-
BMC Palliative Care May 2024Indigenous palliative persons and their families often have different values, spiritual traditions, and practices from Western culture and Canadian health systems....
BACKGROUND
Indigenous palliative persons and their families often have different values, spiritual traditions, and practices from Western culture and Canadian health systems. Additionally, many healthcare policies and practices have been established without adequate consultation of the Indigenous populations they are meant to serve. This can result in barriers to Innu receiving culturally safe end-of-life care. Innu community leaders from Sheshatshiu, Labrador, have identified a need for further research in this area. The purpose of this study is to: (1) describe the cultural and spiritual practices related to death and dying of the Innu in Sheshatshiu; (2) identify aspects of current end-of-life care delivery that serve and/or fail to meet the cultural and spiritual needs of the Innu in Sheshatshiu; and (3) explore ways to integrate current end-of-life care delivery practices with Innu cultural and spiritual practices to achieve culturally safer care delivery for the Innu.
METHODS
This qualitative patient-oriented research study was co-led by Innu investigators and an Innu advisory committee to conduct semi-structured interviews of 5 healthcare providers and 6 decision-makers serving the community of Sheshatshiu and a focus group of 5 Innu Elders in Sheshatshiu. Data was analyzed thematically from verbatim transcripts. The codebook, preliminary themes, and final themes were all reviewed by Innu community members, and any further input from them was then incorporated. Quotations in this article are attributed to Innu Elders by name at the Elders' request.
RESULTS
The findings are described using eight themes, which describe the following: relationships and visitation support a "peaceful death"; traditional locations of death and dying; the important role of friends and community in providing care; flexibility and communication regarding cultural practices; adequate and appropriate supports and services; culturally-informed policies and leadership; and Innu care providers and patient navigators.
CONCLUSIONS
The Innu in Sheshatshiu have a rich culture that contributes to the health, care, and overall well-being of Innu people approaching end of life. Western medicine is often beneficial in the care that it provides; however, it becomes culturally unsafe when it fails to take Innu cultural and spiritual knowledge and traditions into account.
Topics: Humans; Terminal Care; Qualitative Research; Female; Male; Aged; Middle Aged; Canada
PubMed: 38760796
DOI: 10.1186/s12904-024-01431-5 -
Health Affairs Scholar Oct 2023Variation in availability, format, and standardization of patient attributes across health care organizations impacts patient-matching performance. We report on the...
Variation in availability, format, and standardization of patient attributes across health care organizations impacts patient-matching performance. We report on the changing nature of patient-matching features available from 2010-2020 across diverse care settings. We asked 38 health care provider organizations about their current patient attribute data-collection practices. All sites collected name, date of birth (DOB), address, and phone number. Name, DOB, current address, social security number (SSN), sex, and phone number were most commonly used for cross-provider patient matching. Electronic health record queries for a subset of 20 participating sites revealed that DOB, first name, last name, city, and postal codes were highly available (>90%) across health care organizations and time. SSN declined slightly in the last years of the study period. Birth sex, gender identity, language, country full name, country abbreviation, health insurance number, ethnicity, cell phone number, email address, and weight increased over 50% from 2010 to 2020. Understanding the wide variation in available patient attributes across care settings in the United States can guide selection and standardization efforts for improved patient matching in the United States.
PubMed: 38756741
DOI: 10.1093/haschl/qxad047 -
Journal of Medicine and Life Jan 2024The latest edition of the WHO Classification of thyroid tumors was released in 2022 and incorporates novel concepts vital to patient management. Thyroid follicular...
The latest edition of the WHO Classification of thyroid tumors was released in 2022 and incorporates novel concepts vital to patient management. Thyroid follicular nodular disease is a term used to collectively represent a wide variety of benign and non-neoplastic lesions, including both clonal and non-clonal proliferations that manifest clinically as multinodular goiter. Thyroid neoplasms develop from follicular cells and can be either benign, low-risk, or malignant. To avoid classifying all lesions under 1 cm in diameter as low-risk illnesses, the new classification method highlights the need for subtyping papillary thyroid cancer based on histomorphologic indicators rather than tumor size. Formerly known as the cribriform-morular variety of papillary thyroid carcinoma, this tumor is now more commonly referred to by its more accurate name, cribriform-morular thyroid carcinoma. Its histogenesis is unknown. Similar to the traditional definition of 'poorly differentiated thyroid carcinoma' according to the Turin criteria, the newly defined 'differentiated high-grade thyroid carcinoma' encompasses papillary thyroid cancer, follicular thyroid carcinomas, and oncocytic carcinomas with high-grade characteristics linked to worse prognosis. The squamous cell subtype of anaplastic thyroid cancer has also recently been characterized as a distinct morphologic pattern. In this article, we will discuss the latest revision to the World Health Organization's classification system for thyroid cancer.
