenter study. Pak J Med Sci 2022; 38:40-46. [PMID: 35035398 PMCID: PMC8713222 DOI: 10.12669/pjms.38.1.4964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/16/2021] [Accepted: 08/30/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives: To evaluate patient safety attitudes of the frontline health workers in hospitals of Lahore, Pakistan. Methods: A self-administered Safety Attitudes Questionnaire (SAQ) survey was deployed in five hospitals across Lahore, Pakistan (July 2019 to June 2020). A total of 1250 consecutive consenting nurses and postgraduate trainee physicians of under five years working experience were recruited. Assessment for each of the six subdomains (teamwork climate, safety climate, job satisfaction, stress recognition, perception of management, working conditions) was done on a 0-100 scale. Multivariate analyses examined their relationship with job cadre (nurses and physicians), duration of respondents’ work experience (< 2 years, 3 - 4 years, > 4 years), and hospital sector (private and public). Results: The response rate was 97% (1212 individuals; 765 nurses, 447 physicians). Nurses scored less than physicians in teamwork climate (-2.4, 95% CI -4.5 – -0.2, p=0.02) and stress recognition (-10.6, 95% CI -13.5 – -7.7, p<0.001), but more in perception of management (4.2, 95% CI 1.5 – 6.8, p=0.002) and working conditions (3.4, 95% CI 0.66 – 6.2, p=0.01). Increasing work experience was related to greater scores in all subdomains. Private hospitals scored generally higher than public ones. Conclusion: Duration of job experience was positively correlated with patient safety attitudes of hospital staff. These finding could serve as the baseline to shape staff perceptions by cadre in both public and private sector hospitals.
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Affiliation(s)
- Javed Arkam
- Prof. Javed Akram, MBBS, FRCP. Vice Chancellor, University of Health Sciences, Khayabaan e Jamia Punjab, Lahore 54000, Pakistan
| | - Shehnoor Azhar
- Dr. Shehnoor Azhar, BDS, MPH. Assistant Professor, Department of Public Health, Doctoral Candidate Public Health, University of Granada, Spain. University of Health Sciences, Khayabaan e Jamia Punjab, Lahore 54000, Pakistan. Distinguished Investigator, Department of Clinical Medicine & Public Health, University of Granada, Spain
| | - Khalid Saeed Khan
- Prof. Khalid Saeed Khan, FCPS, MRCGOB. Distinguished Investigator, Department of Clinical Medicine & Public Health, University of Granada, Spain
| | - Arifa Aman
- Dr. Arifa Aman, MBBS. Private Medical Practitioner, Lahore, Pakistan
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The cerebral mechanism of acupuncture for chronic insomnia with gastrointestinal disorder: protocol for a randomized controlled trial. Trials 2021; 22:386. [PMID: 34098994 PMCID: PMC8186179 DOI: 10.1186/s13063-021-05332-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 05/19/2021] [Indexed: 11/20/2022] Open
Abstract
Background Many patients with chronic insomnia disorder (CID) have gastrointestinal (GI) symptoms. First-line insomnia medications do not treat GI problems. Acupuncture has a comprehensive regulative action on both CID and GI disorder and is receiving increasing attention. Recent studies indicate that both CID and GI diseases may cause abnormal brain activity. However, the neurological mechanism underlying the effect of acupuncture on such diseases is still unclear. The aim of this study is to explore the pathological mechanisms of CID with GI discomfort, as well as the main response characteristics of acupuncture treatment from multiple perspectives using multimodal magnetic resonance imaging (MRI). Methods A total of 60 participants with CID and GI disorders will be randomly divided into two groups (real acupuncture group and sham acupuncture group; ratio of 1:1). Patients will receive 20 sessions (five sessions per week) of real acupuncture treatment or sham acupuncture treatment. The primary outcome is the aggregate score on the Pittsburgh Sleep Quality Index. Secondary outcomes are scores on the Gastrointestinal Symptom Rating Scale, Self-Rating Anxiety Scale, and Self-Rating Depression Scale. Multimodal MRI scans and clinical assessments will be performed both at baseline and post-treatment. Another 30 age-, sex-, and education-matched healthy subjects will be recruited as controls and will receive MRI scans and clinical evaluations. Discussion This study aims to provide scientific evidence for the mechanism of acupuncture in treating CID with GI disorder using multimodal MRI imaging data on brain structure, function, and metabolism. Trial registration Chinese Clinical Trial Registry, ChiCTR1800017092 (URL: http://www.chictr.org.cn/showproj.aspx?proj=27173). Registered on July 11, 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05332-3.
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