Eur Heart J. 2022 May 24:ehac266. doi: 10.1093/eurheartj/ehac266. Online ahead of print.

ABSTRACT

Congenital heart disease (CHD) is often comprised of complex three-dimensional (3D) anatomy that must be well understood to assess the pathophysiological consequences and guide therapy. Thus, detailed cardiac imaging for early detection and planning of interventional and/or surgical treatment is paramount. Advanced technologies have revolutionized diagnostic and therapeutic practice in CHD, thus playing an increasing role in its management. Traditional reliance on standard imaging modalities including echocardiography, cardiac computed tomography (CT) and magnetic resonance imaging (MRI) has been augmented by the use of recent technologies such as 3D printing, virtual reality, augmented reality, computational modelling, and artificial intelligence because of insufficient information available with these standard imaging techniques. This has created potential opportunities of incorporating these technologies into routine clinical practice to achieve the best outcomes through delivery of personalized medicine. In this review, we provide an overview of these evolving technologies and a new approach enabling physicians to better understand their real-world application in adult CHD as a prelude to clinical workflow implementation.

PMID:35608227 | DOI:10.1093/eurheartj/ehac266

Pharmacotherapy. 2022 May 24. doi: 10.1002/phar.2703. Online ahead of print.

ABSTRACT

INTRODUCTION: Treatment of HIV and tuberculosis (TB) co-infection leads to significant mortality in pediatric patients, and treatment can be challenging due to the clinically significant drug-drug interaction (DDI) between lopinavir/ritonavir (LPV/RTV) and rifampin. Doubling LPV/RTV doses results in insufficient lopinavir trough concentrations in pediatric patients also receiving rifampin.

OBJECTIVE: The objective of this study is to leverage physiologically-based pharmacokinetic (PBPK) modeling to optimize the adjusted doses of LPV/RTV in children receiving the World Health Organization (WHO) revised doses of rifampin (15 mg/kg daily).

METHODS: Adult and pediatric PBPK models for LPV/RTV with rifampin were developed and evaluated including CYP3A and P-glycoprotein inhibition and induction.

RESULTS: Simulated parameters were within 2-fold of observations for LPV, RTV, and rifampin in adults and children ≥ 2 weeks old. The model predicted that, in healthy adults receiving LPV/RTV 400/100 mg oral twice daily (BID), co-treatment with rifampin 600 mg oral daily decreased the steady-state area under the concentration vs. time curve of LPV by 79%, in line with the observed change of 75% reported in healthy adults. Simulated and observed concentration profiles were comparable for LPV/RTV (230/57.5 mg/m² ) PO BID without rifampin and super-boosted LPV/RTV (230/230 mg/m² ) PO BID with rifampin 10 mg/kg PO daily in pediatric patients. 16 mg/kg of super-boosted LPV (LPV/RTV 1:1) PO BID with rifampin 15 mg/kg PO daily achieved simulated LPV troughs >1 mg/L in ≥93% of virtual children weighing 3.0-24.9 kg, which was comparable with 10 mg/kg PO daily rifampin.

CONCLUSIONS: Super-boosted LPV/RTV with 15 mg/kg rifampin achieves therapeutic LPV troughs in HIV/TB-infected simulated children.

PMID:35607886 | DOI:10.1002/phar.2703

Comput Intell Neurosci. 2022 May 14;2022:6234883. doi: 10.1155/2022/6234883. eCollection 2022.

ABSTRACT

The current boom in Internet technology has paved the way for the research and evolution of various technologies related to it. One such technology is immersive virtual reality (IVR). Immersive technology is referred to as creating a reality-like experience by combining the physical world with digital reality. There are two main types of immersive technologies. Immersion in virtual reality is the perception of being physically present in an artificially created world. Perception is artificially created by images, videos, sounds, or other stimuli with the help of a virtual reality (VR) system that the user is connected to. VR uses rendered computer-generated simulations and results in a complete sense of immersion. Immersive virtual reality (immersive VR) refers to engaging users in an artificial environment that replaces their natural surroundings and fully engages them with the artificially created environment. In this research, we will research immersive physiology courses based on artificial intelligence combined with wireless network VR technology in the context of 5G. The teaching methodology has been kept up-to-date along with the technology. Teaching physiology courses also incorporate new technologies like immersive technologies. The use of technology in anatomy and physiology courses allows students to view structures and physiological concepts in a realistic environment. Virtual dissection in 3D is available with a life-like artificial environment. Students can attend the classes with VR headsets, laptops, or smartphones to experience immersive and interactive 3D classes. This advanced technology enhances and empowers the students to learn from real-life situations like those available in the classes. In this research, CNN with AI is proposed for effective learning of physiology courses. This algorithm is compared with the existing NNGA, KNN, and Random Forest, and it is observed that the proposed model has obtained an accuracy of 99%.

PMID:35607477 | PMC:PMC9124104 | DOI:10.1155/2022/6234883

BMC Pregnancy Childbirth. 2022 May 23;22(1):431. doi: 10.1186/s12884-022-04731-x.

ABSTRACT

BACKGROUND: Obstetric infections are the third most common cause of maternal mortality, with the largest burden in low and middle-income countries (LMICs). We analyzed causes of infection-related maternal deaths and near-miss identified contributing factors and generated suggested actions for quality of care improvement.

METHOD: An international, virtual confidential enquiry was conducted for maternal deaths and near-miss cases that occurred in 15 health facilities in 11 LMICs reporting at least one death within the GLOSS study. Facility medical records and local review committee documents containing information on maternal characteristics, timing and chain of events, case management, outcomes, and facility characteristics were summarized into a case report for each woman and reviewed by an international external review committee. Modifiable factors were identified and suggested actions were organized using the three delays framework.

RESULTS: Thirteen infection-related maternal deaths and 19 near-miss cases were reviewed in 20 virtual meetings by an international external review committee. Of 151 modifiable factors identified during the review, delays in receiving care contributed to 71/85 modifiable factors in maternal deaths and 55/66 modifiable factors in near-miss cases. Delays in reaching a GLOSS facility contributed to 5/85 and 1/66 modifiable factors for maternal deaths and near-miss cases, respectively. Two modifiable factors in maternal deaths were related to delays in the decision to seek care compared to three modifiable factors in near-miss cases. Suboptimal use of antibiotics, missing microbiological culture and other laboratory results, incorrect working diagnosis, and infrequent monitoring during admission were the main contributors to care delays among both maternal deaths and near-miss cases. Local facility audits were conducted for 2/13 maternal deaths and 0/19 near-miss cases. Based on the review findings, the external review committee recommended actions to improve the prevention and management of maternal infections.

CONCLUSION: Prompt recognition and treatment of the infection remain critical addressable gaps in the provision of high-quality care to prevent and manage infection-related severe maternal outcomes in LMICs. Poor uptake of maternal death and near-miss reviews suggests missed learning opportunities by facility teams. Virtual platforms offer a feasible solution to improve routine adoption of confidential maternal death and near-miss reviews locally.

PMID:35606709 | DOI:10.1186/s12884-022-04731-x

Math Biosci Eng. 2022 Apr 15;19(6):6204-6233. doi: 10.3934/mbe.2022290.

ABSTRACT

In the medical field, researchers are often unable to obtain the sufficient samples in a short period of time necessary to build a stable data-driven forecasting model used to classify a new disease. To address the problem of small data learning, many studies have demonstrated that generating virtual samples intended to augment the amount of training data is an effective approach, as it helps to improve forecasting models with small datasets. One of the most popular methods used in these studies is the mega-trend-diffusion (MTD) technique, which is widely used in various fields. The effectiveness of the MTD technique depends on the degree of data diffusion. However, data diffusion is seriously affected by extreme values. In addition, the MTD method only considers data fitted using a unimodal triangular membership function. However, in fact, data may come from multiple distributions in the real world. Therefore, considering the fact that data comes from multi-distributions, in this paper, a distance-based mega-trend-diffusion (DB-MTD) technique is proposed to appropriately estimate the degree of data diffusion with less impacts from extreme values. In the proposed method, it is assumed that the data is fitted by the triangular and trapezoidal membership functions to generate virtual samples. In addition, a possibility evaluation mechanism is proposed to measure the applicability of the virtual samples. In our experiment, two bladder cancer datasets are used to verify the effectiveness of the proposed DB-MTD method. The experimental results demonstrated that the proposed method outperforms other VSG techniques in classification and regression items for small bladder cancer datasets.

PMID:35603398 | DOI:10.3934/mbe.2022290

Front Virtual Real. 2022 Mar;3:855895. doi: 10.3389/frvir.2022.855895. Epub 2022 Mar 8.

ABSTRACT

OBJECTIVE: Distractions inordinately impair attention in children with Attention-Deficit Hyperactivity Disorder (ADHD) but examining this behavior under real-life conditions poses a challenge for researchers and clinicians. Virtual reality (VR) technologies may mitigate the limitations of traditional laboratory methods by providing a more ecologically relevant experience. The use of eye-tracking measures to assess attentional functioning in a VR context in ADHD is novel. In this proof of principle project, we evaluate the temporal dynamics of distraction via eye-tracking measures in a VR classroom setting with 20 children diagnosed with ADHD between 8 and 12 years of age.

