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International Journal of Environmental... Feb 2022For a service robot to serve travelers at an airport or for a social robot to live with a human partner at home, it is vital for robots to possess the ability to... (Review)
Review
For a service robot to serve travelers at an airport or for a social robot to live with a human partner at home, it is vital for robots to possess the ability to empathize with human partners and express congruent emotions accordingly. We conducted a systematic review of the literature regarding empathy in interpersonal, virtual agents, and social robots research with inclusion criteria to analyze empirical studies in a peer-reviewed journal, conference proceeding, or a thesis. Based on the review, we define empathy for human-robot interaction (HRI) as the robot's () capability and process to recognize the human's () emotional state, thoughts, and situation, and produce affective or cognitive responses to elicit a positive perception of humans. We reviewed all prominent empathy theories and established a conceptual framework that illuminates critical components to consider when designing an empathic robot, including the empathy process, outcome, and the and characteristics. This model is complemented by empirical research involving empathic virtual agents and social robots. We suggest critical factors such as domain dependency, multi-modality, and empathy modulation to consider when designing, engineering, and researching empathic social robots.
Topics: Emotions; Empathy; Humans; Robotics; Social Interaction
PubMed: 35162909
DOI: 10.3390/ijerph19031889 -
Andrologia Jun 2019Elevated platelet levels have been postulated to be associated with cardiovascular diseases, conditions closely linked to erectile dysfunction (ED). The current... (Meta-Analysis)
Meta-Analysis
Elevated platelet levels have been postulated to be associated with cardiovascular diseases, conditions closely linked to erectile dysfunction (ED). The current systematic review and meta-analysis was performed to assess the platelet indices, which including platelet count (PLT), mean platelet volume (MPV) and platelet distribution width (PDW) in subjects with ED compared to controls in an attempt to clarify the possible role of platelet indices in the pathogenesis of ED. We initially screened the candidate studies observing the possible association between platelet indices and ED following literature search of database Cochrane Library, PubMed, EMBASE and MEDLINE and therefore included the studies based on the pre-defined inclusion and exclusion criteria. Two independent investigators extracted the related information on article data and outcome measures from the qualified studies, and a meta-analysis was therefore performed using Stata 12.0 software. Subgroup analyses were conducted by the different ED aetiology obtained from the eligible studies. The standard mean difference (SMD) and the corresponding 95% confidence intervals (95% CIs) were applied to estimate the outcome measures. A total of 14 articles were qualified in our meta-analysis with a total of 1595 cases and 987 controls included. Pooled estimate was in favour of increased MPV levels in subjects with ED with a SMD of 0.651 fl, 95% CI 0.567-0.735, p = 0.000. Subgroup analysis showed that vasculogenic ED had a higher MPV levels than controls as well (SMD [95% CI] = 1.026 [0.823-1.228], p = 0.000). However, pooled analysis based on PLT and PDW levels has produced inconsistent results and not strong evidence on platelet level and ED correlation. In conclusion, vasculogenic ED patients had a higher MPV level in our study. However, the results need further interpretation with caution and more high-quality studies are warranted.
Topics: Blood Platelets; Humans; Impotence, Vasculogenic; Male; Mean Platelet Volume; Platelet Count
PubMed: 30740770
DOI: 10.1111/and.13248 -
Acta Obstetricia Et Gynecologica... Sep 2023Ectopic pregnancy is an important health condition which affects up to 1 in 100 women. Women who present with mild symptoms and low serum human chorionic gonadotrophin... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Ectopic pregnancy is an important health condition which affects up to 1 in 100 women. Women who present with mild symptoms and low serum human chorionic gonadotrophin (hCG) are often treated with methotrexate (MTX), but expectant management with close monitoring is a feasible alternative. Studies comparing the two treatments have not shown a statistically significant difference in uneventful resolution of ectopic pregnancy, but these studies were too small to define whether certain subgroups could benefit more from either treatment.
