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Musicò A. "Masked dissociation": the many faces of technology. Am J Psychoanal 2024; 84:111-118. [PMID: 38424251 DOI: 10.1057/s11231-024-09439-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
After briefly explaining the concepts of dissociation and repression and discussing the new interest that the concept of dissociation has acquired within the actual psychoanalytic panorama, the author explains the concept of a dissociative continuum and presents Peter Goldberg's theory on somatic dissociation. Starting from this model, she proposes an interpretation of the use of technology, and especially of the internet, as a dissociative modality that helps separate the mind from the body, one that allows the maintenance of personal security-a concept dear to Sullivan-through physical distance. The implications of this point of view are discussed.
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Affiliation(s)
- Alessia Musicò
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
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Alegret M, García-Gutiérrez F, Muñoz N, Espinosa A, Ortega G, Lleonart N, Rodríguez I, Rosende-Roca M, Pytel V, Cantero-Fortiz Y, Rentz DM, Marquié M, Valero S, Ruiz A, Butler C, Boada M. FACEmemory®, an Innovative Online Platform for Episodic Memory Pre-Screening: Findings from the First 3,000 Participants. J Alzheimers Dis 2024; 97:1173-1187. [PMID: 38217602 DOI: 10.3233/jad-230983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
BACKGROUND The FACEmemory® online platform comprises a complex memory test and sociodemographic, medical, and family questions. This is the first study of a completely self-administered memory test with voice recognition, pre-tested in a memory clinic, sensitive to Alzheimer's disease, using information and communication technologies, and offered freely worldwide. OBJECTIVE To investigate the demographic and clinical variables associated with the total FACEmemory score, and to identify distinct patterns of memory performance on FACEmemory. METHODS Data from the first 3,000 subjects who completed the FACEmemory test were analyzed. Descriptive analyses were applied to demographic, FACEmemory, and medical and family variables; t-test and chi-square analyses were used to compare participants with preserved versus impaired performance on FACEmemory (cut-off = 32); multiple linear regression was used to identify variables that modulate FACEmemory performance; and machine learning techniques were applied to identify different memory patterns. RESULTS Participants had a mean age of 50.57 years and 13.65 years of schooling; 64.07% were women, and 82.10% reported memory complaints with worries. The group with impaired FACEmemory performance (20.40%) was older, had less schooling, and had a higher prevalence of hypertension, diabetes, dyslipidemia, and family history of neurodegenerative disease than the group with preserved performance. Age, schooling, sex, country, and completion of the medical and family history questionnaire were associated with the FACEmemory score. Finally, machine learning techniques identified four patterns of FACEmemory performance: normal, dysexecutive, storage, and completely impaired. CONCLUSIONS FACEmemory is a promising tool for assessing memory in people with subjective memory complaints and for raising awareness about cognitive decline in the community.
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Affiliation(s)
- Montserrat Alegret
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Nathalia Muñoz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ana Espinosa
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Ortega
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Núria Lleonart
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Isabel Rodríguez
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Maitee Rosende-Roca
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Vanesa Pytel
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Yahveth Cantero-Fortiz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Dorene M Rentz
- Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergi Valero
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Agustín Ruiz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Christopher Butler
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Brain Sciences, Imperial College London, London, UK
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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Mateo-Orcajada A, Vaquero-Cristóbal R, Abenza-Cano L. Mobile application interventions to increase physical activity and their effect on kinanthropometrics, body composition and fitness variables in adolescent aged 12-16 years old: An umbrella review. Child Care Health Dev 2024; 50:e13146. [PMID: 37387258 DOI: 10.1111/cch.13146] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 05/03/2023] [Accepted: 06/02/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND The aims of the present umbrella review were (a) to summarize the available evidence on the effectiveness of mobile applications aimed at increasing physical activity; (b) to analyse the effect of an increase in physical activity on kinanthropometric variables, body composition and physical fitness of adolescents aged 12-16 years old; and (c) to determine the strengths and limitations of the interventions carried out with adolescents aged 12-16 years old through the use of mobile applications, to provide recommendations for future research. METHODS The most relevant inclusion criteria were (a) adolescents aged 12-16 years old; (b) interventions carried out only with mobile apps; (c) pre-post measurements; (d) participants without illnesses or injuries; and (e) interventions lasting more than 8 weeks. The databases used to identify the systematic reviews were the Web of Science, Google Scholar, PubMed and Scopus. Two reviewers independently used the AMSTAR-2 scale to measure the methodological quality of the included reviews and also carried out an analysis of external validity, with a third reviewer participating in the cases in which consensus was not reached. RESULTS A total of 12 systematic reviews were included (these included a total of 273 articles that used electronic devices, of which 22 studies exclusively used mobile applications with adolescents aged 12-16). Regarding physical activity and its effect on body composition, kinanthropometric variables and physical fitness, no significant differences were found for any of the variables analysed, and the results were not sufficiently consistent to determine the influence of these interventions. CONCLUSIONS It is important to highlight that the scientific research conducted so far showed that mobile applications were not effective in increasing physical activity and changing the kinanthropometric variables, body composition or physical fitness of adolescents. Thus, future research with stronger methodological rigour and larger samples is needed to provide stronger evidence.
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Pérez-Maletzki J, Dominguez-Navarro F, Hernández-Guillen D, Roig-Casasús S, Blasco JM. Effectiveness of strategies to improve adherence to physical therapy in patients with knee and hip osteoarthritis: a systematic review and meta-analysis. Disabil Rehabil 2023:1-16. [PMID: 38059584 DOI: 10.1080/09638288.2023.2288678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/23/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE To determine the effectiveness of current strategies oriented to increase adherence to physical therapy in subjects with knee and hip osteoarthritis (OA). MATERIAL AND METHODS A systematic review of electronic databases was conducted from inception until March 2023. Studies with experimental interventions using strategies to increase adherence to physical therapy programs in subjects with knee or hip OA were included. A meta-analysis compared the effects of such interventions with usual care for adherence-related measures (primary outcome), and functional and pain outcomes, using standardized mean differences (SMD) with a 95% confidence interval (CI). GRADE was used to determine the strength of the resultant evidence and the external validity of the findings. RESULTS Fifteen articles, assessing 1,818 participants, were included. The interventions included cognitive-behavior strategies, telephone calls, internet-based interventions, communication technologies, and booster sessions. A meta-analysis revealed that the experimental interventions increased adherence over usual care with a moderate effect size of SMD = 0.39 (95%CI = 0.08-0.71) and moderate certainty in this evidence. CONCLUSION Overall, this review supports that the strategies to promote adherence to physical therapy in individuals with knee and hip OA are effective. However, the positive impact on adherence rates does not always translate into improved clinical outcomes.
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Affiliation(s)
- José Pérez-Maletzki
- Group in Physiotherapy of the Aging Processes: Social and Healthcare Strategies, Department of Physiotherapy, Universitat de València, València, Spain
- Faculty of Health Sciences, Universidad Europea de Valencia, València, Spain
| | - Fernando Dominguez-Navarro
- Group in Physiotherapy of the Aging Processes: Social and Healthcare Strategies, Department of Physiotherapy, Universitat de València, València, Spain
- Faculty of Health Sciences, Universidad Europea de Valencia, València, Spain
| | - David Hernández-Guillen
- Group in Physiotherapy of the Aging Processes: Social and Healthcare Strategies, Department of Physiotherapy, Universitat de València, València, Spain
- Departament de Fisioterapia. Facultad de Fisioterapia, Universitat de València, València, Spain
| | - Sergio Roig-Casasús
- Group in Physiotherapy of the Aging Processes: Social and Healthcare Strategies, Department of Physiotherapy, Universitat de València, València, Spain
- Hospital Universitari i Politècnic La Fe de València, València, Spain
| | - José-María Blasco
- Group in Physiotherapy of the Aging Processes: Social and Healthcare Strategies, Department of Physiotherapy, Universitat de València, València, Spain
- Departament de Fisioterapia. Facultad de Fisioterapia, Universitat de València, València, Spain
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Teruel-Hernández E, López-Pina JA, Souto-Camba S, Báez-Suárez A, Medina-Ramírez R, Gómez-Conesa A. Improving Sleep Quality, Daytime Sleepiness, and Cognitive Function in Patients with Dementia by Therapeutic Exercise and NESA Neuromodulation: A Multicenter Clinical Trial. Int J Environ Res Public Health 2023; 20:7027. [PMID: 37947583 PMCID: PMC10650908 DOI: 10.3390/ijerph20217027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/28/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
Dementia is a progressive decline in cognitive functions caused by an alteration in the pattern of neural network connections. There is an inability to create new neuronal connections, producing behavioral disorders. The most evident alteration in patients with neurodegenerative diseases is the alteration of sleep-wake behavior. The aim of this study was to test the effect of two non-pharmacological interventions, therapeutic exercise (TE) and non-invasive neuromodulation through the NESA device (NN) on sleep quality, daytime sleepiness, and cognitive function of 30 patients diagnosed with dementia (non-invasive neuromodulation experimental group (NNG): mean ± SD, age: 71.6 ± 7.43 years; therapeutic exercise experimental group (TEG) 75.2 ± 8.63 years; control group (CG) 80.9 ± 4.53 years). The variables were evaluated by means of the Pittsburg Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Mini-Cognitive Exam Test at four different times during the study: at baseline, after 2 months (after completion of the NNG), after 5 months (after completion of the TEG), and after 7 months (after 2 months of follow-up). Participants in the NNG and TEG presented significant improvements with respect to the CG, and in addition, the NNG generated greater relevant changes in the three variables with respect to the TEG (sleep quality (p = 0.972), daytime sleepiness (p = 0.026), and cognitive function (p = 0.127)). In conclusion, with greater effects in the NNG, both treatments were effective to improve daytime sleepiness, sleep quality, and cognitive function in the dementia population.
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Affiliation(s)
| | | | - Sonia Souto-Camba
- Department of Physiotherapy, Medicine and Biomedical Sciences, University of A Coruña, 15006 A Coruña, Spain;
| | - Aníbal Báez-Suárez
- Health Science Faculty, University of Las Palmas de Gran Canaria, 35016 Las Palmas, Spain;
| | - Raquel Medina-Ramírez
- SocDig Research Group, University of Las Palmas de Gran Canaria, 35016 Las Palmas, Spain;
| | - Antonia Gómez-Conesa
- Research Methods and Evaluation in the Social Sciences Research Group, Mare Nostrum Campus of International Excellence, University of Murcia, 30100 Murcia, Spain;
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Hod M, Divakar H, Kihara AB, Geary M. The femtech revolution-A new approach to pregnancy management: Digital transformation of maternity care-The hybrid e-health perinatal clinic addressing the unmet needs of low- and middle-income countries. Int J Gynaecol Obstet 2023; 163:4-10. [PMID: 37554042 DOI: 10.1002/ijgo.15032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
Prenatal care and infant mortality rates are crucial indicators of healthcare quality. However, millions of women in low-income countries lack access to adequate care. Factors such as high-risk pregnancies and unmanaged diet increase the risk of developing complications during pregnancy, highlighting the need for continuous monitoring of maternal health. The increasing burden of non-communicable diseases represents a significant threat to fragile health systems. The lack of access to appropriate prenatal care and poor maternal and newborn health outcomes are major concerns in low- and middle-income countries (LMICs). It emphasizes the need for innovative, integrative approaches to healthcare delivery, especially in pregnant women. The health services need to be reorganized holistically and effectively, focusing on factors that directly impact maternal, neonatal, and infant mortality, resulting in improved access to maternity services and survival of "at-risk" mothers and their offspring in many LMICs. Based on the FIGO (the International Federation of Gynecology & Obstetrics) recommendations of extending preconception care to the postpartum stage, the authors of this review have developed a new model of care-PregCare-based on the triple-intervention-based holistic and multidisciplinary maternal and fetal medicine model for low-risk pregnancies. This model will help transform the traditional model's high visitation frequency into a safe and reduced office visit, while increasing virtual connections, point of care and self-care with doctors, nurses, and community-based providers of self-care. This shall be based on a sophisticated central PregCare call center powered by innovative technologies combined with experienced personnel in perinatal management (doctors and nurses/midwives).