METHOD: We recorded continuous eye movements while participants performed math, Stroop, and continuous performance test (CPT) tasks with a series of "real-world" classroom distractors presented. We analyzed the impact of the distractors on rates of on-task performance and on-task, eye-gaze (i.e., looking at a classroom whiteboard) versus off-task eye-gaze (i.e., looking away from the whiteboard).

RESULTS: We found that while children did not always look at distractors themselves for long periods of time, the presence of a distractor disrupted on-task gaze at task-relevant whiteboard stimuli and lowered rates of task performance. This suggests that children with attention deficits may have a hard time returning to tasks once those tasks are interrupted, even if the distractor itself does not hold attention. Eye-tracking measures within the VR context can reveal rich information about attentional disruption.

CONCLUSIONS: Leveraging virtual reality technology in combination with eye-tracking measures is well-suited to advance the understanding of mechanisms underlying attentional impairment in naturalistic settings. Assessment within these immersive and well-controlled simulated environments provides new options for increasing our understanding of distractibility and its potential impact on the development of interventions for children with ADHD.

PMID:35601272 | PMC:PMC9119405 | DOI:10.3389/frvir.2022.855895

Orthop Res Rev. 2022 May 16;14:169-186. doi: 10.2147/ORR.S360933. eCollection 2022.

ABSTRACT

In orthopaedic oncology, surgical planning and intraoperative execution errors may result in positive tumor resection margins that increase the risk of local recurrence and adversely affect patients' survival. Computer navigation and 3D-printed resection guides have been reported to address surgical inaccuracy by replicating the surgical plans in complex cases. However, limitations include surgeons' attention shift from the operative field to view the navigation monitor and expensive navigation facilities in computer navigation surgery. Practical concerns are lacking real-time visual feedback of preoperative images and the lead-time in manufacturing 3D-printed objects. Mixed Reality (MR) is a technology of merging real and virtual worlds to produce new environments with enhanced visualizations, where physical and digital objects coexist and allow users to interact with both in real-time. The unique MR features of enhanced medical images visualization and interaction with holograms allow surgeons real-time and on-demand medical information and remote assistance in their immediate working environment. Early application of MR technology has been reported in surgical procedures. Its role is unclear in orthopaedic oncology. This review aims to provide orthopaedic tumor surgeons with up-to-date knowledge of the emerging MR technology. The paper presents its essential features and clinical workflow, reviews the current literature and potential clinical applications, and discusses the limitations and future development in orthopaedic oncology. The emerging MR technology adds a new dimension to digital assistive tools with a more accessible and less costly alternative in orthopaedic oncology. The MR head-mounted display and hand-free control may achieve clinical point-of-care inside or outside the operating room and improve service efficiency and patient safety. However, lacking an accurate hologram-to-patient matching, an MR platform dedicated to orthopaedic oncology, and clinical results may hinder its wide adoption. Industry-academic partnerships are essential to advance the technology with its clinical role determined through future clinical studies.

PMID:35601186 | PMC:PMC9121991 | DOI:10.2147/ORR.S360933

World Med Health Policy. 2022 Mar;14(1):150-177. doi: 10.1002/wmh3.498. Epub 2022 Mar 14.

ABSTRACT

The ongoing COVID-19 pandemic has posed tremendous challenges for economies and individuals around the world. At the same time, it has also laid bare the blatant and growing inequities that many individuals, particularly children, are confronted with on a daily basis. With communities in lockdowns and schools going virtual in many parts of the United States, the important role that schools and school-based services play in the lives of many children have gained new attention. Nonetheless, only 3% of American schools have school-based health centers on campus, and they remain relegated to the fringes of both health care and education. One key limitation has been the lack of appropriately trained health-care professionals. Over the past 2 years, we have interviewed dozens of individuals about their experiences in school-based health centers. Based on this study, we explore what it means for a health-care professional to work in school-based health care and how it differs from more traditional health-care settings. Our analysis particularly focuses on training and education, work environments, and their unique demands that come from being embedded within the educational setting. We conclude by addressing the important role that governmental policies could play in augmenting this crucial workforce.

PMID:35600495 | PMC:PMC9111193 | DOI:10.1002/wmh3.498

Br J Educ Technol. 2022 May;53(3):577-592. doi: 10.1111/bjet.13189. Epub 2022 Feb 10.

ABSTRACT

The annual instructional virtual team Project X brings together professors and students from across the globe to engage in client projects. The 2020 project was challenged by the global disruption of the COVID-19 pandemic. This paper draws on a quantitative dataset from a post-project survey among 500 participating students and a qualitative narrative inquiry of personal experiences of the faculty members. The findings reveal how innovative use of a variety of collaboration and communication technologies helped students and their professors in building emotional connection and compassion to support each other in the midst of the crisis, and to accomplish the project despite connectivity disruptions. The results suggest that the role of an instructor changed to a coach and mentor, and technology was used to create a greater sense of inclusion and co-presence in student-faculty interactions. Ultimately, the paper highlights the role of technology to help the participants navigate sudden crisis affecting a global online instructional team project. The adaptive instructional teaching strategies and technologies depicted in this study offer transformative potential for future developments in higher education.

PMID:35600422 | PMC:PMC9111488 | DOI:10.1111/bjet.13189

Br J Educ Technol. 2022 May;53(3):512-533. doi: 10.1111/bjet.13205. Epub 2022 Feb 20.

ABSTRACT

The world-wide pivot to remote learning due to the exogenous shocks of COVID-19 across educational institutions has presented unique challenges and opportunities. This study documents the lived experiences of instructors and students and recommends emerging pathways for teaching and learning strategies post-pandemic. Seventy-one instructors and 122 students completed online surveys containing closed and open-ended questions. Quantitative and qualitative analyses were conducted, including frequencies, chi-square tests, Welch Two-Samples t-tests, and thematic analyses. The results demonstrated that with effective online tools, remote learning could replicate key components of content delivery, activities, assessments, and virtual proctored exams. However, instructors and students did not want in-person learning to disappear and recommended flexibility by combining learning opportunities in in-person, online, and asynchronous course deliveries according to personal preferences. The paper concludes with future directions and how the findings influenced our planning for Fall 2021 delivery. The video abstract for this article is available at https://www.youtube.com/watch?v=F48KBg_d8AE.

PMID:35600416 | PMC:PMC9111695 | DOI:10.1111/bjet.13205

Comput Methods Programs Biomed. 2022 May 10;221:106857. doi: 10.1016/j.cmpb.2022.106857. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Independent living and transportation are crucial aspects for people living with a disability. After an injury, it is important to assess driving ability, in terms of physical and psychological conditions, and to test the effects of prescribed drugs. Within this framework, driving simulators are suitable tools for training driving skills; however, available tools are expensive or lack appropriate sets of behavioral measures to fully characterize the drivers' ability.

METHODS: This work presents the first step toward the development of ADRIS, a new open-source, accessible, realistic virtual reality simulator for training and testing driving skills of people with sensory-motor disability. This includes a prototype based on an open-source simulator for autonomous driving research (CARLA), with the addition of customized features such as adaptable driving controllers, a virtual reality headset, and the possibility to collect behavioral and physiological data. Also, the new system allows to set different environmental conditions, to include and control the timing of potentially dangerous situations, and to set scenarios with various difficulty levels.

RESULTS: Tests on 17 healthy participants demonstrated that the simulator is well tolerated in terms of discomfort, physical fatigue, and mental effort. Also, the system is easy to use and is capable of providing a realistic driving experience, allowing the extraction of reliable behavioral parameters.

CONCLUSIONS: ADRIS combines a high-fidelity virtual world, with customizable features specifically designed for the training and testing of people living with a disability, thus making it usable in many contexts such as home training, rehabilitation, education, and research.

PMID:35597201 | DOI:10.1016/j.cmpb.2022.106857

BMC Med Educ. 2022 May 20;22(1):387. doi: 10.1186/s12909-022-03470-z.

ABSTRACT

BACKGROUND: To ensure successful medical education despite the COVID-19 pandemic, the demand for online instruction has substantially increased. Fast and efficient teaching in a digital format poses a great challenge for medical students and lecturers as well as the universities.

OBJECTIVE: The aim of this study is to capture the readiness of medical students and faculty members to participate in rapidly- evolving online education.

METHODS: This cross-sectional study is based on two questionnaires distributed among medical students and associate deans for education in Germany, Austria and Switzerland. Questions included decision- making questions, categorical questions, and open-ended questions, all addressing the frequency and format of the digital education offered, the perceived quality of digital education, and medical student satisfaction with digital education. Questions about missing content and areas for improvement from the perspectives of medical students were included. The associate deans were asked for their opinions about the impact of the pandemic on teaching, the organizational setup and implementation of digital education by universities, and plans for future initiatives.