MATERIAL AND METHODS
We performed a systematic review and individual participant data meta-analysis (IPD-MA) of randomized controlled trials comparing systemic MTX and expectant management in women with tubal ectopic pregnancy and low hCG (<2000 IU/L). A one-stage IPD-MA was performed to assess overall treatment effects of MTX and expectant management to generate a pooled intervention effect. Subgroup analyses and exploratory multivariable analyses were undertaken according to baseline serum hCG and progesterone levels. Primary outcome was treatment success, defined as resolution of clinical symptoms and decline in level of serum hCG to <20 IU/L, or a negative urine pregnancy test by the initial intervention strategy, without any additional treatment. Secondary outcomes were need for blood transfusion, surgical intervention, additional MTX side-effects and hCG resolution times.
TRIAL REGISTRATION NUMBER
PROSPERO: CRD42021214093.
RESULTS
1547 studies reviewed and 821 remained after duplicates removed. Five studies screened for eligibility and three IPD requested. Two randomized controlled trials supplied IPD, leading to 153 participants for analysis. Treatment success rate was 65/82 (79.3%) after MTX and 48/70 (68.6%) after expectant management (IPD risk ratio [RR] 1.16, 95% confidence interval [CI] 0.95-1.40). Surgical intervention rates were not significantly different: 8/82 (9.8%) vs 13/70 (18.6%) (RR 0.65, 95% CI 0.23-1.14). Mean time to success was 19.7 days (95% CI 17.4-22.3) after MTX and 21.2 days (95% CI 17.8-25.2) after expectant management (P = 0.25). MTX specific side-effects were reported in 33 MTX compared to four in the expectant group.
CONCLUSIONS
Our IPD-MA showed no statistically significant difference in treatment efficacy between MTX and expectant management in women with tubal ectopic pregnancy with low hCG. Initial expectant management could be the preferred strategy due to fewer side-effects.
Topics: Pregnancy; Humans; Female; Methotrexate; Watchful Waiting; Pregnancy, Tubal; Pregnancy, Ectopic; Chorionic Gonadotropin; Abortifacient Agents, Nonsteroidal; Retrospective Studies
PubMed: 37345445
DOI: 10.1111/aogs.14617 -
Trauma, Violence & Abuse Dec 2016Post-traumatic stress disorder (PTSD) widely occurs among victims or witness of disasters. With flashbacks, hyperarousal, and avoidance being the typical symptoms, PTSD... (Review)
Review
Post-traumatic stress disorder (PTSD) widely occurs among victims or witness of disasters. With flashbacks, hyperarousal, and avoidance being the typical symptoms, PTSD became a focus of psychological research. The earthquake in Wenchuan, China, on May 12, 2008, was without precedent in magnitude and aftermath and caused huge damage, which drew scientists' attention to mental health of the survivors. We conducted a systematic overview by collecting published articles from the PubMed database and classifying them into five points: epidemiology, neuropathology, biochemistry, genetics and epigenetics, and treatment. The large body of research during the past 6 years showed that adolescents and adults were among the most studied populations with high prevalence rates for PTSD. Genomic and transcriptomic studies focusing on gene × environment studies as well as epigenetics are still rare, although a few available data showed great potential to better understand the pathophysiology of PTSD as multifactorial disease. Phytotherapy with Chinese herbs and acupuncture are rarely reported as of yet, although the first published data indicated promising therapy effects. Future studies should focus on the following points: (1) The affected populations under observation should be better defined concerning individual risk factor, time of observation, spatial movement, and individual disease courses of patients. (2) The role of social support for prevalence rates of PTSD should be observed in more detail. (3) Efficacy and safety of Chinese medicine should be studied to find potential interventions and effective treatments of PTSD.