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Affiliation(s)
- Moshe Hod
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Mor Comprehensive Women's Health Care Center, Tel-Aviv, Israel
| | - Hema Divakar
- Divakars Speciality Hospital, Bengaluru, Karnataka, India
- Karnataka College of Obstetrics and Gynaecology, Bengaluru, Karnataka, India
- Asian Research and Training Institute for Skill Transfer (ARTIST), Bengaluru, Karnataka, India
- International Federation of Gynecology and Obstetrics (FIGO), London, UK
- Federation of Obstetricians and Gynaecologists Societies of India (FOGSI), Mumbai, India
| | - Anne B Kihara
- Federation of Obstetricians and Gynaecologists Societies of India (FOGSI), Mumbai, India
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
- African Federation of Obstetricians and Gynaecologists (AFOG), Khartoum, Sudan
- Kenyan Obstetrical and Gynaecological Society (KOGS), Nairobi, Kenya
| | - Michael Geary
- Department of Obstetrics and Gynaecology, The Rotunda Hospital, Dublin, Ireland
- Royal College of Surgeons Ireland, Dublin, Ireland
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Miegel F, Jelinek L, Moritz S, Lohse L, Yassari AH, Bücker L. Mixed results for exposure and response prevention therapy in mixed reality for patients with contamination-related obsessive-compulsive disorder: A randomized controlled pilot study. J Clin Psychol 2023; 79:2317-2336. [PMID: 37317567 DOI: 10.1002/jclp.23550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/22/2023] [Accepted: 05/28/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Technology-supported exposure and response prevention (ERP) for patients with obsessive-compulsive disorder (OCD) as tested in clinical research, holds promise but also has limitations. The present study aims to overcome these limitations by using mixed reality for ERP (MERP). The objectives of this pilot study were to evaluate the safety, feasibility, and acceptance of MERP and to identify possible obstacles. METHODS Twenty inpatients with contamination-related OCD were recruited and randomized to two conditions: MERP (six sessions in 3 weeks) and care as usual treatment. Patients were assessed before treatment (baseline), after the 3-week intervention period (post), as well as 3 months after post assessment (follow-up) regarding symptomatology (Y-BOCS). RESULTS Results showed a similar reduction in symptomatology in both groups from baseline to post. Regarding safety, no clinically significant deterioration was detected in the MERP group. Patients' evaluation of the MERP was heterogeneous. The qualitative feedback provided helpful indications for further development of the software. Sense of presence was below the midpoint of the scales. CONCLUSION This is the first study evaluating a MERP for patients with OCD that shows cautious evidence for the acceptance and safety of MERP. The results of the subjective evaluation suggest revisions of the software.
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Affiliation(s)
- Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany
| | - Luzie Lohse
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany
| | - Amir H Yassari
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany
| | - Lara Bücker
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany
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Brochhagen J, Coll Barroso MT, Baumgart C, Wasmus DT, Freiwald J, Hoppe MW. Age, sex, endurance capacity, and chronic heart failure affect central and peripheral factors of oxygen uptake measured by non-invasive and continuous technologies: support of pioneer work using invasive or non-continuous measures. Front Sports Act Living 2023; 5:1218948. [PMID: 37731479 PMCID: PMC10507902 DOI: 10.3389/fspor.2023.1218948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction It is known that maximum oxygen uptake depends on age, sex, endurance capacity, and chronic heart failure. However, due to the required invasive or often applied non-continuous approaches, less is known on underlying central and peripheral factors. Thus, this study aimed to investigate the effects of age, sex, endurance capacity, and chronic heart failure on non-invasively and continuously measured central and peripheral factors of oxygen uptake. Methods 15 male children (11 ± 1 years), 15 male (24 ± 3 years) and 14 female recreationally active adults (23 ± 2 years), 12 male highly trained endurance athletes (24 ± 3 years), and 10 male elders (59 ± 6 years) and 10 chronic heart failure patients (62 ± 7 years) were tested during a cardiopulmonary exercise test on a cycling ergometer until exhaustion for: blood pressure, heart rate, stroke volume, cardiac output, cardiac power output, vastus lateralis muscle oxygen saturation, and (calculated) arterio-venous oxygen difference. For the non-invasive and continuous measurement of stroke volume and muscle oxygen saturation, bioreactance analysis and near-infrared spectroscopy were used, respectively. A two-factor repeated measure ANOVA and partial eta-squared effect sizes (η p 2 ) were applied for statistical analyses at rest, 80, and 100% of oxygen uptake. Results For the age effect, there were statistically significant group differences for all factors (p ≤ .033; η p 2 ≥ .169 ). Concerning sex, there were group differences for all factors (p ≤ .010; η p 2 ≥ .223 ), except diastolic blood pressure and heart rate (p ≥ .698; η p 2 ≤ .006 ). For the effect of endurance capacity, there were no group differences for any of the factors (p ≥ .065; η p 2 ≤ .129 ). Regarding chronic heart failure, there were group differences for the heart rate and arterio-venous oxygen difference (p ≤ .037; η p 2 ≥ .220 ). Discussion Age, sex, endurance capacity, and chronic heart failure affect central and peripheral factors of oxygen uptake measured by non-invasive and continuous technologies. Since most of our findings support pioneer work using invasive or non-continuous measures, the validity of our applied technologies is indirectly confirmed. Our outcomes allow direct comparison between different groups serving as reference data and framework for subsequent studies in sport science and medicine aiming to optimise diagnostics and interventions in athletes and patients.
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Affiliation(s)
- Joana Brochhagen
- Movement and Training Science, Faculty of Sport Science, Leipzig University, Leipzig, Germany
| | | | - Christian Baumgart
- Department of Movement and Training Science, Faculty of Humanities and Social Sciences, Institute of Sport Science, University of Wuppertal, Wuppertal, Germany
| | - Daniel T. Wasmus
- Movement and Training Science, Faculty of Sport Science, Leipzig University, Leipzig, Germany
| | - Jürgen Freiwald
- Department of Movement and Training Science, Faculty of Humanities and Social Sciences, Institute of Sport Science, University of Wuppertal, Wuppertal, Germany
| | - Matthias W. Hoppe
- Movement and Training Science, Faculty of Sport Science, Leipzig University, Leipzig, Germany
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Rocha R, Fernandes SM, Santos IM. The Importance of Technology in the Combined Interventions of Cognitive Stimulation and Physical Activity in Cognitive Function in the Elderly: A Systematic Review. Healthcare (Basel) 2023; 11:2375. [PMID: 37685409 PMCID: PMC10486873 DOI: 10.3390/healthcare11172375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/15/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Numerous studies have been developed in an attempt to understand which factors best predict improvements in cognitive function in the elderly such as exergaming. The aim of this study was to investigate and systematize literature on intervention programs that simultaneously include cognitive stimulation and physical activity, understand the importance of the use of new technology, including exergaming or computer programs, and understand their impact on cognitive function in older adults, giving indications about their contribution to healthy aging. METHODS A narrative approach was used for extraction and synthesis of the data. Relevant studies were identified from electronic databases such as PubMed, Scopus, Web of Science, and Academic Search Complete. RESULTS Thirty-two articles, involving 2815 participants, were identified. All selected studies were randomized controlled studies. The studies were published between 2011 and 2020. All studies included a combination of cognitive and physical interventions. Many of the studies used technology to administer the cognitive stimulation program. CONCLUSIONS Most of the analyzed studies used exergaming in physical and cognitive interventions, demonstrating that this new form of intervention exerts lasting and stable benefits in cognition. However, we concluded that more studies are needed to compare interventions that use exergaming or computer programs with traditional interventions.
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Affiliation(s)
- Rute Rocha
- Centro Social e Paroquial de S. Mamede do Coronado, Aveiro University, 3810-193 Aveiro, Portugal
| | | | - Isabel M. Santos
- William James Center for Research, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal;
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Rodler S, Kidess MA, Westhofen T, Kowalewski KF, Belenchon IR, Taratkin M, Puliatti S, Gómez Rivas J, Veccia A, Piazza P, Checcucci E, Stief CG, Cacciamani GE. A Systematic Review of New Imaging Technologies for Robotic Prostatectomy: From Molecular Imaging to Augmented Reality. J Clin Med 2023; 12:5425. [PMID: 37629467 PMCID: PMC10455161 DOI: 10.3390/jcm12165425] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/01/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
New imaging technologies play a pivotal role in the current management of patients with prostate cancer. Robotic assisted radical prostatectomy (RARP) is a standard of care for localized disease and through the already imaging-based console subject of research towards combinations of imaging technologies and RARP as well as their impact on surgical outcomes. Therefore, we aimed to provide a comprehensive analysis of the currently available literature for new imaging technologies for RARP. On 24 January 2023, we performed a systematic review of the current literature on Pubmed, Scopus and Web of Science according to the PRISMA guidelines and Oxford levels of evidence. A total of 46 studies were identified of which 19 studies focus on imaging of the primary tumor, 12 studies on the intraoperative tumor detection of lymph nodes and 15 studies on the training of surgeons. While the feasibility of combined approaches using new imaging technologies including MRI, PSMA-PET CT or intraoperatively applied radioactive and fluorescent dyes has been demonstrated, the prospective confirmation of improvements in surgical outcomes is currently ongoing.
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Affiliation(s)
- Severin Rodler
- Department of Urology, University Hospital of Munich, 81377 Munich, Germany (T.W.); (C.G.S.)
| | - Marc Anwar Kidess
- Department of Urology, University Hospital of Munich, 81377 Munich, Germany (T.W.); (C.G.S.)
| | - Thilo Westhofen
- Department of Urology, University Hospital of Munich, 81377 Munich, Germany (T.W.); (C.G.S.)
| | | | - Ines Rivero Belenchon
- Urology and Nephrology Department, Virgen del Rocío University Hospital, Manuel Siurot s/n, 41013 Seville, Spain;
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, 117418 Moscow, Russia;
| | - Stefano Puliatti
- Department of Urology, University of Modena and Reggio Emilia, 42122 Modena, Italy;
| | - Juan Gómez Rivas
- Department of Urology, Hospital Clinico San Carlos, 28040 Madrid, Spain;
| | - Alessandro Veccia
- Urology Unit, Azienda Ospedaliera Universitaria Integrata Verona, 37126 Verona, Italy;
| | - Pietro Piazza
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Enrico Checcucci
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy;
| | - Christian Georg Stief
- Department of Urology, University Hospital of Munich, 81377 Munich, Germany (T.W.); (C.G.S.)
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Zorzetti N, Lauro A, Cuoghi M, La Gatta M, Marino IR, Sorrenti S, D’Andrea V, Mingoli A, Navarra GG. A Hypothetical New Challenging Use for Indocyanine Green Fluorescence during Laparoscopic Appendectomy: A Mini-Series of Our Experience and Literary Review. J Clin Med 2023; 12:5173. [PMID: 37629215 PMCID: PMC10455468 DOI: 10.3390/jcm12165173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Laparoscopic appendectomy (LA) is a well-standardized surgical procedure, but there are still controversies about the different devices to be used for the appendiceal stump closure and the related postoperative complications. Indocyanine green (ICG) fluorescence angiography (FA) has already been shown to be helpful in elective and emergency surgery, providing intraoperative information on tissue and organ perfusion, thus guiding the surgical decisions and the technical strategies. According to these two aspects, we report a mini-series of the first five patients affected by gangrenous and flegmonous acute appendicitis intraoperatively evaluated with ICG-FA during LA. The patients were admitted to the Emergency Department with an usual range of symptoms for acute appendicitis. The patients were successfully managed by fully LA with the help of a new hypothetical challenging use of ICG-FA.
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Affiliation(s)
- Noemi Zorzetti
- Department of General Surgery, “A. Costa” Hospital—Alto Reno Terme, 40046 Bologna, Italy (M.L.G.); (G.G.N.)