RESULTS: Three thousand and thirty medical students (m = 752 and f = 2245) from 53 universities participated in the study. The study showed that 92% of students were affected by the pandemic, and 19% of the students viewed the changes as entirely negative. 97% of the medical students were able to participate in digital courses, but only 4% were able to learn exclusively online. For 77% of the medical students, digital offerings accounted for over 80% of the education offered. In terms of content, medical students complained about a lack of practical teaching, such as contact with patients, lecturers, fellow medical students, and a poor perceived quality of teaching due to dubbing, frequent changeover of seminars, problem-oriented learning groups and in-person teaching, a lack of interaction possibilities and a lack of technical equipment, such as lecturers' knowledge and server capacities, at the universities. Overall, almost half of the medical students (42%) rated the implementation of digital teaching at their universities as good or very good. Forty-one of the 53 associate deans responded to the questionnaire, and 35 felt medical education was influenced by the pandemic. The associate deans (80%; 33/41) felt that the digitalization of medical education was negatively influenced by the pandemic. Only 44% (18/41) felt that their universities were well or very well positioned for digital teaching. All the associate deans believe that digital teaching in medicine will continue after the pandemic.

CONCLUSIONS: In the German-speaking world, the rapid conversion of medical teaching to a digital format has been well implemented in many cases. The perceived quality of the implementation of digital education still lacks practical relevance and the use of new digital media, such as learning games, VR, and online question time. The digital format of medical education will likely continue beyond the COVID-19 pandemic.

PMID:35596161 | PMC:PMC9121080 | DOI:10.1186/s12909-022-03470-z

Vaccine. 2022 May 2:S0264-410X(22)00523-0. doi: 10.1016/j.vaccine.2022.04.069. Online ahead of print.

ABSTRACT

Vaccine effectiveness is lower and wanes faster against infection and symptomatic disease caused by the omicron variant of SARS-CoV-2 than was observed with previous variants. Vaccine effectiveness against severe omicron disease, on average, is higher, but has shown variability, including rapid apparent waning, in some studies. Assessing vaccine effectiveness against omicron severe disease using hospital admission as a measure of severe disease has become more challenging because of omicron's attenuated intrinsic severity and its high prevalence of infection. Many hospital admissions likely occur among people with incidental omicron infection or among those with infection-induced exacerbation of chronic medical conditions. To address this challenge, the World Health Organization held a virtual meeting on March 15, 2022, to review evidence from several studies that assessed Covid-19 vaccine effectiveness against severe omicron disease using several outcome definitions. Data was shown from studies in South Africa, the United States, the United Kingdom and Qatar. Several approaches were proposed that better characterize vaccine protection against severe Covid-19 disease caused by the omicron variant than using hospitalization of omicron-infected persons to define severe disease. Using more specific definitions for severe respiratory Covid-19 disease, such as indicators of respiratory distress (e.g. oxygen requirement, mechanical ventilation, and ICU admission), showed higher vaccine effectiveness than against hospital admission. Second, vaccine effectiveness against progression from omicron infection to hospitalization, or severe disease, also showed higher vaccine protection. These approaches might better characterize vaccine performance against severe Covid-19 disease caused by omicron, as well as future variants that evade humoral immunity, than using hospitalization with omicron infection as an indicator of severe disease.

PMID:35595662 | PMC:PMC9058052 | DOI:10.1016/j.vaccine.2022.04.069

Innov Aging. 2022 Mar 17;6(3):igac015. doi: 10.1093/geroni/igac015. eCollection 2022.

ABSTRACT

BACKGROUND AND OBJECTIVES: Exposure to nature and nature-based imagery has been shown to improve mood states and stave off cognitive decline in older adults. Even "micro-doses" of natural scenery can provide beneficial effects in situations where more extensive interactions with nature are not feasible. In the current study, we evaluated the use of virtual reality (VR) for delivering interactive nature-based content with the goal of prompting active engagement and improving mood states in older adults.

RESEARCH DESIGN AND METHODS: The researchers developed a novel VR environment that combined 360-degree videos of natural areas and botanical gardens with interactive digital features that allowed users to engage with aspects of the environment. We recruited 50 older adults to try out this VR environment and measured changes in mood states and attitudes toward VR from before versus after the sessions. We controlled for variables such as age, education level, and exposure to nature in everyday life, and we looked for differences in responses to the VR among participants with cognitive impairments (CIs) versus without, and participants with physical disabilities versus without.

RESULTS: The findings indicated significant improvements in "good" mood and "calm" mood dimensions after exposure to the VR, as well as improvements in attitudes toward the technology. These positive outcomes were significantly greater for participants with physical disabilities compared to those without disabilities. No differences were found in the responses of participants with CIs versus those without. Exit interviews provided a variety of helpful suggestions about ways to improve the VR equipment design and content to meet the needs of an older adult population.

DISCUSSION AND IMPLICATIONS: The study demonstrates that VR can provide a cost-effective, noninvasive, and nonpharmaceutical approach for improving the lives of older adults in both clinical and recreational settings, particularly when real-world access to nature is limited.

PMID:35592668 | PMC:PMC9113189 | DOI:10.1093/geroni/igac015

Sensors (Basel). 2022 Apr 24;22(9):3259. doi: 10.3390/s22093259.

ABSTRACT

Inertial capture (InCap) systems combined with musculoskeletal (MSK) models are an attractive option for monitoring 3D joint kinematics in an ecological context. However, the primary limiting factor is the sensor-to-segment calibration, which is crucial to estimate the body segment orientations. Walking, running, and stair ascent and descent trials were measured in eleven healthy subjects with the Xsens InCap system and the Vicon 3D motion capture (MoCap) system at a self-selected speed. A novel integrated method that combines previous sensor-to-segment calibration approaches was developed for use in a MSK model with three degree of freedom (DOF) hip and knee joints. The following were compared: RMSE, range of motion (ROM), peaks, and R² between InCap kinematics estimated with different calibration methods and gold standard MoCap kinematics. The integrated method reduced the RSME for both the hip and the knee joints below 5°, and no statistically significant differences were found between MoCap and InCap kinematics. This was consistent across all the different analyzed movements. The developed method was integrated on an MSK model workflow, and it increased the sensor-to-segment calibration accuracy for an accurate estimate of 3D joint kinematics compared to MoCap, guaranteeing a clinical easy-to-use approach.

PMID:35590949 | PMC:PMC9104520 | DOI:10.3390/s22093259

Sensors (Basel). 2022 Apr 22;22(9):3209. doi: 10.3390/s22093209.

ABSTRACT

The research of object classification and part segmentation is a hot topic in computer vision, robotics, and virtual reality. With the emergence of depth cameras, point clouds have become easier to collect and increasingly important because of their simple and unified structures. Recently, a considerable number of studies have been carried out about deep learning on 3D point clouds. However, data captured directly by sensors from the real-world often encounters severe incomplete sampling problems. The classical network is able to learn deep point set features efficiently, but it is not robust enough when the method suffers from the lack of point clouds. In this work, a novel and general network was proposed, whose effect does not depend on a large amount of point cloud input data. The mutual learning of neighboring points and the fusion between high and low feature layers can better promote the integration of local features so that the network can be more robust. The specific experiments were conducted on the ScanNet and Modelnet40 datasets with 84.5% and 92.8% accuracy, respectively, which proved that our model is comparable or even better than most existing methods for classification and segmentation tasks, and has good local feature integration ability. Particularly, it can still maintain 87.4% accuracy when the number of input points is further reduced to 128. The model proposed has bridged the gap between classical networks and point cloud processing.

PMID:35590899 | PMC:PMC9102113 | DOI:10.3390/s22093209

Sensors (Basel). 2022 Apr 21;22(9):3181. doi: 10.3390/s22093181.

ABSTRACT

Augmented reality (AR) and Internet of Things (IoT) are among the core technological elements of modern information systems and applications in which advanced features for user interactivity and monitoring are required. These technologies are continuously improving and are available nowadays in all popular programming environments and platforms, allowing for their wide adoption in many different business and research applications. In the fields of healthcare and assisted living, AR is extensively applied in the development of exergames, facilitating the implementation of innovative gamification techniques, while IoT can effectively support the users' health monitoring aspects. In this work, we present a prototype platform for exergames that combines AR and IoT on commodity mobile devices for the development of serious games in the healthcare domain. The main objective of the solution was to promote the utilization of gamification techniques to boost the users' physical activities and to assist the regular assessment of their health and cognitive statuses through challenges and quests in the virtual and real world. With the integration of sensors and wearable devices by design, the platform has the capability of real-time monitoring the users' biosignals and activities during the game, collecting data for each session, which can be analyzed afterwards by healthcare professionals. The solution was validated in real world scenarios and the results were analyzed in order to further improve the performance and usability of the prototype.

PMID:35590871 | PMC:PMC9102367 | DOI:10.3390/s22093181

J Appl Biomech. 2022 May 19:1-11. doi: 10.1123/jab.2020-0324. Online ahead of print.