Topics: Adolescent; Adult; Brain; Child; China; Earthquakes; Female; Humans; Hypothalamo-Hypophyseal System; Male; Mass Casualty Incidents; Medicine, Chinese Traditional; Pituitary-Adrenal System; Prevalence; Risk Factors; Social Support; Stress Disorders, Post-Traumatic; Survivors; Time Factors
PubMed: 26028651
DOI: 10.1177/1524838015585313 -
The Journal of Continuing Education in... 2017Health care delivery involves multiple health professions, and increasingly, diagnostic and therapeutic decisions are made through interprofessional teamwork. We define... (Review)
Review
INTRODUCTION
Health care delivery involves multiple health professions, and increasingly, diagnostic and therapeutic decisions are made through interprofessional teamwork. We define collaborative clinical reasoning (CCR) as the process in which two or more health care team members negotiate diagnostic, therapeutic, or prognostic issues of an individual patient resulting in an illness or treatment plan (and to reduce uncertainty). In a systematic review, we aimed to answer the following research question: Which empirically observable factors are considered crucial influences on performance in CCR in current empirical research?
METHODS
A systematic literature review was conducted. We included empirical studies taking place in a hospital setting, with a clear focus on CCR and published between January 1990 and September 2014. The studies were only included when at least one physician was part of the team. Nine articles were included in the review.
RESULTS
The factors crucially influencing the CCR performance (ie, diagnosis or treatment plan of patients) are (1) the initial distribution of information over team members, (2) clinical experience of physicians within a team, (3) information exchange within a team, and (4) individual retrieval of information from the team or information representation.
DISCUSSION
Despite the sparse empirical evidence on CCR, four factors influencing performance were extracted from the literature. Overall, there is little evidence though how each of these factors actually influences CCR performance. Thus, we need more empirical studies to better understand and foster CCR performance.
Topics: Clinical Competence; Cooperative Behavior; Decision Making; Humans; Interprofessional Relations; Thinking
PubMed: 28562501
DOI: 10.1097/CEH.0000000000000158 -
Severe Anaphylaxis in Pregnancy: A Systematic Review of Clinical Presentation to Determine Outcomes.Journal of Personalized Medicine Oct 2021Anaphylactic reactions during pregnancy can range from subjective cutaneous symptoms to anaphylaxis and lethal anaphylactic shock. The fetal and maternal outcomes are... (Review)
Review
Anaphylactic reactions during pregnancy can range from subjective cutaneous symptoms to anaphylaxis and lethal anaphylactic shock. The fetal and maternal outcomes are unpredictable. This study is the first systematic review of the clinical presentation of severe anaphylaxis in pregnancy as defined by the World Allergy Organization to determine maternal and fetal outcomes. We searched PubMed, the Web of Science, and Scopus databases for articles published between 1 January 1985 and 15 April 2021 using the following terms (((anaphylactic shock) AND (pregnancy)) OR ((anaphylaxis) AND (pregnancy))). In 42 studies involving 47 patients, 36.17% of patients were 31-35 years old, and 74.47% of cases occurred peripartum, mostly during cesarean section. Accurate diagnosis with valid and reliable outcome measures was reported for 71.74% of cases. Twenty-two allergens were identified: antibiotics (penicillins and cephalosporins), anesthetic drugs (suxamethonium, mepivacaine), latex, oxytocin, sodium and sucrose iron, laminaria, misoprostol, rubber from Foley catheter, oral phytomenadione, ranitidine, chamomile, and ant sting. Two cases of maternal death related to latex and intravenous iron sucrose, and six infants with neurological disease were reported, mostly related to antibiotics. This review of the currently available literature shows that favorable outcomes are attainable with a high degree of observation, multidisciplinary cooperation, and rapid treatment.
PubMed: 34834412
DOI: 10.3390/jpm11111060 -
Journal of Pediatric Surgery Nov 2022The nutcracker syndrome (NCS) is defined by compression of the left renal vein (LVR) and may present with a wide variety of symptoms. Due to its rarity in pediatric... (Review)
Review
BACKGROUND
The nutcracker syndrome (NCS) is defined by compression of the left renal vein (LVR) and may present with a wide variety of symptoms. Due to its rarity in pediatric patients, incidence, diagnostics and performed therapy regimen are widely undefined. To this date, there are only case reports and small collectives of pediatric patients described but comprehensive research is lacking.
METHODS
A systematic literature research on pediatric NCS was carried out on Medline and Scopus databases according to PRISMA principles using predefined search terms and inclusion criteria. The PROSPERO registered review (CRD42021237415) identified patients' characteristics regarding age, sex, clinical symptoms, applied diagnostic methods and treatment options.