- Department of Surgical Sciences, La Sapienza University, 00186 Rome, Italy; (A.L.); (S.S.); (V.D.); (A.M.)
| | - Augusto Lauro
- Department of Surgical Sciences, La Sapienza University, 00186 Rome, Italy; (A.L.); (S.S.); (V.D.); (A.M.)
| | - Manuela Cuoghi
- Department of General Surgery, “A. Costa” Hospital—Alto Reno Terme, 40046 Bologna, Italy (M.L.G.); (G.G.N.)
| | - Marco La Gatta
- Department of General Surgery, “A. Costa” Hospital—Alto Reno Terme, 40046 Bologna, Italy (M.L.G.); (G.G.N.)
| | - Ignazio R. Marino
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA;
| | - Salvatore Sorrenti
- Department of Surgical Sciences, La Sapienza University, 00186 Rome, Italy; (A.L.); (S.S.); (V.D.); (A.M.)
| | - Vito D’Andrea
- Department of Surgical Sciences, La Sapienza University, 00186 Rome, Italy; (A.L.); (S.S.); (V.D.); (A.M.)
| | - Andrea Mingoli
- Department of Surgical Sciences, La Sapienza University, 00186 Rome, Italy; (A.L.); (S.S.); (V.D.); (A.M.)
| | - Giuseppe Giovanni Navarra
- Department of General Surgery, “A. Costa” Hospital—Alto Reno Terme, 40046 Bologna, Italy (M.L.G.); (G.G.N.)
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12
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Pizzoli SFM, Monzani D, Conti L, Ferraris G, Grasso R, Pravettoni G. Issues and opportunities of digital phenotyping: ecological momentary assessment and behavioral sensing in protecting the young from suicide. Front Psychol 2023; 14:1103703. [PMID: 37441331 PMCID: PMC10333535 DOI: 10.3389/fpsyg.2023.1103703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Digital phenotyping refers to the collection of real-time biometric and personal data on digital tools, mainly smartphones, and wearables, to measure behaviors and variables that can be used as a proxy for complex psychophysiological conditions. Digital phenotyping might be used for diagnosis, clinical assessment, predicting changes and trajectories in psychological clinical conditions, and delivering tailored interventions according to individual real-time data. Recent works pointed out the possibility of using such an approach in the field of suicide risk in high-suicide-risk patients. Among the possible targets of such interventions, adolescence might be a population of interest, since they display higher odds of committing suicide and impulsive behaviors. The present work systematizes the available evidence of the data that might be used for digital phenotyping in the field of adolescent suicide and provides insight into possible personalized approaches for monitoring and treating suicidal risk or predicting risk trajectories. Specifically, the authors first define the field of digital phenotyping and its features, secondly, they organize the available literature to gather all the digital indexes (active and passive data) that can provide reliable information on the increase in the suicidal odds, lastly, they discuss the challenges and future directions of such an approach, together with its ethical implications.
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Affiliation(s)
- Silvia Francesca Maria Pizzoli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Heart,, Milan, Italy
| | - Dario Monzani
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Lorenzo Conti
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Giulia Ferraris
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Grasso
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
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13
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Mateo-Orcajada A, Vaquero-Cristóbal R, Albaladejo-Saura MD, Abenza-Cano L. The Degree of Problematic Technology Use Negatively Affects Physical Activity Level, Adherence to Mediterranean Diet and Psychological State of Adolescents. Healthcare (Basel) 2023; 11:1706. [PMID: 37372824 DOI: 10.3390/healthcare11121706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/04/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
The previous scientific literature has shown how detrimental addictive internet and mobile phone use can be for the adolescent population. However, little is known about their influence on the physical activity, kinanthropometry and body composition, nutrition patterns, psychological state, and physical fitness of this population. For this reason, the objectives of this research were (a) to determine the differences in the physical activity level, kinanthropometric and body composition variables, adherence to Mediterranean diet (AMD), psychological state, and physical fitness according to gender and different levels of problematic use of the internet and mobile phones; and (b) to establish the differences in the physical activity level, kinanthropometric and body composition variables, AMD, psychological state, and physical fitness among adolescents when considering problematic use of the internet and mobile phones in combination. The sample consisted of 791 adolescent males and females between 12 and 16 years of age (1st to 4th course) from four compulsory secondary schools (404 males and 387 females; mean age: 14.39 ± 1.26 years-old; mean height: 163.47 ± 8.94 cm; mean body mass: 57.32 ± 13.35 kg; mean BMI: 21.36 ± 3.96 kg/m2). The physical activity level (baseline score: 2.64 ± 0.67), kinanthropometric variables and body composition, AMD (baseline score: 6.48 ± 2.48), psychological state (baseline life satisfaction: 17.73 ± 4.83; competence: 26.48 ± 7.54; autonomy: 25.37 ± 6.73; relatedness: 24.45 ± 6.54), and physical condition variables were measured. The results showed that adolescent males and females with problematic internet and/or mobile phone use presented a worse psychological state, but it is especially relevant to highlight that females also had a lower level of physical activity and AMD, with problematic mobile phone use being especially relevant, mainly in the psychological state of adolescents. In conclusion, problematic use of the internet and mobile phones can have detrimental effects on the level of physical activity, AMD, and psychological state of adolescents, with the differences found in females being particularly relevant.
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Affiliation(s)
| | | | | | - Lucía Abenza-Cano
- Facultad de Deporte, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain
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14
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Segarra S, Sanmiguel D, Zuriaga E, Leclerc S, Cabañas J, Seigneuric E, Miquel A, Vázquez A, Ferrer L. Sphingomyelin-Rich Lipid Extract Collar for Canine Atopic Dermatitis. Vet Sci 2023; 10:389. [PMID: 37368775 DOI: 10.3390/vetsci10060389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
The management of canine atopic dermatitis (CAD) is complex, and it needs to be multimodal, combining topical and systemic therapies. Given that the currently available options are not always totally effective and might have some associated adverse effects, novel alternatives are needed. For this reason, a new collar for CAD was developed with 2.5% of a sphingomyelin-rich lipid extract (LE) with proven benefits for skin health. The release of the active ingredient when incorporated into the collar was tested in vitro, showing an adequate kinetic profile. Then, the efficacy and safety of the collar were assessed in 12 client-owned dogs with CAD in a pilot study. After eight weeks, the dogs experienced significant clinical improvements on the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-4, Pruritus Index for Canine Atopic Dermatitis (PCAD) and Pruritus Visual Analogue Scale (PVAS) scores, without any adverse effects. Additionally, further in vitro studies were performed, indicating that this LE collar should be compatible with antiparasitic collars (with deltamethrin or imidacloprid/flumethrin) if worn simultaneously. Given the observed benefits of this LE collar, combining it with other CAD therapies could potentially allow for drug sparing, reduction in adverse effects, enhanced owner compliance, and reduced treatment costs.
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Affiliation(s)
- Sergi Segarra
- R&D Bioiberica S.A.U., Avinguda dels Països Catalans, 34, 08950 Esplugues de Llobregat, Spain
| | - David Sanmiguel
- Clínica Veterinaria Wecan De Carreres, Avinguda Mutxamel, 1, Local 2, 03550 Sant Joan d'Alacant, Spain
| | - Eliseo Zuriaga
- Hospital Veterinario Global, Carrer Laminacio, 18, 46520 Port de Sagunt, Spain
| | | | - Jesús Cabañas
- R&D Bioiberica S.A.U., Avinguda dels Països Catalans, 34, 08950 Esplugues de Llobregat, Spain
| | | | | | - Ana Vázquez
- Servei d'Estadística Aplicada, Facultat de Ciències, Universitat Autònoma de Barcelona, C5b/111, Edifici C, 08193 Cerdanyola del Vallès, Spain
| | - Lluís Ferrer
- Departament de Medicina i Cirurgia Animals, S/N, Campus Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
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15
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Stasolla F, Di Gioia M. Combining reinforcement learning and virtual reality in mild neurocognitive impairment: a new usability assessment on patients and caregivers. Front Aging Neurosci 2023; 15:1189498. [PMID: 37293666 PMCID: PMC10244593 DOI: 10.3389/fnagi.2023.1189498] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 04/26/2023] [Indexed: 06/10/2023] Open
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16
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Niculescu M, Honțaru OS, Popescu G, Sterian AG, Dobra M. Challenges of Integrating New Technologies for Orthopedic Doctors to Face up to Difficulties during the Pandemic Era. Healthcare (Basel) 2023; 11:1524. [PMID: 37297666 PMCID: PMC10288938 DOI: 10.3390/healthcare11111524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023] Open
Abstract
In the field of orthopedics, competitive progress is growing faster because new technologies used to facilitate the work of physicians are continuously developing. Based on the issues generated in the pandemic era in this field, a research study was developed to identify the intention of orthopedic doctors to integrate new medical technologies. The survey was based on a questionnaire that was used for data collection. The quantitative study registered a sample of 145 orthopedic doctors. The data analysis was performed based on the IBM SPSS program. A multiple linear regression model was applied, which analyzed how the independent variables can influence the dependent variables. After analyzing the data, it was observed that the intention of orthopedic doctors to use new medical technologies is influenced by the advantages and disadvantages perceived by them, the perceived risks, the quality of the medical technologies, the experience of physicians in their use, and their receptivity to other digital tools. The obtained results are highly important both for hospital managers and authorities, illustrating the main factors that influence doctors to use emergent technologies in their clinical work.
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Affiliation(s)
- Marius Niculescu
- Faculty of Medicine, “Titu Maiorescu” University of Bucharest, 031593 Bucharest, Romania;
- Colentina Hospital, Șoseaua Ștefan cel Mare 19-21, 020125 Bucharest, Romania
| | - Octavia-Sorina Honțaru
- Faculty of Sciences, Physical Education and Informatics, University of Pitesti, Târgul din Vale 1, 110040 Arges, Romania
- Department of Public Health Arges, Exercitiu 39 bis, 110438 Arges, Romania
| | - George Popescu
- Emergency Clinical Hospital Dr. Bagdasar-Arseni, Șoseaua Berceni 12, 041915 Bucharest, Romania
| | - Alin Gabriel Sterian
- Emergency Hospital for Children Grigore Alexandrescu, 30-32 Iancu de Hunedoara Boulevard, 011743 Bucharest, Romania;
- Department of Pediatric Surgery and Orthopedics, University of Medicine and Pharmacy “Carol Davila” Bucharest, 020021 Bucharest, Romania
| | - Mihai Dobra
- Center of Uronephrology and Renal Transplant Fundeni, University of Medicine and Pharmacy “Carol Davila” Bucharest, 020021 Bucharest, Romania;
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17
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Chamlal H, Belahsen R. Opinion on weight management in the age of new technologies. Pan Afr Med J 2023; 45:7. [PMID: 37346918 PMCID: PMC10280700 DOI: 10.11604/pamj.2023.45.7.35023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 04/08/2023] [Indexed: 06/23/2023] Open
Abstract
In a Moroccan context characterized by the resurgence of metabolic diseases and over nutrition, an emergence of digital media in the daily life of individuals, has led to the expansion of the use of digital diets for therapeutic or aesthetic purposes. This work raises the question of the effectiveness of unguided nutritional approaches and the associated consequences, with potential effects on the health of individuals.
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Affiliation(s)
- Hamid Chamlal
- Laboratory of Biotechnology, Biochemistry and Nutrition, School of Sciences, Chouaib Doukkali University, El Jadida, Morocco
| | - Rekia Belahsen
- Laboratory of Biotechnology, Biochemistry and Nutrition, School of Sciences, Chouaib Doukkali University, El Jadida, Morocco
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18
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Smith T, Ferri FA, Frieder J, Montorfano L, Medina M. Detection of Sentinel Lymph Nodes Using Indocyanine Green After Failing Scintigraphy in Merkel Cell Carcinoma. Cureus 2023; 15:e38453. [PMID: 37273297 PMCID: PMC10234671 DOI: 10.7759/cureus.38453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/06/2023] Open
Abstract
Merkel cell carcinoma (MCC) is a rare but highly aggressive skin cancer that carries a high rate of lymph node involvement and death. The National Comprehensive Cancer Network recommends sentinel lymph node (SLN) biopsy for the staging of the disease. Scintigraphy using radioactive isotopes (RI) such as technetium 99m (Tc99) remains the gold standard for the detection of SLNs, however, recently indocyanine green (ICG) fluorescence imaging has been used to aid in the detection of SLNs.We present the case of a patient who presented with MCC of the face and two SLNs successfully identified with ICG fluorescence despite the fact that they were not detected by intraoperative scintigraphy using Tc99. The use of ICG fluorescence imaging in MCC is safe and improves the ability to detect SLNs when combined with RI.