ABSTRACT

Patients following unilateral total knee arthroplasty (TKA) display interlimb differences in knee joint kinetics during gait and more recently, stationary cycling. The purpose of this study was to use musculoskeletal modeling to estimate total, medial, and lateral tibiofemoral compressive forces for patients following TKA during stationary cycling. Fifteen patients of unilateral TKA, from the same surgeon, participated in cycling at 2 workrates (80 and 100 W). A knee model (OpenSim 3.2) was used to estimate total, medial, and lateral tibiofemoral compressive forces for replaced and nonreplaced limbs. A 2 × 2 (limb × workrate) and a 2 × 2 × 2 (compartment × limb × workrate) analysis of variance were run on the selected variables. Peak medial tibiofemoral compressive force was 23.5% lower for replaced compared to nonreplaced limbs (P = .004, G = 0.80). Peak medial tibiofemoral compressive force was 48.0% greater than peak lateral tibiofemoral compressive force in nonreplaced limbs (MD = 344.5 N, P < .001, G = 1.6) with no difference in replaced limbs (P = .274). Following TKA, patients have greater medial compartment loading on their nonreplaced compared to their replaced limbs and ipsilateral lateral compartment loading. This disproportionate loading may be cause for concern regarding exacerbating contralateral knee osteoarthritis.

PMID:35588765 | DOI:10.1123/jab.2020-0324

JMIR Res Protoc. 2022 May 19;11(5):e33023. doi: 10.2196/33023.

ABSTRACT

BACKGROUND: Informal carers play a significant role in supporting people living with dementia; however, carers in rural areas are often isolated, with limited access to support services. Although dementia-friendly communities provide valued support for carers, access to them is limited as they are few and geographically dispersed.

OBJECTIVE: This study's aim was to increase support and services for rural informal carers of people living with dementia by using information and communication technologies accessed through an integrated website and mobile app-the Verily Connect app. The objective of this protocol is to detail the research design used in a complex study that was situated in a challenging real-world setting integrating web-based and on-ground technology and communication. Therefore, it is anticipated that this protocol will strengthen the research of others exploring similar complex concepts.

METHODS: A stepped-wedge, open-cohort cluster randomized controlled trial was conducted to implement Verily Connect across 12 rural Australian communities. The Verily Connect intervention delivered web-based, curated information about dementia, a localized directory of dementia services and support, group and individual chat forums, and peer support through videoconference. During the implementation phase of 32 weeks, Verily Connect was progressively implemented in four 8-weekly waves of 3 communities per wave. Usual care, used as a comparator, was available to carers throughout the study period. Participants and researchers were unblinded to the intervention. There were 3 cohorts of participants: carers, volunteers, and staff; participants were recruited from their communities. The primary outcome measure was perceived carer social support measured using the Medical Outcomes Study-Social Support Survey. Volunteers and staff provided feedback on their participation in Verily Connect as qualitative data. Qualitative data were collected from all cohorts of participants through interviews and focus groups. Process evaluation data were collected through interviews and memos written by research staff. Data on the costs of implementing Verily Connect were collected by the research team members and evaluated by a health economist.

RESULTS: Between August 2018 and September 2019, a total of 113 participants were recruited. There were 37 (32.7%) carers, 39 (34.5%) volunteers, and 37 (32.7%) health service staff. The study was complex because of the involvement of multiple and varied communities of carers, volunteers, health service staff, and research team members originating from 5 universities. Web-based technologies were used as intervention strategies to support carers and facilitate the process of undertaking the study.

CONCLUSIONS: The Verily Connect trial enabled the testing and further development of a web-based approach to increasing support for carers of people living with dementia across a diverse rural landscape in Australia. This protocol provides an example of how to conduct a pragmatic evaluation of a complex and co-designed intervention involving multiple stakeholders.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12618001213235; https://tinyurl.com/4rjvrasf.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/33023.

PMID:35588366 | DOI:10.2196/33023

J Med Internet Res. 2022 May 19;24(5):e36431. doi: 10.2196/36431.

ABSTRACT

BACKGROUND: Exposure and response prevention, a type of cognitive-behavioral therapy, is an effective first-line treatment for obsessive-compulsive disorder (OCD). Despite extensive evidence of the efficacy of exposure and response prevention (ERP) from clinical studies and in real-world samples, it is still underused as a treatment. This is likely due to the limits to access to care that include the availability of adequately trained therapists, as well as geographical location, time, and cost barriers. To address these, NOCD created a digital behavioral health treatment for OCD using ERP delivered via video teletherapy and with technology-assisted elements including app-based therapy tools and between-session therapist messaging.

OBJECTIVE: We examined treatment outcomes in a large naturalistic sample of 3552 adults with a primary OCD diagnosis who received NOCD treatment.

METHODS: The treatment model consisted of twice-weekly, live, face-to-face video teletherapy ERP for 3 weeks, followed by 6 weeks of once-weekly brief video teletherapy check-ins for 30 minutes. Assessments were conducted at baseline, at midpoint after completion of 3 weeks of twice-weekly sessions, and at the end of 6 weeks of brief check-ins (endpoint). Longitudinal assessments were also obtained at 3, 6, 9, and 12 months after endpoint.

RESULTS: Treatment resulted in clinically and statistically significant improvements, with a 43.4% mean reduction in obsessive-compulsive symptoms (g=1.0; 95% CI 0.93 to 1.03) and a 62.9% response rate. Treatment also resulted in a 44.2% mean reduction in depression, a 47.8% mean reduction in anxiety, and a 37.3% mean reduction in stress symptoms. Quality of life improved by a mean of 22.7%. Reduction in OCD symptoms and response rates were similar for those with mild, moderate, or severe symptoms. The mean duration of treatment was 11.5 (SD 4.0) weeks, and the mean total therapist time was 10.6 (SD 1.1) hours. Improvements were maintained at 3, 6, 9, and 12 months.

CONCLUSIONS: In this sample, representing the largest reported treated cohort of patients with OCD to date, video teletherapy treatment demonstrated effectiveness in reducing obsessive-compulsive and comorbid symptoms and improved quality of life. Further, it achieved meaningful results in less than half the total therapist time compared with standard once-weekly outpatient treatment, an efficiency that represents substantial monetary and time savings. The effect size was large and similar to studies of in-person ERP. This technology-assisted remote treatment is readily accessible for patients, offering an advancement in the field in the dissemination of effective evidence-based care for OCD.

PMID:35587365 | DOI:10.2196/36431

J Healthc Eng. 2022 May 9;2022:3733218. doi: 10.1155/2022/3733218. eCollection 2022.

ABSTRACT

BACKGROUND: The relationship between hamstring flexibility and the risk of OSD continues to be a debate, and whether hamstring stretching exercises should be considered as one of the conservative treatments of OSD is still unclear.

OBJECTIVES: To investigate the relationship between hamstring flexibility and the risk of OSD by assessing the changes of loading on the tibial tuberosity caused by the changes of hamstring optimal lengths.

METHODS: Experimental data of a young adult running at 4 m/s were used, which were collected by an eight-camera motion capture system together with an instrumented treadmill. Muscle forces were estimated in OpenSim when hamstring optimal lengths changed in the range of 70-130% of the control case in 5% increments. The force and accumulated force of quadriceps muscle were calculated to evaluate the impact of hamstring optimal lengths on the loading on tibial tuberosity. The changes in muscle forces throughout the gait cycle were compared by using statistical parametric mapping (SPM). The average peak force and accumulated force of five gait cycles were compared.

RESULTS: Although the maximum force of the quadriceps muscle was slightly affected by changes in hamstring optimal lengths, the accumulated force of quadriceps muscle increased by 21.97% with hamstring optimal lengths decreased by 30% of the control case. The increase of the muscle force mainly occurred in the early stance phase and terminal swing phase (P < 0.05). However, when hamstring optimal lengths were longer than the control, it had a little effect on accumulated force of quadriceps muscle.

CONCLUSIONS: The results of this study indicate that a shorter hamstring optimal length, which means lack of flexibility, can cause a high accumulated force on tibial tuberosity, thus increasing the risk of OSD. Hamstring stretching exercise is only effective for people with lack of hamstring flexibility.

PMID:35586681 | PMC:PMC9110230 | DOI:10.1155/2022/3733218

Clin Med (Lond). 2022 May;22(3):197-202. doi: 10.7861/clinmed.2021-0512.

ABSTRACT

BACKGROUND: There is a lack of data on the safety of providing oxygen at home to stable patients recovering from COVID-19.

METHODS: A retrospective analysis of patients discharged to a COVID-19 virtual ward (CVW) between January 2021 and March 2021 at a UK district general hospital was performed. Patients with improving clinical trajectories and oxygen requirements up to 4 L/minute were eligible. Outcomes measured were 30-day mortality and readmission rate.

RESULTS: From 02 January 2021 to 16 March 2021 (74 days), 147 patients discharged to the CVW were included: 71 received continuous or ambulatory oxygen, and 76 received pulse oximetry monitoring only. Five patients were readmitted within 30 days and two patients died. There were no significant differences between readmission and mortality rates between those discharged with or without oxygen.

CONCLUSION: Provision of oxygen at home for selected patients recovering from COVID-19 is safe with low risk of readmission and death.

PMID:35584838 | DOI:10.7861/clinmed.2021-0512

IEEE Trans Neural Syst Rehabil Eng. 2022 May 18;PP. doi: 10.1109/TNSRE.2022.3176410. Online ahead of print.