RESULTS
In total 47 articles were included. Overall, 423 children (218 boys and 205 girls) with diagnosed NCS were included in the analysis. Mean age was 12.0 (boys 12.9, girls 12.0) years. Hematuria was most common presentation (55.5%), followed by proteinuria (49.9%). Classical flank pain was only detected in 19.1% of patients. Sonographic evaluation was the most commonly used diagnostic tool (99%). Invasive diagnostic studies were performed in 97 children. 86.8% patients were treated conservatively and 94.9% showed complete resolution (42.8%) or at least improvement (52.2%) of symptoms. Type of operative treatment comprised of open surgery with transposition of LRV, endovascular stenting and laparoscopy.
CONCLUSIONS
Overall, data quality regarding NCS in children is poor. However, conservative approach in pediatric patients is recommended and should be regarded first treatment option. Diagnostic and treatment should follow a defined algorithm when NCS is suspected. Sufficient observation and follow-up must be assured in all patients to get significant results in this heterogenous syndrome.
LEVEL OF EVIDENCE
V-IV.
Topics: Child; Female; Hematuria; Humans; Male; Renal Nutcracker Syndrome; Renal Veins
PubMed: 35065803
DOI: 10.1016/j.jpedsurg.2021.12.019 -
Journal of Vascular Surgery. Venous and... May 2018Venous aneurysms are uncommon vascular abnormalities that may be identified anywhere in the body. Historically, they were often misdiagnosed as soft tissue lesions, but... (Review)
Review
OBJECTIVE
Venous aneurysms are uncommon vascular abnormalities that may be identified anywhere in the body. Historically, they were often misdiagnosed as soft tissue lesions, but with the advent of readily available noninvasive imaging (such as duplex ultrasound), they can now be easily identified. Our aim was to review the presentation of venous aneurysms, available imaging modalities for defining them, and management.
METHODS
The English-language literature before March 2017 was reviewed, and only reports of primary venous aneurysms of the deep veins were included. Reports were subdivided on the basis of the location of the venous aneurysm, and reports containing sample imaging studies were referenced from Elsevier publications.
RESULTS
In total, our review identified reports of 35 head and neck venous aneurysms, 42 thoracic venous aneurysms, 152 intra-abdominal venous aneurysms, and 279 venous aneurysms of the extremities. Venous aneurysms of the lower extremity deep veins were most likely to be manifested by venous thromboembolic events, with approximately 25% to 50% of popliteal vein aneurysms presenting with pulmonary embolism. Diagnosis can be made by duplex ultrasound, computed tomography venography, magnetic resonance venography, or invasive venography. Management varies by location; most thoracic and head and neck aneurysms are observed, whereas venous aneurysms of the extremities are treated with surgical intervention, given the potential for venous thromboembolism. Few reports describe endovascular management of these lesions, so open surgical intervention remains the standard of care.
CONCLUSIONS
Venous aneurysms are rare vascular malformations that occur throughout the body. Many are identified on routine imaging ordered for other indications, whereas venous aneurysms of the deep veins of the extremities are often manifested with venous thromboembolism. Management of these lesions is determined largely by location and the potential morbidity and mortality of the untreated aneurysms vs surgery; aneurysms of the head and neck and thorax are managed with observation and serial imaging over time, whereas those of the abdomen and extremities are treated with surgical intervention. Endovascular techniques continue to lack a defined role in their management, and the standard of care remains open repair, when indicated.
Topics: Aneurysm; Humans; Jugular Veins; Magnetic Resonance Angiography; Mesenteric Veins; Phlebography; Popliteal Vein; Subclavian Vein; Tomography, X-Ray Computed; Ultrasonography, Doppler, Duplex
PubMed: 29661366
DOI: 10.1016/j.jvsv.2017.11.014 -
Transplantation Reviews (Orlando, Fla.) Jan 2022Infective endocarditis (IE) is a rare but potentially fatal complication following heart transplantation (HTx). There is a lack of literature regarding the patterns and... (Review)
Review
PURPOSE
Infective endocarditis (IE) is a rare but potentially fatal complication following heart transplantation (HTx). There is a lack of literature regarding the patterns and clinical course of IE development following HTx. We sought to pool the existing data in regards to defining characteristics, management options, and outcomes of IE following HTx.