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Affiliation(s)
| | - Francisco A Ferri
- Plastic and Reconstructive Surgery, Cleveland Clinic Florida, Weston, USA
| | | | | | - Michael Medina
- Head and Neck Surgery, Cleveland Clinic Florida, Weston, USA
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19
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Betlej A. Social Networks, New Technologies, and Wellbeing-An Interview Study on Factors Influencing Older Adults' Successful Ageing. Int J Environ Res Public Health 2023; 20:5279. [PMID: 37047895 PMCID: PMC10094130 DOI: 10.3390/ijerph20075279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
Many factors are considered vital in supporting successful ageing and older adults' wellbeing. Whilst evidence exists around facilitating and hindering factors in the general use of various forms of institutional and family support and personal development-oriented education and/or new technologies, evidence is limited with regards to older people's motivations, expectations, and experiences surrounding ageing. Hence, in this study, the author used a qualitative explanatory method to interpret the factors influencing seniors' successful ageing. The author's focus was on how seniors experience ageing. The second issue was how they have been organizing life in old age. The third point concerned their expectations towards ageing now and in the future. Thirteen older adults (60+) were interviewed nationwide using a semi-structured scenario tool. Their objective was to give rich descriptions of their experiences of ageing. The interviews revealed the older adults' own experiences and enabled an understanding of their motivations, perceptions, moderators, and expectations around successful ageing. Based on the analysis of the qualitative data, the author developed three main themes, each with its own sub-themes: 1. Life satisfaction (transitioning to retirement, using coping strategies in adaptation to negative changes, reaching personal goals, leading a meaningful life); 2. Supportive environments (being independent but using temporary assistance from relatives and/or people close to oneself, living with family members (e.g., husband or wife, children, grandchildren), having access to health care system); 3. Social integration (social relations, social engagement, independence in using technological advancements). The main categories that emerged from the three themes were social networks, new technologies, and wellbeing. To analyze these issues, the author used a sociological approach. The theoretic explorations were embedded mainly in two methods: criticism of writing and the analytical and comparative one.
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Affiliation(s)
- Alina Betlej
- Centre of Sociological Research on the Economy and the Internet, The Department of Economic and Digital Sociology, The John Paul II Catholic University of Lublin, Al. Racławickie 14, 20-950 Lublin, Poland
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20
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Chen Y, Zhou E, Wang Y, Wu Y, Xu G, Chen L. The past, present, and future of sleep quality assessment and monitoring. Brain Res 2023; 1810:148333. [PMID: 36931581 DOI: 10.1016/j.brainres.2023.148333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023]
Abstract
Sleep quality is considered to be an individual's self-satisfaction with all aspects of the sleep experience. Good sleep not only improves a person's physical, mental and daily functional health, but also improves the quality-of-life level to some extent. In contrast, chronic sleep deprivation can increase the risk of diseases such as cardiovascular diseases, metabolic dysfunction and cognitive and emotional dysfunction, and can even lead to increased mortality. The scientific evaluation and monitoring of sleep quality is an important prerequisite for safeguarding and promoting the physiological health of the body. Therefore, we have compiled and reviewed the existing methods and emerging technologies commonly used for subjective and objective evaluation and monitoring of sleep quality, and found that subjective sleep evaluation is suitable for clinical screening and large-scale studies, while objective evaluation results are more intuitive and scientific, and in the comprehensive evaluation of sleep, if we want to get more scientific monitoring results, we should combine subjective and objective monitoring and dynamic monitoring.
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Affiliation(s)
- Yanyan Chen
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Enyuan Zhou
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Yu Wang
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Yuxiang Wu
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Guodong Xu
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China
| | - Lin Chen
- School of Physical Education, Jianghan University, Wuhan Hubei, 430056, China.
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21
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Troisi M, Marini E, Abbiento V, Stazzoni S, Andreano E, Rappuoli R. A new dawn for monoclonal antibodies against antimicrobial resistant bacteria. Front Microbiol 2022; 13:1080059. [PMID: 36590399 PMCID: PMC9795047 DOI: 10.3389/fmicb.2022.1080059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
Antimicrobial resistance (AMR) is a quickly advancing threat for human health worldwide and almost 5 million deaths are already attributable to this phenomenon every year. Since antibiotics are failing to treat AMR-bacteria, new tools are needed, and human monoclonal antibodies (mAbs) can fill this role. In almost 50 years since the introduction of the first technology that led to mAb discovery, enormous leaps forward have been made to identify and develop extremely potent human mAbs. While their usefulness has been extensively proved against viral pathogens, human mAbs have yet to find their space in treating and preventing infections from AMR-bacteria and fully conquer the field of infectious diseases. The novel and most innovative technologies herein reviewed can support this goal and add powerful tools in the arsenal of weapons against AMR.
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Affiliation(s)
- Marco Troisi
- Monoclonal Antibody Discovery (MAD) Laboratory, Fondazione Toscana Life Sciences, Siena, Italy
| | - Eleonora Marini
- Monoclonal Antibody Discovery (MAD) Laboratory, Fondazione Toscana Life Sciences, Siena, Italy
| | - Valentina Abbiento
- Monoclonal Antibody Discovery (MAD) Laboratory, Fondazione Toscana Life Sciences, Siena, Italy
| | - Samuele Stazzoni
- Monoclonal Antibody Discovery (MAD) Laboratory, Fondazione Toscana Life Sciences, Siena, Italy
| | - Emanuele Andreano
- Monoclonal Antibody Discovery (MAD) Laboratory, Fondazione Toscana Life Sciences, Siena, Italy,*Correspondence: Emanuele Andreano
| | - Rino Rappuoli
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy,Fondazione Biotecnopolo di Siena, Siena, Italy,Rino Rappuoli
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22
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Andreucci-Annunziata P, Mellado A, Vega-Muñoz A. Telesupervision in Psychotherapy: A Bibliometric and Systematic Review. Int J Environ Res Public Health 2022; 19:16366. [PMID: 36498438 PMCID: PMC9735903 DOI: 10.3390/ijerph192316366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/25/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: This systematic review supported by a bibliometric analysis identified quantitative and qualitative empirical studies that allowed us to respond to the objective of identifying and discussing the scope and limitations of the clinical-psychotherapeutic supervision in virtual modality or telesupervision. (2) Methods: The articles were selected according to the Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the eligibility criteria proposed by the PICOS strategy (population, interventions, comparators, outcomes, and study design) based on 396 records of scientifically identified articles in the Journal Citation Report databases of the Web of Science. (3) Results: The literature review stages allowed the selection of three articles, which were added three others that were already included in a previous review, to enrich the analysis and discussion. The results of the present review highlighted aspects of nonverbal communication, alliance, comfort, preference, trust, and construction of professional identity, among others, both considering only the telesupervision format and comparing it with traditional face-to-face supervision. (4) Conclusions: The contributions that these results are providing to the understanding of the scope and limitations of the practice of telesupervision are discussed, also considering its interference in the construction of the professional identity of supervisors and supervisees.
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Affiliation(s)
- Paola Andreucci-Annunziata
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
| | - Augusto Mellado
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
| | - Alejandro Vega-Muñoz
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
- Escuela de Doctorado, Universidad Rovira i Virgili, 43007 Tarragona, Spain
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23
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Abstract
Cross-sectional imaging-ultrasonography, computed tomography enterography, and magnetic resonance enterography-is a routine and indispensable tool for patients with Crohn's disease (CD) that helps to detect or monitor disease characteristics before, during, and after CD treatment. New emerging radiological technologies may have further clinical applications in the management of CD. In this review article, we focus on the latest developments in cross-sectional imaging in CD research, including its role in intra- and extra-luminal lesion detection, intestinal inflammation and fibrosis grading, therapeutic response assessment and outcome prediction, postoperative recurrence detection and prediction, and the gut-brain axis.
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Affiliation(s)
- Yang‐di Wang
- Department of RadiologyThe First Affiliated Hospital, Sun Yat‐Sen UniversityGuangzhouPeople's Republic of China
| | - Ruo‐nan Zhang
- Department of RadiologyThe First Affiliated Hospital, Sun Yat‐Sen UniversityGuangzhouPeople's Republic of China
| | - Ren Mao
- Department of GastroenterologyThe First Affiliated Hospital, Sun Yat‐Sen UniversityGuangzhouPeople's Republic of China
| | - Xue‐hua Li
- Department of RadiologyThe First Affiliated Hospital, Sun Yat‐Sen UniversityGuangzhouPeople's Republic of China
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24
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Tyubaeva PM, Varyan IA, Zykova AK, Yarysheva AY, Ivchenko PV, Olkhov AA, Arzhakova OV. Bioinspired Electropun Fibrous Materials Based on Poly-3-Hydroxybutyrate and Hemin: Preparation, Physicochemical Properties, and Weathering. Polymers (Basel) 2022; 14. [PMID: 36433006 DOI: 10.3390/polym14224878] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
The development of innovative fibrous materials with valuable multifunctional properties based on biodegradable polymers and modifying additives presents a challenging direction for modern materials science and environmental safety. In this work, high-performance composite fibrous materials based on semicrystalline biodegradable poly-3-hydroxybutyrate (PHB) and natural iron-containing porphyrin, hemin (Hmi) were prepared by electrospinning. The addition of Hmi to the feed PHB mixture (at concentrations above 3 wt.%) is shown to facilitate the electrospinning process and improve the quality of the electrospun PHB/Hmi materials: the fibers become uniform, their average diameter decreases down to 1.77 µm, and porosity increases to 94%. Structural morphology, phase composition, and physicochemical properties of the Hmi/PHB fibrous materials were studied by diverse physicochemical methods, including electronic paramagnetic resonance, optical microscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy, elemental analysis, differential scanning calorimetry, Fourier-transformed infrared spectroscopy, mechanical analysis, etc. The proposed nonwoven Hmi/PHB composites with high porosity, good mechanical properties, and retarded biodegradation due to high antibacterial potential can be used as high-performance and robust materials for biomedical applications, including breathable materials for wound disinfection and accelerated healing, scaffolds for regenerative medicine and tissue engineering.
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Penuelas J, Sardans J, Terradas J. Increasing divergence between human and biological elementomes. Trends Ecol Evol 2022; 37:935-938. [PMID: 36100488 DOI: 10.1016/j.tree.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/19/2022]
Abstract
The human elementome, the number and amounts of elements used biologically and nonbiologically by humans, has increasingly diverged from the biological elementome that characterizes the elements used by the nonhuman living organisms. This increasing divergence due to human cultural evolution has huge ecological, evolutionary, environmental, and geopolitical consequences.