ABSTRACT

Powered lower-limb prostheses with vision sensors are expected to restore amputees' mobility in various environments with supervised learning-based environmental recognition. Due to the sim-to-real gap, such as real-world unstructured terrains and the perspective and performance limitations of vision sensor, simulated data cannot meet the requirement for supervised learning. To mitigate this gap, this paper presents an unsupervised sim-to-real adaptation method to accurately classify five common real-world (level ground, stair ascent, stair descent, ramp ascent and ramp descent) and assist amputee's terrain-adaptive locomotion. In this study, augmented simulated environments are generated from a virtual camera perspective to better simulate the real world. Then, unsupervised domain adaptation is incorporated to train the proposed adaptation network consisting of a feature extractor and two classifiers is trained on simulated data and unlabeled real-world data to minimize domain shift between source domain (simulation) and target domain (real world). To interpret the classification mechanism visually, essential features of different terrains extracted by the network are visualized. The classification results in walking experiments indicate that the average accuracy on eight subjects reaches (98.06% ± 0.71%) and (95.91% ± 1.09%) in indoor and outdoor environments respectively, which is close to the result of supervised learning using both type of labeled data (98.37% and 97.05%). The promising results demonstrate that the proposed method is expected to realize accurate real-world environmental classification and successful sim-to-real transfer.

PMID:35584064 | DOI:10.1109/TNSRE.2022.3176410

Curr Dev Nutr. 2022 May 13;6(5):nzac041. doi: 10.1093/cdn/nzac041. eCollection 2022 May.

ABSTRACT

BACKGROUND: Reduced health and nutrition services as a result of coronavirus disease 2019 (COVID-19) measures endanger children's well-being. The Bangladesh Rajshahi Division of Maternal and Child Nutrition (BRDMCN; 2018-2020) involving social behavior change communication (SBCC) and an economic development (ED) of asset transfer was implemented.

OBJECTIVES: This study describes how the implementation modality of the BRDMCN was adapted, and changes in the program's short/intermediate-term outcomes during the COVID-19 pandemic compared with pre-pandemic.

METHODS: The following evaluation components were assessed: 1) program fidelity, 2) program reach, 3) program acceptance, 4) perceived influence of COVID-19, and 5) short-term outcomes over the 3 y. We compared the first 2 y ("pre-COVID-19," from April 2018 through December 2019) and the final year ("during COVID-19," from January to December 2020) for all components except for (3) and (4). Data were collected through multiple sources: reviews of program annual progress reports, monitoring records of SBCC and ED programs, and cohort surveys (n = 1094).

RESULTS: The percentage dose delivery of activities decreased from 66.7-118% at pre-COVID-19 to 0-90% during COVID-19. The SBCC programs were altered to reduce the frequency of activities as well as the number of participants per session. The ED program involving large group meetings was modified to include within-member meetings, individual visits of community facilitators, or virtual discussions. Production activity using received assets continued during the pandemic, with no significant reduction compared with pre-COVID-19. The percentage of children recovering from underweight after 30 d of a Positive deviance/Hearth (PD/Hearth) session, a component of the SBCC program, remained constant at 16.5-20.3 percentage points before and during the COVID-19 pandemic.

CONCLUSIONS: Program activities were scaled back and changed due to the pandemic. The BRDMCN maintained asset management and the degree of short-term outcomes over the course of a 3-y project. Further study is required to determine whether adaptive program management would achieve the long-term expected impact at a population level.

PMID:35582237 | PMC:PMC9098368 | DOI:10.1093/cdn/nzac041

J Hypertens. 2022 May 17. doi: 10.1097/HJH.0000000000003205. Online ahead of print.

ABSTRACT

The coronavirus disease 2019 pandemic caused an unprecedented shift from in person care to delivering healthcare remotely. To limit infectious spread, patients and providers rapidly adopted distant evaluation with online or telephone-based diagnosis and management of hypertension. It is likely that virtual care of chronic diseases including hypertension will continue in some form into the future. The purpose of the International Society of Hypertension's (ISH) position paper is to provide practical guidance on the virtual management of hypertension to improve its diagnosis and blood pressure control based on the currently available evidence and international experts' opinion for nonpregnant adults. Virtual care represents the provision of healthcare services at a distance with communication conducted between healthcare providers, healthcare users and their circle of care. This statement provides consensus guidance on: selecting blood pressure monitoring devices, accurate home blood pressure assessments, delivering patient education virtually, health behavior modification, medication adjustment and long-term virtual monitoring. We further provide recommendations on modalities for the virtual assessment and management of hypertension across the spectrum of resource availability and patient ability.

PMID:35579481 | DOI:10.1097/HJH.0000000000003205

Energy Nexus. 2022 Jun 16;6:100080. doi: 10.1016/j.nexus.2022.100080. Epub 2022 May 12.

ABSTRACT

The novel coronavirus 2019 is spreading around the world and causing serious concern. However, there is limited information about novel coronavirus that hinders the design of effective drug. Bioactive compounds are rich source of chemo preventive ingredients. In our present research focuses on identifying and recognizing bioactive chemicals in Lantana camara, by evaluating their potential toward new coronaviruses and confirming the findings using molecular docking, ADMET, network analysis and dynamics investigations.. The spike protein receptor binding domain were docked with 25 identified compounds and 2,4-Ditertbutyl-phenol (-6.3kcal/mol) shows highest docking score, its interactions enhances the increase in binding and helps to identify the biological activity. The ADME/toxicity result shows that all the tested compounds can serve as inhibitors of the enzymes CYP1A2 and CYP2D6. In addition, Molecular dynamics simulations studies with reference inhibitors were carried out to test the stability. This study identifies the possible active molecules against the receptor binding domain of spike protein, which can be further exploited for the treatment of novel coronavirus 2019. The results of the toxicity risk for phytocompounds and their active derivatives showed a moderate to good drug score.

PMID:35578668 | PMC:PMC9095257 | DOI:10.1016/j.nexus.2022.100080

Am J Trop Med Hyg. 2022 May 16:tpmd211164. doi: 10.4269/ajtmh.21-1164. Online ahead of print.

ABSTRACT

The second conference of the Nigerian Bioinformatics and Genomics Network (NBGN21) was held from October 11 to October 13, 2021. The event was organized by the Nigerian Bioinformatics and Genomics Network. A 1-day genomic analysis workshop on genome-wide association study and polygenic risk score analysis was organized as part of the conference. It was organized primarily as a research capacity building initiative to empower Nigerian researchers to take a leading role in this cutting-edge field of genomic data science. The theme of the conference was "Leveraging Bioinformatics and Genomics for the attainments of the Sustainable Development Goals." The conference used a hybrid approach-virtual and in-person. It served as a platform to bring together 235 registered participants mainly from Nigeria and virtually, from all over the world. NBGN21 had four keynote speakers and four leading Nigerian scientists received awards for their contributions to genomics and bioinformatics development in Nigeria. A total of 100 travel fellowships were awarded to delegates within Nigeria. A major topic of discussion was the application of bioinformatics and genomics in the achievement of the Sustainable Development Goals (SDG3-Good Health and Well-Being, SDG4-Quality Education, and SDG 15-Life on Land [Biodiversity]). In closing, most of the NBGN21 conference participants were interviewed and interestingly they agreed that bioinformatics and genomic analysis of African genomes are vital in identifying population-specific genetic variants that confer susceptibility to different diseases that are endemic in Africa. The knowledge of this can empower African healthcare systems and governments for timely intervention, thereby enhancing good health and well-being.

PMID:35576945 | DOI:10.4269/ajtmh.21-1164

Neurorehabil Neural Repair. 2022 May 16:15459683221100510. doi: 10.1177/15459683221100510. Online ahead of print.

ABSTRACT

BACKGROUND: Cognitive and motor function must work together quickly and seamlessly to allow us to interact with a complex world, but their integration is difficult to assess directly. Interactive technology provides opportunities to assess motor actions requiring cognitive control.

OBJECTIVE: To adapt a reverse reaching task to an interactive robotic platform to quantify impairments in cognitive-motor integration following stroke.

METHODS: Participants with subacute stroke (N=59) performed two tasks using the Kinarm: Reverse Visually Guided Reaching (RVGR) and Visually Guided Reaching (VGR). Tasks required subjects move a cursor "quickly and accurately" to virtual targets. In RVGR, cursor motion was reversed compared to finger motion (i.e., hand moves left, cursor moves right). Task parameters and Task Scores were calculated based on models developed from healthy controls, and accounted for the influence of age, sex, and handedness.

RESULTS: Many stroke participants (86%) were impaired in RVGR with their affected arm (Task Score > 95% of controls). The most common impairment was increased movement time. Seventy-three percent were also impaired with their less affected arm. The most common impairment was larger initial direction angles of reach. Impairments in RVGR improved over time, but 71% of participants tested longitudinally were still impaired with the affected arm ∼6 months post-stroke. Importantly, although 57% were impaired with the less affected arm at 6 months, these individuals were not impaired in VGR.

CONCLUSIONS: Individuals with stroke were impaired in a reverse reaching task but many did not show similar impairments in a standard reaching task, highlighting selective impairment in cognitive-motor integration.