METHODS
An electronic search of Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Ovid Medline, and the Scopus databases were performed to identify all articles in the English literature that report IE following HTx in adult patients. Patient-level data were extracted and analyzed.
RESULTS
Systematic search yielded 57 patients from 32 articles. Median patient age was 52 [IQR 43, 59] and 75% of patients (43/57) were male. Median time to IE presentation post-HTx was 8.4 [IQR 3.0, 35.8] months. IE of the mitral valve was observed in 36.8% (21/57) of patients, followed by mural IE in 24.6% (14/57), and tricuspid valve IE in 21.1% (12/57). The most common organisms were Staphylococcus aureus in 26.3% (15/57), Aspergillus fumigatus in 19.3% (11/57), Enterococcus faecalis in 12.3% (7/57), and an undetermined or unspecified organism in 14.0% (8/57) patients. Overall case fatality was 44.6% (25/56). Fungal IE was associated with a significantly higher case fatality 75.0% (9/12) than that of bacterial IE 36.1% (13/36) (p = 0.02). Surgical management of post-HTx IE was observed in 35.1% (20/57) of patients. This included valve surgery for 70.0% (14/20), including the mitral valve in 50.0% (7/14), aortic valve in 35.7% (5/14), and the tricuspid valve in 14.3% (2/14) of patients.
CONCLUSION
In addition to bacterial organisms, fungi also represent a frequent cause of IE in post-HTx patients. Overall HTx patient survival in the setting of IE is poor and may be worse if caused by A. fumigatus.
Topics: Adult; Endocarditis; Endocarditis, Bacterial; Heart Transplantation; Humans; Male; Staphylococcal Infections; Staphylococcus aureus
PubMed: 34826752
DOI: 10.1016/j.trre.2021.100672 -
Aerospace Medicine and Human Performance Aug 2016Cognitive performance is crucial during military operations. It is suggested that impaired cognitive performance accounts for most of the accidents during training... (Review)
Review
INTRODUCTION
Cognitive performance is crucial during military operations. It is suggested that impaired cognitive performance accounts for most of the accidents during training courses and actual battle. There is a need to define when soldiers' operational readiness becomes impaired. The objective of this systematic review was to investigate the effects of sustained military operations (SUSOPS) on vigilance, reaction time, working memory, and reasoning in order to select good indicators for performance impairment.
METHODS
A systematic literature search was performed using publicly accessible databases (IngentaConnect, PubMed, Science Direct, and Defense Technical Information Center online) that were screened until July 2015. Keywords were military, sustained operations, (cognitive) performance, soldier, and training.
RESULTS
Only 7 out of 589 studies met the inclusion criteria. Selected studies were difficult to compare due to different methodologies, cognitive tasks, and military courses. Vigilance, reaction time, and working memory were affected after only a few hours, showing severe impairment. They are linearly related to military stress up to 80 h of SUSOPS. These three indicators needed little recovery time to return to baseline levels. After more than 80 h of SUSOPS, no significant impairments of those indicators were observed. Reasoning becomes impaired after high stress levels of relatively short duration and can remain affected after more than 80 h of SUSOPS.
DISCUSSION
Vigilance, reaction time, and working memory are affected after only a few hours while little recovery time is needed. For reasoning to return to baseline values, longer recovery is needed than the time available during SUSOPS. Vrijkotte S, Roelands B, Meeusen R, Pattyn N. Sustained military operations and cognitive performance. Aerosp Med Hum Perform. 2016; 87(8):718-727.
Topics: Attention; Cognitive Dysfunction; Fatigue; Humans; Memory; Military Personnel; Reaction Time; Stress, Psychological; Task Performance and Analysis; Time Factors
PubMed: 27634607
DOI: 10.3357/AMHP.4468.2016