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Affiliation(s)
- Josep Penuelas
- CSIC, Global Ecology Unit CREAF-CSIC-UAB, 08913 Cerdanyola del Vallès, Catalonia, Spain; CREAF, 08913 Cerdanyola del Vallès, Catalonia, Spain.
| | - Jordi Sardans
- CSIC, Global Ecology Unit CREAF-CSIC-UAB, 08913 Cerdanyola del Vallès, Catalonia, Spain; CREAF, 08913 Cerdanyola del Vallès, Catalonia, Spain
| | - Jaume Terradas
- CREAF, 08913 Cerdanyola del Vallès, Catalonia, Spain; BABVE, UAB, 08913 Cerdanyola del Vallès, Catalonia, Spain
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26
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Fabio RA, Caprì T, Colombo B, Mohammadhasani N. Editorial: New Technologies and Rehabilitation in Neurodevelopment. Front Psychol 2022; 13:849888. [PMID: 35558690 PMCID: PMC9087845 DOI: 10.3389/fpsyg.2022.849888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Rosa Angela Fabio
- Department of Economics, University of Messina, Via Verdi 75, Messina, Italy
| | - Tindara Caprì
- Department of Life and Health Sciences, Link University, Via del Casale di S. Pio V, 44, 00165, Rome, Italy.,Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Barbara Colombo
- Behavioral Neuroscience Lab, Champlain College, Burlington, VT, United States
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Vischer AS, Rosania J, Socrates T, Blaschke C, Eckstein J, Proust YM, Bonnier G, Proença M, Lemay M, Burkard T. Comparability of a Blood-Pressure-Monitoring Smartphone Application with Conventional Measurements-A Pilot Study. Diagnostics (Basel) 2022; 12:diagnostics12030749. [PMID: 35328302 PMCID: PMC8947665 DOI: 10.3390/diagnostics12030749] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 02/06/2023] Open
Abstract
(1) Background: New cuffless technologies attempting blood-pressure measurements (BPM) offer possibilities to improve hypertension awareness and control. The aim of this study was to compare a smartphone application (app)-based algorithm with office BPM (OBPM). (2) Methods: We included consecutive patients with an indication for ambulatory BPM. The smartphone app (RIVA digital) acquired the pulse wave in the fingers’ arterial bed using the phone’s camera and estimated BP based on photoplethysmographic (PPG) waveforms. Measurements were alternatingly taken with an oscillometric cuff-based device and smartphone BPM (AppBP) on two consecutive days. AppBP were calibrated to the first OBPM. Each AppBP was compared to its CuffBP (mean of the previous/following OBPM). (3) Results: 50 participants were included, resulting in 50 AppBP values on Day 1 and 33 on Day 2 after exclusion of 225 AppBP due to insufficient quality. The mean ± SD of the differences between AppBP and CuffBP was 0.7 ± 9.4/1.0 ± 4.5 mmHg (p-value 0.739/0.201) on Day 1 and 2.6 ± 8.2/1.3 ± 4.1 mmHg (p-value 0.106/0.091) on Day 2 for systolic/diastolic values, respectively. There were no significant differences between the deviations on Day 1 and Day 2 (p-value 0.297/0.533 for systolic/diastolic values). Overall, there were 10 (12%) systolic measurement pairs differing by >15 mmHg. (4) Conclusions: In this pilot evaluation, the RIVA Digital app shows promising results when compared to oscillometric cuff-based measurements, especially regarding diastolic values. Its differences between AppBP−CuffBP have a good stability one day after calibration. Before clinical use, signal acquisition needs improvement and the algorithm needs to undergo formal validation against a gold-standard BPM method.
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Affiliation(s)
- Annina S. Vischer
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (J.R.); (T.S.); (C.B.); (T.B.)
- Correspondence:
| | - Jana Rosania
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (J.R.); (T.S.); (C.B.); (T.B.)
| | - Thenral Socrates
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (J.R.); (T.S.); (C.B.); (T.B.)
| | - Christina Blaschke
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (J.R.); (T.S.); (C.B.); (T.B.)
| | - Jens Eckstein
- Department of Internal Medicine, University Hospital Basel, 4031 Basel, Switzerland;
| | - Yara-Maria Proust
- Centre Suisse d’Electronique et de Microtechnique (CSEM), 2002 Neuchatel, Switzerland; (Y.-M.P.); (G.B.); (M.P.); (M.L.)
| | - Guillaume Bonnier
- Centre Suisse d’Electronique et de Microtechnique (CSEM), 2002 Neuchatel, Switzerland; (Y.-M.P.); (G.B.); (M.P.); (M.L.)
| | - Martin Proença
- Centre Suisse d’Electronique et de Microtechnique (CSEM), 2002 Neuchatel, Switzerland; (Y.-M.P.); (G.B.); (M.P.); (M.L.)
| | - Mathieu Lemay
- Centre Suisse d’Electronique et de Microtechnique (CSEM), 2002 Neuchatel, Switzerland; (Y.-M.P.); (G.B.); (M.P.); (M.L.)
| | - Thilo Burkard
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (J.R.); (T.S.); (C.B.); (T.B.)
- Department of Cardiology, University Hospital Basel, 4031 Basel, Switzerland
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Spruijt-Metz D, Marlin BM, Pavel M, Rivera DE, Hekler E, De La Torre S, El Mistiri M, Golaszweski NM, Li C, Braga De Braganca R, Tung K, Kha R, Klasnja P. Advancing Behavioral Intervention and Theory Development for Mobile Health: The HeartSteps II Protocol. Int J Environ Res Public Health 2022; 19:2267. [PMID: 35206455 DOI: 10.3390/ijerph19042267] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023]
Abstract
Background: Recent advances in mobile and wearable technologies have led to new forms of interventions, called “Just-in-Time Adaptive Interventions” (JITAI). JITAIs interact with the individual at the most appropriate time and provide the most appropriate support depending on the continuously acquired Intensive Longitudinal Data (ILD) on participant physiology, behavior, and contexts. These advances raise an important question: How do we model these data to better understand and intervene on health behaviors? The HeartSteps II study, described here, is a Micro-Randomized Trial (MRT) intended to advance both intervention development and theory-building enabled by the new generation of mobile and wearable technology. Methods: The study involves a year-long deployment of HeartSteps, a JITAI for physical activity and sedentary behavior, with 96 sedentary, overweight, but otherwise healthy adults. The central purpose is twofold: (1) to support the development of modeling approaches for operationalizing dynamic, mathematically rigorous theories of health behavior; and (2) to serve as a testbed for the development of learning algorithms that JITAIs can use to individualize intervention provision in real time at multiple timescales. Discussion and Conclusions: We outline an innovative modeling paradigm to model and use ILD in real- or near-time to individually tailor JITIAs.
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Dimasi L. Beyond the garden: The complexity of "global and individual living" at the heart of the international commitment towards a healthy, more resilient and fairer society. Int J Risk Saf Med 2022; 33:111-116. [PMID: 35147558 DOI: 10.3233/jrs-227004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The right to fully enjoy the highest possible state of health is certainly nothing new in the agenda of the world's governments, and yet today it becomes a top priority not just in the restructuring of the health care system, but also in the promotion of multi-sector policies aimed at fostering and safeguarding the potential of every individual to achieve what could be defined, in general terms, as "common good". OBJECTIVE The current paper aimed at singling out the most useful strategies to promoting and achieving a healthy, more resilient and fairer society. METHODS Starting from principles 1 and 14 of the Declaration of Rome, the aim was to analyse and develop the concepts of resilience and health, questioning their possible future variations against the background of the current health emergency and the increasingly radical widespread use of new technologies as universally-applied and cross-sectional tools for human progress. RESULTS The "health for all" objective can only be achieved if we act on three key aspects: 1. Adding life to years; 2. Adding life to life; 3. Adding years to life. CONCLUSIONS Each individual should raise their health awareness as a key resource to leading a fulfilling existence and to developing the required qualities to fully tap into health possibilities - whether integral or residual - to tackle life.
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Affiliation(s)
- Luca Dimasi
- University of Bologna, Bologna, Italy E-mail:
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30
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Akimov AV, Gemueva KA, Semenova NK. The Seventh Population Census in the PRC: Results and Prospects of the Country's Demographic Development. Her Russ Acad Sci 2022; 91:724-735. [PMID: 35125844 PMCID: PMC8807378 DOI: 10.1134/s1019331621060083] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/15/2021] [Accepted: 07/25/2021] [Indexed: 06/10/2023]
Abstract
This article is dedicated to a comprehensive analysis of the data of the Seventh Census in China, conducted in 2020 and to the identification of the most important demographic and socioeconomic trends in the development of the population of the People's Republic of China. The relevance of this study is due to the impact that demographic changes have on the world's largest economy. Given the current high level of globalization and the scale of the PRC population, any risks and threats of a demographic nature have a direct impact not only on China's security but potentially on the situation in the Asia-Pacific region and the world as a whole. The practical significance of this work for Russia is obvious, in particular, from the point of view of improving the migration policy of the Russian Federation. This study is based on a large array of statistical data, including from the PRC National Bureau of Statistics. The quantitative and qualitative changes in the Chinese population are analyzed, including the ratio of birthrates, mortality, natural increase and fertility, gender and age imbalances, and internal migration.
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Affiliation(s)
- A. V. Akimov
- Institute of Oriental Studies (IOS), Russian Academy of Sciences, Moscow, Russia
| | - K. A. Gemueva
- Primakov Institute of the World Economy and International Relations (IMEMO), Russian Academy of Sciences, Moscow, Russia
| | - N. K. Semenova
- Institute of Oriental Studies (IOS), Russian Academy of Sciences, Moscow, Russia
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Al Ghafri H, Hasan N, Elarabi HF, Radwan D, Shawky M, Al Mamari S, Abdelgawad T, El Rashid A, Kodera A, Al Kathiri H, Lee AJ, Wanigaratne S. The impact of family engagement in opioid assisted treatment: Results from a randomised controlled trial. Int J Soc Psychiatry 2022; 68:166-170. [PMID: 33325311 DOI: 10.1177/0020764020979026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Family interventions in substance use disorders (SUD) treatment is limited despite the evidence for benefits. Providing family interventions is hampered by patient resistance, social stigma, logistics and factors related to the capacity of the treatment programmes. AIMS The purpose of the study was to examine the association between family engagement in treatment, and opioid use defined by percentage negative opioid screen and rate retention in treatment defined by completion of study period. METHODS Data from a 16-week outpatient randomised controlled trial (RCT) of 141 adults with opioid use disorder (OUD) receiving Opioid Assisted Treatment (OAT) using buprenorphine/naloxone film (BUP/NX-F) was, used to examine the association between family engagement in and opioid use and rate of retention in treatment. Multiple logistic regression was, applied to examine the independent prediction of family engagement on opioid use and rate retention in treatment. RESULTS Family engagement was significantly associated with retention in treatment (Spearman's rho 0.25, p < 0.01) and was subsequently found to increase the likelihood of retention in treatment by approximately 3-fold (adjusted odds ratio (OR) 2.95, 95% CI 1.31-6.65). CONCLUSION Family engagement in treatment is an independent predictor of retention in treatment but not opioid use in adults receiving OAT. It is, recommended that SUD treatment programmes integrate family related interventions in mainstream treatment. Delivering a personalised multicomponent family programme using digitised virtual communications that has been increasingly utilised during the Covid-19 pandemic is highly suggested.
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Affiliation(s)
- Hamad Al Ghafri
- National Rehabilitation Centre, Abu Dhabi, United Arab Emirates
| | - Nael Hasan
- National Rehabilitation Centre, Abu Dhabi, United Arab Emirates
| | - Hesham Farouk Elarabi
- National Rehabilitation Centre, Abu Dhabi, United Arab Emirates.,Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Doa Radwan
- National Rehabilitation Centre, Abu Dhabi, United Arab Emirates.,Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Mansour Shawky
- National Rehabilitation Centre, Abu Dhabi, United Arab Emirates.,Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Samya Al Mamari
- National Rehabilitation Centre, Abu Dhabi, United Arab Emirates
| | - Tarek Abdelgawad
- National Rehabilitation Centre, Abu Dhabi, United Arab Emirates.,Faculty of Medicine, Assuit University, Asyut, Egypt
| | - Abuelgasim El Rashid
- National Rehabilitation Centre, Abu Dhabi, United Arab Emirates.,Academy of Clinical Sciences and Laboratory Medicine, Dublin, Ireland
| | - Ayman Kodera
- National Rehabilitation Centre, Abu Dhabi, United Arab Emirates
| | | | - Amanda J Lee
- Medical Statistics Team, University of Aberdeen, Aberdeen, UK
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Rasburn M, Crosbie H, Tonkinson A, Chandler D, Dhanji T, Habgood S, O'Brien S. Innovative Patient Involvement During Covid-19: Keeping Patients at the Heart of HTA. Front Med Technol 2022; 3:793119. [PMID: 35047972 PMCID: PMC8757719 DOI: 10.3389/fmedt.2021.793119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic and lockdown measures in the United Kingdom resulted in significant challenges and created opportunities for innovation to keep patients at the heart of HTA. The introduction of the Coronavirus Act 2020 and the associated public health guidance meant that NICE's conventional HTA methods were no longer feasible. NICE introduced rapid, innovative updates to patient and public involvement (PPI), decision-making meetings, and consultations to harness the expertise of patients and the public to ensure guidance addressed the expected concerns and identified barriers which could impact access. This article describes the PPI support for NICE's rapid shift to virtual meetings and virtual engagement. We utilize the authors' experience and patient and public contributor feedback to understand the experience of participating in a virtual setting and identify four themes: accessibility; inclusivity; transparency; and intrapersonal relationships and committee dynamics. The article also considers how patient representatives participated in, and facilitated, the development of guidance for a hypothetical technology to keep patients and the public at the heart of expedited and novel HTA processes to identify and understand the expected patient concerns and potential barriers for when a technology would be introduced.