PMID:35576434 | DOI:10.1177/15459683221100510

J Pediatr Endocrinol Metab. 2022 May 16. doi: 10.1515/jpem-2022-0104. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate if digital approaches can ameliorate the known consequences of social-distancing restrictions in the context of the global COVID-19 pandemic for adolescent participants originally registered for a face-to-face outpatient weight regulation program and whether video-based multiprofessional outpatient obesity therapy is successful for a group of adolescents with preexisting obesity.

METHODS: The certified KiCK outpatient training program for children and adolescents with overweight and obesity was remodeled as a consequence of the lockdown traditional face-to-face program to a completely digital and video-based format on short notice. The virtual approach was compared with the results of the conventional program regarding metabolic parameters, body mass index standard deviation score (BMI SDS), well-being, and physical fitness.

RESULTS: Sixty-nine of 77 enrolled participants for KiCK (age 8 to 17 years, BMI z score >2.0) were able and willing to participate virtually. After the first lockdown significant improvements of BMI SDS (mean 0.18; p=0.02), homeostasis model assessment (HOMA) index (mean 1.4; p=0.016), triglycerides (mean 0.18 mmol/dL; p=0.021), 6 minute-walk-test (mean 97.0 m; p=0.030, and well-being according to the World Health Organization 5 (WHO-5) questionnaire (mean 2.5; p=0.002) were found after the virtual intervention, which was comparable to the results observed previously in matched pairs data from the program during the pre-COVID period. After the end of the second lockdown weight SDS, BMI SDS, HOMA INDEX, and cholesterol were also measured reduced compared to baseline parameters measured before program initiation. Walking distance in the 6 MWT and improvement in general well-being in the WHO-5 questionnaire also persisted.

CONCLUSIONS: These results indicate good acceptance and efficacy of the video-intervention for youth with overweight and obesity during the lockdown, supporting the use of virtual modules in future programs after the pandemic.

PMID:35575788 | DOI:10.1515/jpem-2022-0104

Appl Bionics Biomech. 2022 May 5;2022:5751488. doi: 10.1155/2022/5751488. eCollection 2022.

ABSTRACT

Musculoskeletal disorders (MSDs) of the upper extremities and computer use are common in modern societies, and both show a growing trend. This study was conducted to determine the posture and 3D moments of wrist and elbow joints at different keyboard distances on a desk. Twelve healthy right-handed male volunteers attended the motion analysis laboratory. A keyboard was placed at three different distances from the participants' bodies while performing a standard computer task. The workstation was adjusted according to ANSI/HFES-100-2007 standard for each participant to maintain a comfortable ergonomic posture for controlling confounding variables. Qualisys motion capture system, OpenSim (Ver. 4.1), and visual analog scale were used to collect and analyze the data. The highest levels of wrist flexion and radial deviation as well as elbow flexion and pronation were observed when the keyboard was at the edge of the desk. When the keyboard was 8 cm away from the edge of the desk, the right wrist flexion and radial deviation decreased 83% and 89%, respectively. In the left wrist, flexion and radial deviation decreased 94%. With increasing the distance of the keyboard from the edge of the desk, the right elbow flexion, pronation, and left elbow flexion decreased, 95%, 76%, and 85%, respectively. No significant difference was found for the left elbow pronation, wrist, and elbow joint moments, in the studied keyboard distances. However, a cut-off point has to be specified because large keyboard distances cause high extension and flexion of the limbs. The keyboard position relative to the body is an important parameter in computer work and has a significant impact on the posture of the upper extremities. A keyboard should be located at a distance that allows the upper extremities to remain in a neutral position so that the risk of MSDs is reduced.

PMID:35572063 | PMC:PMC9098337 | DOI:10.1155/2022/5751488

Can Med Educ J. 2022 May 3;13(2):92-95. doi: 10.36834/cmej.73098. eCollection 2022 May.

ABSTRACT

World Café is a methodology where small groups of participants rotate around tables for spirited conversations. It creates an environment for sharing and exchange. Learning about Indigenous healthcare is ideally suited to an intimate discussion format. Adapting the World Café to a virtual platform allowed us to connect disparate learners, encourage peer-to-peer learning, and address inequities in curriculum exposure to different patient groups. Owing to the safe environment, there can be surprising findings too. In our case, participants identified unconscious biases and recognized the program as a new learning opportunity. Try it and see!

PMID:35572024 | PMC:PMC9099175 | DOI:10.36834/cmej.73098

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 May 15;36(5):525-533. doi: 10.7507/1002-1892.202202033.

ABSTRACT

OBJECTIVE: To develop a Matlab toolbox to improve the efficiency of musculoskeletal kinematics analysis while ensuring the consistency of musculoskeletal kinematics analysis process and results.

METHODS: Adopted the design concept of "Batch processing tedious operation", based on the Matlab connection OpenSim interface function ensures the consistency of musculoskeletal kinematics analysis process and results, the functional programming was applied to package the five steps for scale, inverse kinematics analysis, residual reduction algorithm, static optimization analysis, and joint reaction analysis of musculoskeletal kinematics analysis as functional functions, and command programming was applied to analyze musculoskeletal movements in large numbers of patients. A toolbox called LLMKA (Lower Limbs Musculoskeletal Kinematics Analysis) was developed. Taking 120 patients with medial knee osteoarthritis as the research object, a clinical researcher was selected using the LLMKA toolbox and OpenSim to test whether the analysis process and results were consistent between the two methods. The researcher used the LLMKA toolbox again to conduct musculoskeletal kinematics analysis in 120 patients to verify whether the use of this toolbox could improve the efficiency of musculoskeletal kinematics analysis compared with using OpenSim.

RESULTS: Using the LLMKA toolbox could analyze musculoskeletal kinematics analysis in a large number of patients, and the analysis process and results were consistent with the use of OpenSim. Compared to using OpenSim, musculoskeletal kinematics analysis was completed in 120 patients using the LLMKA toolbox with only 2 operations were needed to enter the patient body mass data, operating steps decreased by 99.19%, total analysis time by 66.84%, and manual participation time by 99.72%, just need 0.079 1 hour (4 minutes and 45 seconds).

CONCLUSION: The LLMKA toolbox can complete a large number of musculoskeletal kinematics analysis in patients with one click in a way that is consistent in process and results with using OpenSim, reducing the total time of musculoskeletal kinematics analysis, and liberating clinical researchers from cumbersome steps, making more energy into the clinical significance of musculoskeletal kinematics analysis results.

PMID:35570624 | PMC:PMC9108656 | DOI:10.7507/1002-1892.202202033

Int Breastfeed J. 2022 May 15;17(1):38. doi: 10.1186/s13006-022-00478-5.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has significantly altered how breastfeeding support is provided, resulting in mixed breastfeeding outcomes and experiences for mothers. The World Health Organization has consistently supported breastfeeding from the beginning of the pandemic. However, recommendations from obstetrical and gynaecological societies within individual countries have varied in their alignment with this guidance, resulting in inconsistent recommendations. It is unknown how breastfeeding guidelines, maternal breastfeeding experiences, and breastfeeding initiation and duration compared across five Western countries. The current study is comprised of two parts, each with a different objective. Part One objective: to review pandemic-related changes in professional society guidelines on breastfeeding support in Australia, New Zealand, Canada, the United Kingdom, and the United States; and Part Two objective: to conduct a narrative review to summarize the evidence of how the pandemic has changed breastfeeding initiation, duration, and mothers' breastfeeding experiences during the pandemic in these five countries and provide recommendations for clinical lactation support.

METHODS: We searched for indicators that are impactful on breastfeeding outcomes: skin-to-skin contact, rooming in, direct breastfeeding and breast washing, in the five countries mentioned above and compared these to the recommendations from the World Health Organization. Next, we conducted a narrative review of the literature from these five countries to explore how the pandemic altered breastfeeding outcomes and used this information to provide suggestions for clinical practice moving forward.

RESULTS: Recommendations on the four practices above differed by country and were not always in alignment with the World Health Organization recommendations. Mother-infant separation after birth in the United States was associated with a lower prevalence of breastfeeding initiation and duration. While some mothers reported positive breastfeeding experiences during the pandemic, many mothers indicated negative experiences related to decreased social and professional support.

CONCLUSIONS: The pandemic can inform practice recommendations and can be viewed as an opportunity to permanently modify existing methods to support breastfeeding families. The use of virtual care increased during the pandemic and should continue with specific considerations for prioritizing in-person care. This will help to provide more timely and accessible support for breastfeeding mothers.

PMID:35570307 | PMC:PMC9107585 | DOI:10.1186/s13006-022-00478-5

Nurse Educ Today. 2022 Apr 30;114:105385. doi: 10.1016/j.nedt.2022.105385. Online ahead of print.

ABSTRACT

OBJECTIVES: Bibliometrics is an emerging science in nursing. Quantitative methods were used to conduct a bibliometric analysis of highly cited virtual simulation nursing education articles to describe rank order, breadth of topics and authorship patterns.

DESIGN AND DATA SOURCES: A desktop analysis of publication performance was conducted using the Scopus database as the source of article citation data.