Topics: Humans; Adenocarcinoma, Follicular; Thyroid Neoplasms; World Health Organization
PubMed: 38737660
DOI: 10.25122/jml-2023-0270 -
International Journal of Molecular... Apr 2024Non-muscle invasive bladder cancer is a common tumour in men and women. In case of resistance to the standard therapeutic agents, gemcitabine can be used as off-label...
Non-muscle invasive bladder cancer is a common tumour in men and women. In case of resistance to the standard therapeutic agents, gemcitabine can be used as off-label instillation therapy into the bladder. To reduce potential side effects, continuous efforts are made to optimise the therapeutic potential of drugs, thereby reducing the effective dose and consequently the pharmacological burden of the medication. We recently demonstrated that it is possible to significantly increase the therapeutic efficacy of mitomycin C against a bladder carcinoma cell line by exposure to non-toxic doses of blue light (453 nm). In the present study, we investigated whether the therapeutically supportive effect of blue light can be further enhanced by the additional use of the wavelength-specific photosensitiser riboflavin. We found that the gemcitabine-induced cytotoxicity of bladder cancer cell lines (BFTC-905, SW-1710, RT-112) was significantly enhanced by non-toxic doses of blue light in the presence of riboflavin. Enhanced cytotoxicity correlated with decreased levels of mitochondrial ATP synthesis and increased lipid peroxidation was most likely the result of increased oxidative stress. Due to these properties, blue light in combination with riboflavin could represent an effective therapy option with few side effects and increase the success of local treatment of bladder cancer, whereby the dose of the chemotherapeutic agent used and thus the chemical load could be significantly reduced with similar or improved therapeutic success.
Topics: Humans; Riboflavin; Urinary Bladder Neoplasms; Gemcitabine; Deoxycytidine; Cell Line, Tumor; Light; Photosensitizing Agents; Oxidative Stress; Cell Survival; Lipid Peroxidation; Adenosine Triphosphate; Mitochondria; Blue Light
PubMed: 38732087
DOI: 10.3390/ijms25094868 -
Methods (San Diego, Calif.) Jul 2024Digital Health Technologies (DHTs) have been shown to have variable usability as measured by efficiency, effectiveness and user satisfaction despite large-scale...
INTRODUCTION
Digital Health Technologies (DHTs) have been shown to have variable usability as measured by efficiency, effectiveness and user satisfaction despite large-scale government projects to regulate and standardise user interface (UI) design. We hypothesised that Human-Computer Interaction (HCI) modelling could improve the methodology for DHT design and regulation, and support the creation of future evidence-based UI standards and guidelines for DHTs.
METHODOLOGY
Using a Design Science Research (DSR) framework, we developed novel UI components that adhered to existing standards and guidelines (combining the NHS Common User Interface (CUI) standard and the NHS Design System). We firstly evaluated the Patient Banner UI component for compliance with the two guidelines and then used HCI-modelling to evaluate the "Add New Patient" workflow to measure time to task completion and cognitive load.
RESULTS
Combining the two guidelines to produce new UI elements is technically feasible for the Patient Banner and the Patient Name Input components. There are some inconsistencies between the NHS Design System and the NHS CUI when implementing the Patient Banner. HCI-modelling successfully quantified challenges adhering to the NHS CUI and the NHS Design system for the "Add New Patient" workflow.
DISCUSSION
We successfully developed new design artefacts combing two major design guidelines for DHTs. By quantifying usability issues using HCI-modelling, we have demonstrated the feasibility of a methodology that combines HCI-modelling into a human-centred design (HCD) process could enable the development of standardised UI elements for DHTs that is more scientifically robust than HCD alone.
CONCLUSION
Combining HCI-modelling and Human-Centred Design could improve scientific progress towards developing safer and more user-friendly DHTs.
Topics: Humans; User-Computer Interface; Digital Technology; Biomedical Technology; Digital Health
PubMed: 38729456
DOI: 10.1016/j.ymeth.2024.04.019 -
Heliyon May 2024Antimicrobial residues in animal-derived foods have become a major source of concern around the world. Oxytetracycline (OTC), one of these antibiotics that belongs to...