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Affiliation(s)
- Mark Rasburn
- National Institute for Health and Care Excellence (NICE), Public Involvement Programme, Level 1A, Manchester, United Kingdom
| | - Helen Crosbie
- National Institute for Health and Care Excellence (NICE), Public Involvement Programme, Level 1A, Manchester, United Kingdom
| | - Amanda Tonkinson
- National Institute for Health and Care Excellence (NICE), Public Involvement Programme, Level 1A, Manchester, United Kingdom
| | - David Chandler
- Psoriasis and Psoriatic Arthritis Alliance, 3 Horseshoe Business Park, St. Albans, United Kingdom
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Porras-Segovia A, Peñuelas-Calvo I, Nobile B, Gutiérrez-Rojas L. Editorial: Interventions based on new technologies for the management of mood disorders. Front Psychiatry 2022; 13:1099947. [PMID: 36569613 PMCID: PMC9768544 DOI: 10.3389/fpsyt.2022.1099947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Alejandro Porras-Segovia
- Mental Health Research Group, Health Research Institute Foundation Jimenez Diaz (IIS-FJD), Madrid, Spain.,Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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Abuín-Porras V, Martinez-Perez C, Romero-Morales C, Cano-de-la-Cuerda R, Martín-Casas P, Palomo-López P, Sánchez-Tena MÁ. Citation Network Study on the Use of New Technologies in Neurorehabilitation. Int J Environ Res Public Health 2021; 19:26. [PMID: 35010288 PMCID: PMC8751120 DOI: 10.3390/ijerph19010026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
New technologies in neurorehabilitation is a wide concept that intends to find solutions for individual and collective needs through technical systems. Analysis through citation networks is used to search scientific literature related to a specific topic. On the one hand, the main countries, institutions, and authors researching this topic have been identified, as well as their evolution over time. On the other hand, the links between the authors, the countries, and the topics under research have been analyzed. The publications analysis was performed through the Web of Science database using the search terms "new technolog*," "neurorehabilitation," "physical therapy*," and "occupational therapy*." The selected interval of publication was from 1992 to December 2020. The results were analyzed using CitNetExplorer software. After a Web of Science search, a total of 454 publications and 135 citation networks were found, 1992 being the first year of publication. An exponential increase was detected from the year 2009. The largest number was detected in 2020. The main areas are rehabilitation and neurosciences and neurology. The most cited article was from Perry et al. in 2007, with a citation index of 460. The analysis of the top 20 most cited articles shows that most approach the use of robotic devices and brain-computer interface systems. In conclusion, the main theme was found to be the use of robotic devices to address neuromuscular rehabilitation goals and brain-computer interfaces and their applications in neurorehabilitation.
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Affiliation(s)
- Vanesa Abuín-Porras
- Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
- Fundación DACER, Área de I+D+I, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Clara Martinez-Perez
- ISEC LISBOA—Instituto Superior de Educação e Ciências, 1750-179 Lisboa, Portugal; (C.M.-P.); (M.Á.S.-T.)
| | | | - Roberto Cano-de-la-Cuerda
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, IdISSC, 28040 Madrid, Spain;
| | | | - Miguel Ángel Sánchez-Tena
- ISEC LISBOA—Instituto Superior de Educação e Ciências, 1750-179 Lisboa, Portugal; (C.M.-P.); (M.Á.S.-T.)
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, 28037 Madrid, Spain
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Pech M, Sauzeon H, Yebda T, Benois-Pineau J, Amieva H. Falls Detection and Prevention Systems in Home Care for Older Adults: Myth or Reality? JMIR Aging 2021; 4:e29744. [PMID: 34889755 PMCID: PMC8704100 DOI: 10.2196/29744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/23/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022] Open
Abstract
There is an exponential increase in the range of digital products and devices promoting aging in place, in particular, devices aiming at preventing or detecting falls. However, their deployment is still limited and only few studies have been carried out in population-based settings owing to the technological challenges that remain to be overcome and the barriers that are specific to the users themselves, such as the generational digital divide and acceptability factors specific to the older adult population. To date, scarce studies consider these factors. To capitalize technological progress, the future step should be to better consider these factors and to deploy, in a broader and more ecological way, these technologies designed for older adults receiving home care to assess their effectiveness in real life.
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Affiliation(s)
- Marion Pech
- Medical Research Unit 1219, Bordeaux Population Health Research Center, Inserm, University of Bordeaux, Bordeaux, France
| | - Helene Sauzeon
- National Institute for Research in Digital Science and Technology, University of Bordeaux, Bordeaux, France
| | - Thinhinane Yebda
- Medical Research Unit 5800, Laboratoire Bordelais de Recherche en Informatique, National Center for Scientific Research, University of Bordeaux, Bordeaux, France
| | - Jenny Benois-Pineau
- Medical Research Unit 5800, Laboratoire Bordelais de Recherche en Informatique, National Center for Scientific Research, University of Bordeaux, Bordeaux, France
| | - Helene Amieva
- Medical Research Unit 1219, Bordeaux Population Health Research Center, Inserm, University of Bordeaux, Bordeaux, France
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Lorusso ML, Borasio F, Da Rold M, Martinuzzi A. Towards Consensus on Good Practices for the Use of New Technologies for Intervention and Support in Developmental Dyslexia: A Delphi Study Conducted among Italian Specialized Professionals. Children (Basel) 2021; 8:1126. [PMID: 34943322 DOI: 10.3390/children8121126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 02/01/2023]
Abstract
The use of new technologies for intervention in developmental dyslexia is steadily growing. In order to better understand the needs, the expectations, and the attitudes of Italian expert health professionals concerning such technologies, a national survey was conducted applying the Delphi methodology. Ad-hoc questionnaires were sent out to a group of eighteen experts over three successive rounds, and anonymously collected responses were aggregated and shared with the group after each round, aiming to reach a consensus on the proposed response. The goal was to define a series of statements that could form the basis for international "good practices" in the use of technologies for intervention to support dyslexia in children and adolescents. In the first round, the experts' general opinions were collected with both multiple choice and open questions, and in the second round consensus was assessed on a series of statements based on the first replies. The cut-off of 75% consensus on each statement was reached after three rounds. Fifteen experts completed all the rounds of the process, and a final version of the statements regarding good practice in the use of technologies for dyslexia could be defined.
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37
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Oliveira GS, Oliveira MLS, Miyaji EN, Rodrigues TC. Pneumococcal Vaccines: Past Findings, Present Work, and Future Strategies. Vaccines (Basel) 2021; 9:1338. [PMID: 34835269 DOI: 10.3390/vaccines9111338] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 01/24/2023] Open
Abstract
The importance of Streptococcus pneumoniae has been well established. These bacteria can colonize infants and adults without symptoms, but in some cases can spread, invade other tissues and cause disease with high morbidity and mortality. The development of pneumococcal conjugate vaccines (PCV) caused an enormous impact in invasive pneumococcal disease and protected unvaccinated people by herd effect. However, serotype replacement is a well-known phenomenon that has occurred after the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) and has also been reported for other PCVs. Therefore, it is possible that serotype replacement will continue to occur even with higher valence formulations, but the development of serotype-independent vaccines might overcome this problem. Alternative vaccines are under development in order to improve cost effectiveness, either using proteins or the pneumococcal whole cell. These approaches can be used as a stand-alone strategy or together with polysaccharide vaccines. Looking ahead, the next generation of pneumococcal vaccines can be impacted by the new technologies recently approved for human use, such as mRNA vaccines and viral vectors. In this paper, we will review the advantages and disadvantages of the addition of new polysaccharides in the current PCVs, mainly for low- and middle-income countries, and we will also address future perspectives.
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Boggio A, Yotova R. Gene editing of human embryos is not contrary to human rights law: A reply to Drabiak. Bioethics 2021; 35:956-963. [PMID: 34453362 DOI: 10.1111/bioe.12945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 04/12/2021] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
In an article in this journal, Katherine Drabiak argues that green lighting genome editing of human embryos is contrary to "fundamental human rights law." According to the author, genome editing of human embryos violates what we should recognize as a fundamental human right to inherit a genome without deliberate manipulation. In this reply article, we assess Drabiak's legal analysis and show methodological and substantive flaws. Methodologically, her analysis omits the key international legal instruments that form the so-called International Bill of Rights and thus fails to provide a full and accurate account of the fundamental international human rights standards. Substantively, Drabiak invokes, as a basis for prohibiting gene editing of human embryos, a legal standard (the rights and integrity of the future child) that is unknown to international law. Contrary to Drabiak's account, genome editing of human embryos is not prohibited under international law. Indeed, the right to health and the right to benefit from scientific progress may be interpreted as the basis of a legal duty to provide equality of access to germline gene editing, once determined it is beneficial and safe to use.
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Affiliation(s)
- Andrea Boggio
- Department of History and Social Sciences, Bryant University, Smithfield, Rhode Island, USA
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Mathieu C, McCambridge C, de Kerimel J, Jakovenko D, Lafont C. [Step 1 screening: experimentation in Occitania with nurses and pharmacists]. Soins Gerontol 2021; 26:16-19. [PMID: 34836595 DOI: 10.1016/j.sger.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Screening with the step 1 tool is the principal modality of entry into the ICOPE program. This preliminary step is particularly an initiative of primary care health professionals, who are daily caring older people. In Occitania, as part of the deployment of ICOPE program, nurses and pharmacists, were invited to integrate the step 1 in their practices. They benefited, if they wished, from a free webinar training.
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Affiliation(s)
- Céline Mathieu
- Hôpital La Grave, Cité de la santé, 1(er) étage, gérontopôle, centre hospitalier universitaire Toulouse, place Lange, 31059 Toulouse, France.
| | - Cécile McCambridge
- Hôpital La Grave, Cité de la santé, 1(er) étage, gérontopôle, centre hospitalier universitaire Toulouse, place Lange, 31059 Toulouse, France
| | - Justine de Kerimel
- Hôpital La Grave, Cité de la santé, 1(er) étage, gérontopôle, centre hospitalier universitaire Toulouse, place Lange, 31059 Toulouse, France
| | | | - Christine Lafont
- Hôpital La Grave, Cité de la santé, 1(er) étage, gérontopôle, centre hospitalier universitaire Toulouse, place Lange, 31059 Toulouse, France
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Aleksandrowicz H, Owczarczyk-Saczonek A, Placek W. Venous Leg Ulcers: Advanced Therapies and New Technologies. Biomedicines 2021; 9:1569. [PMID: 34829797 PMCID: PMC8615583 DOI: 10.3390/biomedicines9111569] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/08/2021] [Accepted: 10/23/2021] [Indexed: 12/19/2022] Open
Abstract
The prevalence of venous leg ulcers (VLUs) differs between 1.5% and 3% in the general population. The challenge in treating VLUs is common recurrence. Moreover, VLUs can be resistant to healing, despite appropriate treatment. In these cases, advanced wound therapies should be considered. The number of new technologies, applied in VLUs treatment, has increased in the last years. These therapies include biophysical interventions such as ultrasound therapy, electrical stimulations, electromagnetic therapy, or phototherapy. Furthermore, stem cell therapies, biologic skin equivalents, platelet-rich plasma therapy, oxygen therapies, anti-TNF therapy, or negative pressure wound therapy are advanced venous ulcer therapeutic methods that may support the standard of care. Medical devices, such as a muscle pump activator, or intermittent pneumatic compression device, may be especially useful for specific subgroups of patients suffering from VLUs. Some of the above-mentioned technologies require broader evidence of clinical efficacy and are still considered experimental therapies in dermatology.