RESULTS AND DISCUSSION: The top 100 cited articles clustered over 14-years, 2008 to 2021. Citations per paper ranged from 88 to a low of 3 (median 18, mean 22.1) and in the top 10 studies, from 88 to 41. The citation trajectory was moderately correlated with article maturity (r = -.384, p ≤0.001). Article citations in subsequent publications commenced the first year after publication and three-year-old papers reached the mean citation rate of 22. Nurse Education Today was the most cited journal. There was no significant impact of article type (72% primary research, 17% literature reviews, 11% descriptive papers) (p = 0.755). International representation was strong, as first authors in 21 countries were cited - many (43%) from USA. One highly cited author (M. Verkuyl) from Canada led six papers, with six other authors each leading two studies. Virtual simulation modalities included virtual simulation, virtual reality simulation, 3D virtual reality simulation, virtual games and virtual worlds. The top 10 articles offer a diverse resource for faculty and educators who wish to consider using virtual simulation.

CONCLUSION: Virtual simulation studies in nursing education cover an emerging field of research that has relatively low citation rates. Nursing researchers and faculty need to understand the usefulness and limitations of bibliometric analysis as this methodology can make a unique contribution to research, policy, and funding decisions, and enable productivity assessments of faculty staff and departments.

PMID:35569265 | DOI:10.1016/j.nedt.2022.105385

Eye (Lond). 2022 May 14:1-3. doi: 10.1038/s41433-022-02084-5. Online ahead of print.

NO ABSTRACT

PMID:35568784 | PMC:PMC9107008 | DOI:10.1038/s41433-022-02084-5

Trends Cardiovasc Med. 2022 May 11:S1050-1738(22)00071-8. doi: 10.1016/j.tcm.2022.05.004. Online ahead of print.

ABSTRACT

The recent pandemic launched an acceleration in adopting telemedicine by cardiovascular health and triggered the flourishing of technological advancements, such as the metaverse, which is a novel interactive mix of digital worlds that leverages augmented reality with virtual reality. The CardioVerse represents a theoretical term for the embracement of the metaverse by cardiovascular medicine, encompassing the endless possibilities as well as the challenges that it holds and introduces new dimensions to disease education, prevention and diagnosis. Its applications are numerous, notably in enhancing medical visits, assisting cardiovascular interventions and reshaping the way medical education is provided. Although obstacles are expected in diverse domains such as security, technical, legislative and regulatory, the utilization of non-fungible tokens as a security asset for patient data appears as potential solution.

PMID:35568263 | DOI:10.1016/j.tcm.2022.05.004

J Glob Health. 2022 May 14;12:04034. doi: 10.7189/jogh.12.04034.

ABSTRACT

BACKGROUND: Low- and middle-income countries face distinct challenges in providing health care services and training. The community of practice (CoP) has been described as a method of facilitating much-needed connections and conversations on this topic and has been adapted over time to include virtual CoPs. We describe the development and evaluation of a global Clinical Lead Forum (CLF) using a CoP framework to structure informal continuing professional development (CPD) and enhance the capacity of health care professionals in low- and middle-income countries.

METHODS: Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI) and its network of affiliated, independent non-governmental organizations (NGOs) provide paediatric and maternal health care for vulnerable populations around the world. We established virtual sessions across the network to discuss clinical topics, which evolved based on the need to include a COVID-19 series. We collected demographic, participation, participant and facilitator assessments, as well as leadership notes from each session as part of an educational quality improvement study. We developed and evaluated the program using the Logic Model and used the Kirkpatrick Model to assess learning outcomes.

RESULTS: A total of 299 unique participants engaged in sessions, representing a total of 10 disciplines. There were a total of 1295 participants who joined for the 11 sessions in the regular CLF series and the 23 sessions in the COVID-19 series. Survey responses were overall consistent with a value-added intervention.

CONCLUSIONS: The CLF, via both the regular sessions and the COVID-19 series, served as an impactful global health CoP for CPD. By focusing on creating a safe and inviting space, ensuring equity and inclusion, activating champions, fostering engagement, and promoting innovation and adaptability, this program decreased professional isolation, strengthened peer relationships, and enhanced the knowledge and practices of health care professionals. Our model may be scaled to other systems across the world to bridge divides and create similarly meaningful communities.

PMID:35567589 | PMC:PMC9107096 | DOI:10.7189/jogh.12.04034

Cancers (Basel). 2022 Apr 26;14(9):2147. doi: 10.3390/cancers14092147.

ABSTRACT

Randomized controlled trials (RCT) are the driver of therapeutic innovations. However, it has been frequently shown that less than 5% of adult cancer patients enroll in clinical trials, although 70% of patients are considered as being willing to participate. Barriers to trial participation have been extensively studied. Although there is evidence that trial participation correlates with improved survival and reduced mortality, the rate of participation has not changed substantially. We provide retrospective data from a single-center analysis of 411 patients with multiple myeloma (MM) who were treated at the University Hospital Duesseldorf in Germany between January 2014 and December 2016. Each patient was analyzed for the real-world possibility of participating in a clinical study, based on the inclusion and exclusion (I/E) criteria and the recruiting period of open studies. The overall rate of study participation was 19%. A total of 53% of NDMM patients were eligible for first-line studies (GMMG-HD6, LenaMain). Of these, 80% consented to enrolment (42% of all). In contrast, only 38% of the RRMM population was eligible (GMMG-Relapse, Castor, Tourmaline, Admyre). Of these, only 22% (7% of all) consented. This was confirmed by virtual analysis, showing that only 29% of all RRMM patients would have been eligible for six internationally recruiting trials leading to later drug approval. The majority of cases were rendered ineligible by only one I/E criterion. The most common criteria were study-specific (prior therapies or refractory disease to a specific drug), kidney disease, and previous malignancy, followed by internal, neurologic, and infectious disease. In summary, this single-center analysis showed that I/E criteria permit study participation for most NNDM patients, with a dramatic decrease in the RRMM population. This is aggravated by the fact that the willingness for study participation also significantly declines in RRMM. Thus, addressing patient expectations and priorities seems to be the most promising approach to increasing patient enrollment in clinical trials.

PMID:35565276 | PMC:PMC9106039 | DOI:10.3390/cancers14092147

Int J Environ Res Public Health. 2022 Apr 28;19(9):5389. doi: 10.3390/ijerph19095389.

ABSTRACT

There was a surge in psychological distress and emotional burnout during the COVID-19 pandemic. Virtual reality (VR) is helpful as a psychological intervention whilst maintaining physical or social distancing. The present systematic review assessed the role of VR as a psychological intervention tool for mental health problems during the COVID-19 pandemic. We conducted a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This study used the search-related terms: (Virtual reality OR simulated-3D-environment OR VR) AND (covid! or corona!) AND (mental* OR psychologic* OR well* OR health*) AND (intervention) on six databases, i.e., MEDLINE, PsycINFO, Ovid Medline, EMBASE, ACM digital library, and Cochrane Central Register of Controlled Trials (CENTRAL) from the inception date until 23 June 2021. We finally included four studies in the systematic review out of the 379 references imported for screening. These studies reveal that VR is beneficial as a psychological tool for intervention in individuals with mental health problems. Immersed in the telepresence, interacting in a 3-D format compared to a 2-D layout, having a sense of enjoyment and engagement, activating an affective-motivational state, "escaping" to a virtual from the real world are pivotal faucets of VR as a psychological tool for intervention.

PMID:35564784 | PMC:PMC9102209 | DOI:10.3390/ijerph19095389

J Biomech. 2022 Apr 27;138:111104. doi: 10.1016/j.jbiomech.2022.111104. Online ahead of print.

ABSTRACT

Upper-limb rehabilitation therapy sessions for post-stroke people generally contain rhythmic hand movements in a tiresome manner to rebuild the injured neural circuits. Fatigue formation causes breaks in the training and limits the therapy duration. Therefore, it is essential to establish a correlation between the patient's muscle condition and the rehabilitation exercises to improve the physiotherapy sessions. A self-adapting control method based on online fatigue detection in rhythmic arm movements is presented. Experimental tests were performed on twenty healthy subjects to validate the method's feasibility. Electromyography (EMG) and force signals considered the interfaces between users and the robot. In the first stage of the experiment, utilizing the frequency features from EMG signals, a neural network for fatigue detection trained; however, in the end, it substituted with a simple function as a refinement in the time-consuming aspect for the online employment. The initiation of the fatigue process is followed by reducing the admittance controller damping term based on the EMG signal processing. Trajectory tracking with the robot employs the self-adapting admittance controller (SAAC) method and the non-adapting admittance controller (NAAC). Movement accuracy and smoothness were measured and showed a better performance of the SAAC method related to the NAAC. Simulations with two different stiffness levels were performed on an upper-limb OpenSim model to study a stroke-injured arm and evaluate the proposed method's proficiency. The metabolic cost indicated the movement's superiority in a fatigue situation for reduced environment stiffness.

PMID:35561557 | DOI:10.1016/j.jbiomech.2022.111104

Proc Natl Acad Sci U S A. 2022 May 17;119(20):e2204067119. doi: 10.1073/pnas.2204067119. Epub 2022 May 13.