Antimicrobial residues in animal-derived foods have become a major source of concern around the world. Oxytetracycline (OTC), one of these antibiotics that belongs to the tetracycline family should be detected in these matrices. Nanostructured metal oxides have attracted a lot of scientific attention due to their special characteristics that can be exploited for creating innovative nanodevices. Therefore, in the present study, we report the fabrication of cobalt-doped ZnO/GO nanocomposites for OTC sensors using a simple and environmentally friendly method that does not require toxic solvents. Contact angle measurements, X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and UV-Vis were used to confirm the successful fabrication of the Co-ZnO/GO nanocomposite and to determine the surface area, Structural, morphological features, chemical composition and purity of the nanocomposite. The electrochemical and electrocatalytic properties were recorded using cyclic voltammetry (CV), electrochemical impedance spectroscopy, and differential pulse voltammetry (DPV). Optimizing parameters such as scan rate, pH value, deposition time, and deposition potential, we achieve a wide linear concentration range from 10 M to 10 M, with an impressive detection limit of 1.6 10 M.Notably, our sensor exhibits remarkable selectivity, demonstrating its usefulness for the detection of oxytetracycline traces in real milk samples. These results emphasize the novelty and practical significance of our work and provide a promising avenue for the development of sensitive and selective electrochemical sensing platforms in various fields.
PubMed: 38726196
DOI: 10.1016/j.heliyon.2024.e30265 -
Journal of Education and Health... 2024COVID-19 has caused a wide range of psychological problems, such as panic disorders, anxiety, and depression. Knowing what others have researched on, what constructs... (Review)
Review
COVID-19 has caused a wide range of psychological problems, such as panic disorders, anxiety, and depression. Knowing what others have researched on, what constructs they have focused on, will (a) summarize published information, (b) help identify research gaps, and (c) encourage future research that addresses these gaps. The aim of the study was to analyze the bibliometric indicators of scientific productivity of the impact of COVID-19 on constructs affecting undergraduate happiness. A bibliometric study was conducted. The PubMed database was used. Data summarized were: authors, year of publication, journal name, country, language of publication, and subtopic addressed. A total of 16 English-language studies were identified between April 2022 and December 2022. There were 12 countries that have published on the impact of COVID-19 on constructs affecting college students' happiness. Most of the studies were developed in the United States ( = 4, 25%) and China ( = 2, 12.5%). Thirteen journals publishing these topics were detected. The subtopics considered were organized into nine categories (e.g., a: Psychological impact, b: Adverse childhood experiences, c: Stress, d: Personality traits, e: Perception of the educational environment, f: Spiritual health, g: Distress, h: Uncertainty and socioemotional learning, i: Satisfaction with life). This study suggests that the number of countries and scientific journals that have published on the impact of COVID-19 on constructs affecting college students' happiness is small. In addition, the most discussed subtopics during the pandemic were related to constructs such as psychological impact and stress affecting college students' happiness.
PubMed: 38726077
DOI: 10.4103/jehp.jehp_615_23 -
Clinical Case Reports May 2024Mycoplasma myocarditis is a rare but potentially serious condition that can cause inflammation of the heart muscle, leading to arrhythmia and heart failure. It is...
KEY CLINICAL MESSAGE
Mycoplasma myocarditis is a rare but potentially serious condition that can cause inflammation of the heart muscle, leading to arrhythmia and heart failure. It is important to consider this condition in the differential diagnosis of young patients presenting with unexplained signs of heart failure and SVT, even in the absence of signs of myocardiocytolysis and extra-cardiac disease.
ABSTRACT
infections are often underdiagnosed as a great proportion of patients remain asymptomatic, pauci-symptomatic, or exhibit varying presentations. manifestations can affect different systems, including the heart, with the potential to lead to high degree of morbidity and debilitating sequelae. Here we present an atypical case of associated myocarditis which presented with sustained refractory SVT, symptoms of heart failure, and with no signs of myocardiocytolysis, pulmonary involvement, or systemic infection. Given the lack of signs of myocardial inflammation, the patient was initially misdiagnosed with tachycardia induced cardiomyopathy (TIC), but later correctly diagnosed after showing signs of pneumonia during the hospitalization. The patient received the appropriate antibiotic treatment in addition to corticosteroids, was discharged on the 15th day of hospitalization, and completely recovered after 1 month with no arrhythmia recurrence and normalization of ventricular function.
PubMed: 38721564
DOI: 10.1002/ccr3.8851 -
ADMET & DMPK 2024In this study, we present an electrochemical sensor for the detection of oxypeucedanin (Oxyp) and prantschimgin (Pra), two natural furanocoumarin derivatives. The...