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Affiliation(s)
- Hubert Aleksandrowicz
- Department and Clinic of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, University of Warmia and Mazury, Al. Wojska Polskiego 30, 10-959 Olsztyn, Poland; (A.O.-S.); (W.P.)
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Everard G, Luc A, Doumas I, Ajana K, Stoquart G, Edwards MG, Lejeune T. Self-Rehabilitation for Post-Stroke Motor Function and Activity-A Systematic Review and Meta-Analysis. Neurorehabil Neural Repair 2021; 35:1043-1058. [PMID: 34696645 DOI: 10.1177/15459683211048773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Due to an increasing stroke incidence, a lack of resources to implement effective rehabilitation and a significant proportion of patients with remaining impairments after treatment, there is a rise in demand for effective and prolonged rehabilitation. Development of self-rehabilitation programs provides an opportunity to meet these increasing demands.Objective. The primary aim of this meta-analysis was to determine the effect of self-rehabilitation on motor outcomes, in comparison to conventional rehabilitation, among patients with stroke. The secondary aim was to assess the influence of trial location (continent), technology, time since stroke (acute/subacute vs chronic), dose (total training duration > vs ≤ 15 hours), and intervention design (self-rehabilitation in addition/substitution to conventional therapy) on effect of self-rehabilitation.Methods. Studies were selected if participants were adults with stroke; the intervention consisted of a self-rehabilitation program defined as a tailored program where for most of the time, the patient performed rehabilitation exercises independently; the control group received conventional therapy; outcomes included motor function and activity; and the study was a randomized controlled trial with a PEDro score ≥5.Results. Thirty-five trials were selected (2225 participants) and included in quantitative synthesis regarding motor outcomes. Trials had a median PEDro Score of 7 [6-8]. Self-rehabilitation programs were shown to be as effective as conventional therapy. Trial location, use of technology, stroke stage, and intervention design did not appear to have a significant influence on outcomes.Conclusion. This meta-analysis showed low to moderate evidence that self-rehabilitation and conventional therapy efficacy was equally valuable for post-stroke motor function and activity.
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Affiliation(s)
- Gauthier Everard
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, 193391Université catholique de Louvain, Brussels, Belgium.,Louvain Bionics, 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Alexandre Luc
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, 193391Université catholique de Louvain, Brussels, Belgium
| | - Ioannis Doumas
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, 193391Université catholique de Louvain, Brussels, Belgium.,Louvain Bionics, 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Service de médecine physique et réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Khawla Ajana
- Psychological Sciences Research Institute (IPSY), 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Gaëtan Stoquart
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, 193391Université catholique de Louvain, Brussels, Belgium.,Louvain Bionics, 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Service de médecine physique et réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Martin Gareth Edwards
- Louvain Bionics, 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Psychological Sciences Research Institute (IPSY), 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Thierry Lejeune
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, 193391Université catholique de Louvain, Brussels, Belgium.,Louvain Bionics, 83415Université catholique de Louvain, Louvain-la-Neuve, Belgium.,Service de médecine physique et réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
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Pulvirenti R, Tognon C, Bisoffi S, Ghidini F, De Corti F, Fascetti Leon F, Antoniello LM, Gamba P. Innovative Techniques Associated with Traditional Abdominal Surgery in Complex Pediatric Cases: A Tertiary Center Experience. Children (Basel) 2021; 8:children8100898. [PMID: 34682163 PMCID: PMC8534733 DOI: 10.3390/children8100898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 11/20/2022]
Abstract
Pediatric abdominal surgery is constantly evolving, alongside the advent of new surgical technologies. A combined use of new tools and traditional surgical approaches can be useful in the management of complex cases, allowing less invasive procedures and sometimes even avoiding multiple interventions. This combination of techniques has implications even from the anesthetic point of view, especially in post-operative pain control. Thereby, tertiary level centres, including highly-specialized professionals and advanced equipment, can maximize the effectiveness of treatments to improve the final outcomes. Our paper aims to present some possible combinations of techniques recently used at our institution to provide a one-session, minimally invasive treatment within different areas of abdominal surgery.
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Affiliation(s)
- Rebecca Pulvirenti
- Pediatric Surgery Unit, Women’s and Children’s Health Department, University Hospital of Padua, 35128 Padua, Italy; (S.B.); (F.G.); (F.D.C.); (F.F.L.); (L.M.A.); (P.G.)
- Correspondence: ; Tel.: +39-347-369-6172
| | - Costanza Tognon
- Anesthesiology Pediatric Unit, Women’s and Children’s Health Department, University Hospital of Padua, 35128 Padua, Italy;
| | - Silvia Bisoffi
- Pediatric Surgery Unit, Women’s and Children’s Health Department, University Hospital of Padua, 35128 Padua, Italy; (S.B.); (F.G.); (F.D.C.); (F.F.L.); (L.M.A.); (P.G.)
| | - Filippo Ghidini
- Pediatric Surgery Unit, Women’s and Children’s Health Department, University Hospital of Padua, 35128 Padua, Italy; (S.B.); (F.G.); (F.D.C.); (F.F.L.); (L.M.A.); (P.G.)
| | - Federica De Corti
- Pediatric Surgery Unit, Women’s and Children’s Health Department, University Hospital of Padua, 35128 Padua, Italy; (S.B.); (F.G.); (F.D.C.); (F.F.L.); (L.M.A.); (P.G.)
| | - Francesco Fascetti Leon
- Pediatric Surgery Unit, Women’s and Children’s Health Department, University Hospital of Padua, 35128 Padua, Italy; (S.B.); (F.G.); (F.D.C.); (F.F.L.); (L.M.A.); (P.G.)
| | - Luca Maria Antoniello
- Pediatric Surgery Unit, Women’s and Children’s Health Department, University Hospital of Padua, 35128 Padua, Italy; (S.B.); (F.G.); (F.D.C.); (F.F.L.); (L.M.A.); (P.G.)
| | - Piergiorgio Gamba
- Pediatric Surgery Unit, Women’s and Children’s Health Department, University Hospital of Padua, 35128 Padua, Italy; (S.B.); (F.G.); (F.D.C.); (F.F.L.); (L.M.A.); (P.G.)
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Paganin G, Simbula S. New Technologies in the Workplace: Can Personal and Organizational Variables Affect the Employees' Intention to Use a Work-Stress Management App? Int J Environ Res Public Health 2021; 18:9366. [PMID: 34501956 DOI: 10.3390/ijerph18179366] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/22/2021] [Accepted: 09/01/2021] [Indexed: 11/30/2022]
Abstract
Organizations are interested in finding new and more effective ways to promote the well-being of their workers, to help their workers manage work-related stress. New technologies (e.g., smartphones) are cheaper, allow more workers to be reached, and guarantee their anonymity. However, not all employees agree on the use of new technological interventions for the promotion of well-being. Consequently, organizations need to investigate technological acceptance before introducing these tools. By considering the technology acceptance model (TAM) framework, we investigate both the influence of workers’ perceived usefulness and ease of use on their intentions to use apps that help them managing work stress. Moreover, we contribute to the extension of this model by considering both personal (i.e., self-efficacy, personal innovativeness) and organizational (i.e., organizational support for innovation) variables. Our research involved 251 participants who completed an online self-report questionnaire. The results confirm the central hypothesis of the TAM and the influence of other variables that could influence acceptance of new technologies, such as apps that help manage work stress, and the intentions to use them. These results could help organizations ensure technological acceptance and usage by their workers, increasing the effectiveness of new technologies and interventions to promote well-being.
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Rodrigo-Yanguas M, Martin-Moratinos M, Menendez-Garcia A, Gonzalez-Tardon C, Royuela A, Blasco-Fontecilla H. A Virtual Reality Game (The Secret Trail of Moon) for Treating Attention-Deficit/Hyperactivity Disorder: Development and Usability Study. JMIR Serious Games 2021; 9:e26824. [PMID: 34468332 PMCID: PMC8444038 DOI: 10.2196/26824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 04/11/2021] [Accepted: 06/15/2021] [Indexed: 01/04/2023] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) affects between 4% and 8% of children worldwide. The treatment of choice is multimodal treatment. Multimodal interventions for ADHD may be improved by incorporating new treatments, such as treatment via serious video games. The Secret Trail of Moon (TSTM) is a virtual reality serious video game that was designed for cognitive training related to core ADHD symptoms and executive dysfunction. Objective We aimed to describe the development and usability of TSTM. Methods The usability study included 37 children and adolescents who tested TSTM during the early usability stage (preinclusion) of a randomized controlled clinical trial for testing the effectiveness of TSTM. Chi-square tests were performed to compare patients with ADHD (ADHD combined subtype vs inattentive subtype) and to compare frequent and infrequent video game players in the second study. We used SPSS version 20 for Macintosh (IBM Corporation). Results A total of 31/37 (86%) and 30/37 (83%) of participants liked playing TSTM and wanted to continue playing TSTM, respectively. Further, 5/37 (14%) of participants reported that they experienced either perceived dizziness or virtual reality motion sickness. We found no statistically significant differences after comparing the ADHD combined subtype to the inattentive subtype and frequent video game players to infrequent video game players. Conclusions Serious video games, such as TSTM, may complement the current multimodal approach for treating ADHD. Trial Registration ClinicalTrials.gov NCT04355065; https://clinicaltrials.gov/ct2/show/NCT04355065
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Affiliation(s)
- Maria Rodrigo-Yanguas
- Department of Psychiatry, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana-Puerta de Hierro University Hospital, Majadahonda, Spain.,Autonoma University of Madrid, Madrid, Spain
| | - Marina Martin-Moratinos
- Department of Psychiatry, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana-Puerta de Hierro University Hospital, Majadahonda, Spain.,Autonoma University of Madrid, Madrid, Spain
| | - Angela Menendez-Garcia
- Department of Psychiatry, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana-Puerta de Hierro University Hospital, Majadahonda, Spain
| | | | - Ana Royuela
- Clinical Biostatistics Unit, Health Research Institute Puerta de Hierro-Segovia de Arana, Center for Biomedical Research in Epidemiology and Public Health Network, Madrid, Spain
| | - Hilario Blasco-Fontecilla
- Department of Psychiatry, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana-Puerta de Hierro University Hospital, Majadahonda, Spain.,Autonoma University of Madrid, Madrid, Spain.,Spain Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain.,ITA Mental Health, Madrid, Spain
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Vassolo RS, Mac Cawley AF, Tortorella GL, Fogliatto FS, Tlapa D, Narayanamurthy G. Hospital Investment Decisions in Healthcare 4.0 Technologies: Scoping Review and Framework for Exploring Challenges, Trends, and Research Directions. J Med Internet Res 2021; 23:e27571. [PMID: 34435967 PMCID: PMC8430851 DOI: 10.2196/27571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/11/2021] [Accepted: 07/05/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Alternative approaches to analyzing and evaluating health care investments in state-of-the-art technologies are being increasingly discussed in the literature, especially with the advent of Healthcare 4.0 (H4.0) technologies or eHealth. Such investments generally involve computer hardware and software that deal with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision-making. Besides, the use of these technologies significantly increases when addressed in bundles. However, a structured and holistic approach to analyzing investments in H4.0 technologies is not available in the literature. OBJECTIVE This study aims to analyze previous research related to the evaluation of H4.0 technologies in hospitals and characterize the most common investment approaches used. We propose a framework that organizes the research associated with hospitals' H4.0 technology investment decisions and suggest five main research directions on the topic. METHODS To achieve our goal, we followed the standard procedure for scoping reviews. We performed a search in the Crossref, PubMed, Scopus, and Web of Science databases with the keywords investment, health, industry 4.0, investment, health technology assessment, healthcare 4.0, and smart in the title, abstract, and keywords of research papers. We retrieved 5701 publications from all the databases. After removing papers published before 2011 as well as duplicates and performing further screening, we were left with 244 articles, from which 33 were selected after in-depth analysis to compose the final publication portfolio. RESULTS Our findings show the multidisciplinary nature of the research related to evaluating hospital investments in H4.0 technologies. We found that the most common investment approaches focused on cost analysis, single technology, and single decision-maker involvement, which dominate bundle analysis, H4.0 technology value considerations, and multiple decision-maker involvement. CONCLUSIONS Some of our findings were unexpected, given the interrelated nature of H4.0 technologies and their multidimensional impact. Owing to the absence of a more holistic approach to H4.0 technology investment decisions, we identified five promising research directions for the topic: development of economic valuation methodologies tailored for H4.0 technologies; accounting for technology interrelations in the form of bundles; accounting for uncertainties in the process of evaluating such technologies; integration of administrative, medical, and patient perspectives into the evaluation process; and balancing and handling complexity in the decision-making process.