BACKGROUND AND PURPOSE
In this study, we present an electrochemical sensor for the detection of oxypeucedanin (Oxyp) and prantschimgin (Pra), two natural furanocoumarin derivatives. The determination of the effects of these molecules on DNA is important to be potential drug candidates. Our research focused on exploring the electrochemical behaviour of these compounds and their interaction with DNA.
EXPERIMENTAL APPROACH
The electrochemical properties of Oxyp and Pra were systematically analyzed by evaluating their oxidation currents. Changes in the oxidation currents and peak potentials of guanine bases were monitored before and after interaction in the solution phase and at the electrode surface.
KEY RESULTS
The limit of detection (LOD) and limit of quantitation (LOQ) for Oxyp were determined to be 1.3 and 4.3 μg/mL, respectively. For Pra, the LOD and LOQ were found to be 20 and 68 μg/mL, respectively. Stability studies demonstrated that the Oxyp solution retained its oxidation capacity for over a month, whereas the Pra solution retained its oxidation capacity for nearly 120 min. Our findings suggest that Oxyp interacts with dsDNA, potentially through electrostatic interactions, showing promise as a potential drug candidate targeting DNA. On the other hand, the interaction of Pra with dsDNA requires further exploration to fully understand its mode of action.
CONCLUSION
The electrochemical sensor developed in this study provides a reliable and efficient method for detecting and analysing the interaction of these natural compounds with dsDNA. Our research contributes to advancing the understanding of the interaction between natural furanocoumarins and dsDNA, laying the groundwork for the design and development of novel and effective DNA-targeted drugs.
PubMed: 38720926
DOI: 10.5599/admet.2199 -
Journal of Medical Internet Research May 2024International health policies and researchers have emphasized the value of evaluating patient-reported outcomes (PROs) in clinical studies. However, the characteristics...
BACKGROUND
International health policies and researchers have emphasized the value of evaluating patient-reported outcomes (PROs) in clinical studies. However, the characteristics of PROs in adult tumor clinical trials in China remain insufficiently elucidated.
OBJECTIVE
This study aims to assess the application and characteristics of PRO instruments as primary or secondary outcomes in adult randomized clinical trials related to tumors in China.
METHODS
This cross-sectional study identified tumor-focused randomized clinical trials conducted in China between January 1, 2010, and June 30, 2022. The ClinicalTrials.gov database and the Chinese Clinical Trial Registry were selected as the databases. Trials were classified into four groups based on the use of PRO instruments: (1) trials listing PRO instruments as primary outcomes, (2) trials listing PRO instruments as secondary outcomes, (3) trials listing PRO instruments as coprimary outcomes, and (4) trials without any mention of PRO instruments. Pertinent data, including study phase, settings, geographic regions, centers, participant demographics (age and sex), funding sources, intervention types, target diseases, and the names of PRO instruments, were extracted from these trials. The target diseases involved in the trials were grouped according to the American Joint Committee on Cancer Staging Manual, 8th Edition.
RESULTS
Among the 6445 trials examined, 2390 (37.08%) incorporated PRO instruments as part of their outcomes. Within this subset, 26.82% (641/2390) listed PRO instruments as primary outcomes, 52.72% (1260/2390) as secondary outcomes, and 20.46% (489/2390) as coprimary outcomes. Among the 2,155,306 participants included in these trials, PRO instruments were used to collect data from 613,648 (28.47%) patients as primary or secondary outcomes and from 74,287 (3.45%) patients as coprimary outcomes. The most common conditions explicitly using specified PRO instruments included thorax tumors (217/1280, 16.95%), breast tumors (176/1280, 13.75%), and lower gastrointestinal tract tumors (173/1280, 13.52%). Frequently used PRO instruments included the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire-30, the visual analog scale, the numeric rating scale, the Traditional Chinese Medicine Symptom Scale, and the Pittsburgh Sleep Quality Index.
CONCLUSIONS
Over recent years, the incorporation of PROs has demonstrated an upward trajectory in adult randomized clinical trials on tumors in China. Nonetheless, the infrequent measurement of the patient's voice remains noteworthy. Disease-specific PRO instruments should be more effectively incorporated into various tumor disease categories in clinical trials, and there is room for improvement in the inclusion of PRO instruments as clinical trial end points.
Topics: Humans; Cross-Sectional Studies; China; Patient Reported Outcome Measures; Neoplasms; Adult; Female; Male; Randomized Controlled Trials as Topic; Middle Aged; Clinical Trials as Topic
PubMed: 38718388
DOI: 10.2196/45719