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Affiliation(s)
- Roberto Santiago Vassolo
- IAE Business School, Universidad Austral, Pilar, Argentina.,Department of Industrial and Systems Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Guilherme Luz Tortorella
- IAE Business School, Universidad Austral, Pilar, Argentina.,Department of Mechanical Engineering, University of Melbourne, Melbourne, Australia.,Universidade Federal de Santa Catarina, Florianopolis, Brazil
| | - Flavio Sanson Fogliatto
- Departamento de Engenharia de Produção, Universidade Federal do Rio Grande do Sul, Escola de Engenharia, Porto Alegre, Brazil
| | - Diego Tlapa
- Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California - Campus Ensenada, Baja California, Mexico
| | - Gopalakrishnan Narayanamurthy
- Department of Operations and Supply Chain Management, University of Liverpool Management School, Liverpool, United Kingdom
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Smith GD, Cantatore C, Ohl DA. Microfluidic Systems for Isolation of Spermatozoa from Testicular Specimens of Non-Obstructive Azoospermic Men: Does/Can It Improve Sperm Yield? J Clin Med 2021; 10:3667. [PMID: 34441963 DOI: 10.3390/jcm10163667] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/14/2022] Open
Abstract
Intracytoplasmic sperm injection (ICSI) has allowed reproduction options through assisted reproductive technologies (ARTs) for men with no spermatozoa within the ejaculate (azoospermia). In men with non-obstructive azoospermia (NOA), the options for spermatozoa retrieval are testicular sperm extraction (TESE), testicular sperm aspiration (TESA), or micro-surgical sperm extraction (microTESE). At the initial time of spermatozoa removal from the testis, spermatozoa are immobile. Independent of the means of spermatozoa retrieval, the subsequent steps of removing spermatozoa from seminiferous tubules, determining spermatozoa viability, identifying enough spermatozoa for oocyte injections, and isolating viable spermatozoa for injection are currently performed manually by laboratory microscopic dissection and collection. These laboratory techniques are highly labor-intensive, with yield unknown, have an unpredictable efficiency and/or success rate, and are subject to inter-laboratory personnel and intra-laboratory variability. Here, we consider the potential utility, benefits, and shortcomings of developing technologies such as motility induction/stimulants, microfluidics, dielectrophoresis, and cell sorting as andrological laboratory add-ons to reduce the technical burdens and variabilities in viable spermatozoa isolation from testicular samples in men with NOA.
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Zaprutko T, Zaprutko J, Sprawka J, Pogodzińska M, Michalak M, Paczkowska A, Kus K, Nowakowska E, Baszko A. The comparison of Kardia Mobile and Hartmann Veroval 2 in 1 in detecting first diagnosed atrial fibrillation. Cardiol J 2021; 30:762-770. [PMID: 34355779 PMCID: PMC10635734 DOI: 10.5603/cj.a2021.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is the leading cause of stroke. The European Society of Cardiology (ESC) advises opportunistic AF screening among patients aged ≥ 65 years. Considering this, the aim herein, was compare the feasibility of two different systems of smartphone-based electrocardiogram (ECG) recordings to identify AF among those without a previous arrhythmia history. METHODS Prospective AF screening was conducted at six pharmacies using Kardia Mobile and Hartmann Veroval 2 in 1. A single-lead ECG was acquired by the placement of fingers on the pads. A cardiologist evaluated findings from both devices. RESULTS Atrial fibrillation was identified in 3.60% and previously unknown AF was detected in 1.92% of the study participants. Sensitivity and specificity of the Kardia application in detecting AF were 66.7% (95% confidence interval [CI] 38.4-88.2%) and 98.5% (95% CI 96.7-99.5%), and for Veroval 10.0% (95% CI 0.23-44.5%) and 94.96% (95% CI 92.15-96.98%), accordingly. Inter-rater agreement was k = 0.088 (95% CI 1.59-16.1%). CONCLUSIONS Mobile devices can detect AF, but each finding must be verified by a professional. The Kardia application appeared to be more user-friendly than Veroval. Cardiovascular screening using mobile devices is feasible at pharmacies. Hence it might be considered for routine use.
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Affiliation(s)
- Tomasz Zaprutko
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Poznan, Poland.
| | - Joanna Zaprutko
- Second Department of Cardiology, Poznan University of Medical Sciences, HCP Medical Center, Poznan, Poland
| | - Józefina Sprawka
- Student Scientific Society, Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Pogodzińska
- Student Scientific Society, Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Michalak
- Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Paczkowska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Kus
- Second Department of Cardiology, Poznan University of Medical Sciences, HCP Medical Center, Poznan, Poland
| | - Elżbieta Nowakowska
- Department of Pharmacology and Toxicology, University of Zielona Gora, Poland
| | - Artur Baszko
- Second Department of Cardiology, Poznan University of Medical Sciences, HCP Medical Center, Poznan, Poland
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Barbieri D, Giuliani E, Del Prete A, Losi A, Villani M, Barbieri A. How Artificial Intelligence and New Technologies Can Help the Management of the COVID-19 Pandemic. Int J Environ Res Public Health 2021; 18:ijerph18147648. [PMID: 34300099 PMCID: PMC8303245 DOI: 10.3390/ijerph18147648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/07/2021] [Accepted: 07/16/2021] [Indexed: 12/19/2022]
Abstract
The COVID-19 pandemic has worked as a catalyst, pushing governments, private companies, and healthcare facilities to design, develop, and adopt innovative solutions to control it, as is often the case when people are driven by necessity. After 18 months since the first case, it is time to think about the pros and cons of such technologies, including artificial intelligence—which is probably the most complex and misunderstood by non-specialists—in order to get the most out of them, and to suggest future improvements and proper adoption. The aim of this narrative review was to select the relevant papers that directly address the adoption of artificial intelligence and new technologies in the management of pandemics and communicable diseases such as SARS-CoV-2: environmental measures; acquisition and sharing of knowledge in the general population and among clinicians; development and management of drugs and vaccines; remote psychological support of patients; remote monitoring, diagnosis, and follow-up; and maximization and rationalization of human and material resources in the hospital environment.
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Affiliation(s)
- Davide Barbieri
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Savonarola 9, 44121 Ferrara, Italy;
| | - Enrico Giuliani
- Department of Biomedical, Metabolic and Neuroscience Sciences, University of Modena and Reggio Emilia, Via Del Pozzo 71, 41125 Modena, Italy;
| | - Anna Del Prete
- School of Anesthesiology and Intensive Care, University of Modena and Reggio Emilia, Via Del Pozzo 71, 41125 Modena, Italy; (A.D.P.); (A.B.)
| | - Amanda Losi
- Department of Biomedical, Metabolic and Neuroscience Sciences, University of Modena and Reggio Emilia, Via Del Pozzo 71, 41125 Modena, Italy;
- Correspondence: ; Tel.: +39-0598721234 (ext. 41125)
| | - Matteo Villani
- Department of Anesthesiology and Intensive Care, Azienda USL Piacenza, Via Antonio Anguissola 15, 29121 Piacenza, Italy;
| | - Alberto Barbieri
- School of Anesthesiology and Intensive Care, University of Modena and Reggio Emilia, Via Del Pozzo 71, 41125 Modena, Italy; (A.D.P.); (A.B.)
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Kemp CE, Ravikumar AP. New Technologies Can Cost Effectively Reduce Oil and Gas Methane Emissions, but Policies Will Require Careful Design to Establish Mitigation Equivalence. Environ Sci Technol 2021; 55:9140-9149. [PMID: 34105958 DOI: 10.1021/acs.est.1c03071] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Reducing methane emissions from oil and gas systems is a central component of US and international climate policy. Leak detection and repair (LDAR) programs using optical gas imaging (OGI)-based surveys are routinely used to mitigate fugitive emissions or leaks. Recently, new technologies and platforms such as planes, drones, and satellites promise more cost-effective mitigation than existing approaches. To be approved for use in LDAR programs, new technologies must demonstrate emissions mitigation equivalent to existing approaches. In this work, we use the FEAST modeling tool to (a) identify cost vs mitigation trade-offs that arise from using new technologies and (b) provide a framework for effective design of alternative LDAR programs. We identify several critical insights. First, LDAR programs can trade sensitivity for speed without sacrificing mitigation outcomes. Second, low sensitivity or high detection threshold technologies have an effective upper bound on achievable mitigation that is independent of the survey frequency. Third, the cost effectiveness of tiered LDAR programs using site-level detection technologies depends on their ability to distinguish leaks from routine venting. Finally, "technology equivalence" based on mitigation outcomes differs across basins and should be evaluated independently. The FEAST model will enable operators and regulators to systematically evaluate new technologies in next-generation LDAR programs.
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Affiliation(s)
- Chandler E Kemp
- Department of Systems Engineering, Harrisburg University of Science & Technology, 326 Market St., Harrisburg, Pennsylvania 17101, United States
| | - Arvind P Ravikumar
- Department of Systems Engineering, Harrisburg University of Science & Technology, 326 Market St., Harrisburg, Pennsylvania 17101, United States
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Magne J, Bharucha T, Cikes M, Galderisi M, Price S, Sade LE, Popescu BA, Cosyns B, Edvardsen T. EuroEcho 2019: highlights. Eur Heart J Cardiovasc Imaging 2021; 21:469-478. [PMID: 32182333 DOI: 10.1093/ehjci/jeaa037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 02/19/2020] [Indexed: 11/14/2022] Open
Abstract
The annual meeting of the European Association of Cardiovascular Imaging, EuroEcho 2019, was held in Vienna, Austria, in December 2019. In this article, we present a summary of the 'Highlights' session.
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Affiliation(s)
- Julien Magne
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges F-87042, France.,INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, GEIST, 2, rue Marcland, 87000 Limoges, France
| | - Tara Bharucha
- Department of Congenital Cardiology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Maya Cikes
- Department of Cardiovascular Diseases, University of Zagreb School of Medicine, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, via S. Pansini 5, 80131 Naples, Italy
| | - Suzanna Price
- Unit of Critical Care Medicine, Imperial College School of Medicine, Royal Brompton Hospital, Dovehouse Street, London SW3 6LY, UK
| | - Leyla Elif Sade
- Department of Cardiology, University of Baskent, E Blok, 54. Sokak, Bahcelievler 06490, Ankara, Turkey
| | - Bogdan A Popescu
- University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania
| | - Bernard Cosyns
- Centrum voor Hart en Vaatziekten (CHVZ), Universitair Ziekenhuis Brussel, Vrij Universiteit van Brussel, Brussels, Belgium
| | - Thor Edvardsen
- Department of Cardiology, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,University of Oslo, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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