NO ABSTRACT

PMID:35561221 | DOI:10.1073/pnas.2204067119

J Cancer Policy. 2021 Sep;29:100298. doi: 10.1016/j.jcpo.2021.100298. Epub 2021 Jul 17.

ABSTRACT

BACKGROUND: Gynecologic malignancies represent a significant proportion of the increasing cancer burden in Zambia. The care and outcomes of cancer patients improves in a multidisciplinary team but insufficient coordination in weak health systems is a barrier to this model of care. The World Health Organization (WHO) identifies digital health interventions as tools to bridge the gap between challenges and health systems' goals in low resource environments. A low-cost innovative virtual interaction system (VIS) was integrated into the gynecologic oncology multidisciplinary tumor board to enhance patient navigation and management.

METHODS: Paper-based forms used by each specialist group participating in the tumor board were collected and placed on a digital platform. Tumor board members were interviewed to assess their acceptability of the new digital modules and ensure correct nomenclature was being used for data entry. This was followed by an orientation and launch of VIS.

RESULTS: For a 12-week period following the launch, 197 gynecologic oncology patients were registered at the Zambian national cancer center (Cancer Diseases Hospital), of which 130 were entered in the VIS, and of those less than half had management decisions recorded. The median time from first visit to simulation for radiotherapy was 52 days; from simulation to start of treatment 102.5 days. Eighteen (14 %) of the 130 patients entered into the VIS were recorded as lost to follow up.

CONCLUSION: The introduction and implementation of a digital intervention for navigation and management of gynecologic patients in a low resource environment proved both feasible and acceptable. It provides an instant easily accessible platform for important information on time intervals and delays in the patient pathway. End user orientation and support is an integral part to its successful integration and consistent management of the data is required to maximize its impact on efficiency, effectiveness and patient care.

PMID:35559948 | DOI:10.1016/j.jcpo.2021.100298

PLoS One. 2022 May 12;17(5):e0267511. doi: 10.1371/journal.pone.0267511. eCollection 2022.

ABSTRACT

INTRODUCTION: In support of global targets to end HIV/AIDS and tuberculosis (TB) by 2030, we reviewed interventions aiming to improve TB case-detection and anti-TB treatment among people living with HIV (PLHIV) and HIV testing and antiretroviral treatment initiation among people with TB disease in low- and middle-income countries (LMICs).

METHODS: We conducted a systematic review of comparative (quasi-)experimental interventional studies published in Medline or EMBASE between January 2003-July 2021. We performed random-effects effect meta-analyses (DerSimonian and Laird method) for interventions that were homogenous (based on intervention descriptions); for others we narratively synthesized the intervention effect. Studies were assessed using ROBINS-I, Cochrane Risk-of-Bias, and GRADE. (PROSPERO #CRD42018109629).

RESULTS: Of 21,516 retrieved studies, 23 were included, contributing 53 arms and 84,884 participants from 4 continents. Five interventions were analyzed: co-location of test and/or treatment services; patient education and counselling; dedicated personnel; peer support; and financial support. A majority were implemented in primary health facilities (n = 22) and reported on HIV outcomes in people with TB (n = 18). Service co-location had the most consistent positive effect on HIV testing and treatment initiation among people with TB, and TB case-detection among PLHIV. Other interventions were heterogenous, implemented concurrent with standard-of-care strategies and/or diverse facility-level improvements, and produced mixed effects. Operational system, human resource, and/or laboratory strengthening were common within successful interventions. Most studies had a moderate to serious risk of bias.

CONCLUSIONS: This review provides operational clarity on intervention models that can support early linkages between the TB and HIV care cascades. The findings have supported the World Health Organization 2020 HIV Service Delivery Guidelines update. Further research is needed to evaluate the distinct effect of education and counselling, financial support, and dedicated personnel interventions, and to explore the role of community-based, virtual, and differentiated service delivery models in addressing TB-HIV co-morbidity.

PMID:35552547 | PMC:PMC9098064 | DOI:10.1371/journal.pone.0267511

World Neurosurg. 2022 May 9:S1878-8750(22)00586-1. doi: 10.1016/j.wneu.2022.04.132. Online ahead of print.

ABSTRACT

BACKGROUND: The Tubridge flow diverter (FD) is a novel device aimed at reconstructing the parent artery and eliminating the aneurysm. Numerical simulations based on virtual FD deployment allow the assessment of the complex nature of aneurismal flow changes before the actual intervention but are demanding on computational resources. Here, we evaluate an alternative strategy of modeling FD effects for the Tubridge system using a porous medium. The goal of this study is to reduce demands on time and complexity of the simulation procedure for applications in clinical research.

METHODS: Ten patient-specific aneurysm models were reconstructed from retrospectively collected diagnostic 3D-DSA images. Virtual FDs were deployed (SolidWorks, Meshmixer) and corresponding porous medium patches were constructed at the ostium with a research CFD prototype (Siemens Healthineers, Forchheim, Germany). Hemodynamic conditions were simulated in two approaches.

RESULTS: Hemodynamics inside the aneurysm based on these two approaches were compared. Both approaches yielded similar results. Mean wall shear stress (WSS) and mean pressure of the aneurysmal wall correlated significantly (r=0.8, r=1.0, p-value<0.05) as did mean velocity, mean pressure at a region inside the aneurysm, at the ostium and at a cross section containing the main vertex (for velocities r=0.9; for pressures r=1.0, p-value<0.05). The use of porous medium patches reduced the preparation and simulation time together by approximately 50%.

CONCLUSION: Using a porous medium approach yields comparable mean values for hemodynamic alterations compared to direct virtual FD simulations. Additionally, the porous medium approach greatly reduced the modeling complexity and computation time.

PMID:35552028 | DOI:10.1016/j.wneu.2022.04.132

Vaccine. 2022 May 9:S0264-410X(22)00548-5. doi: 10.1016/j.vaccine.2022.04.095. Online ahead of print.

ABSTRACT

The current WHO Recommendations to assure the quality, safety and efficacy of live attenuated yellow fever vaccines were adopted in 2010. This document recommends that vaccine virus master and working seed lots should be tested for viscerotropism, immunogenicity and neurovirulence in monkeys. A vaccine manufacturer has reported, recently, discrepancies on the clinical scoring of monkeys during assessment of working seed lots and suggested aligning neurotropism assessment of yellow fever vaccines virus seed lots with that of neurovirulence testing of polio vaccines virus seed lots. In this approach, clinical signs are recorded but do not form part of the assessment or pass/fail criteria. At its 71^st meeting in August 2020, the ECBS agreed to establish a drafting group and to consult with manufacturers and other stakeholders on the proposed amendment. Then a survey had been conducted to seek opinions of stakeholders on the neurotropism testing and revision of current WHO Recommendations for yellow fever vaccines. It was recognized from the answers of the survey that the test for neurovirulence in monkeys presents several technical challenges which could be addressed in the amended version of the Recommendations. On 18-19 March 2021, a virtual WHO working group meeting was held to discuss a proposed draft of the amended text with participants of yellow fever vaccine manufacturers and relevant regulators. Overall, there was a consensus among manufacturers and regulators that clinical evaluation provides important information and should be retained as part of the neurotropism test. However, there was also agreement that the test is somewhat subjective, and that analysis can be difficult. It was recognized that there was potential for improvement in both test execution and analysis to increase harmonization between manufacturers. Alternative tests to the non-human primates neurovirulence test would be useful but it was agreed that none seem to be sufficiently developed at present. Based on these working group discussions, it was proposed that the appendix on neurotropism test to be further revised by the WHO drafting group and submitted to ECBS for review and adoption. Issues other than neurotropism test were discussed in the meeting as well. There were a number of points identified during the meeting, such as new platform of production, animal models, deep sequencing, international standards, that are outside the current recommendations that are worthy of further discussion. Therefore, it is recommended that there would be a future meeting with various stakeholders to discuss the potential revision of the whole Recommendations for yellow fever vaccines in order to meet the current needs.

PMID:35550848 | DOI:10.1016/j.vaccine.2022.04.095

Adv Med Educ Pract. 2022 May 5;13:457-465. doi: 10.2147/AMEP.S357514. eCollection 2022.

ABSTRACT

ABSTRACT: Although considerable efforts have been made to incorporate simulation-based learning (SBL) in undergraduate medical education, to date, most of the medical school curricula still focus on pure knowledge or individual assessment of objective structured clinical examination skills (OSCE). To this end, we designed a case study named "iG4 (integrated generation 4) virtual on-call (iVOC)". We aimed to simulate an on-call shift in a high-fidelity virtual hospital setting in order to assess delegates' team-based performance on tasks related to patient handovers (prioritisation, team allocation).

METHODS: A total of 41 clinical year medical students were split into 3 cohorts, each of which included 3 groups of 4 or 5 people. The groups consisted of a structured mix of educational and cultural backgrounds of students to achieve homogeneity. Each performing group received the handover for 5 patients in the virtual hospital and had to identify and deal with the acutely unwell ones within 15 minutes. We used TEAM^TM tool to assess team-based performances.

RESULTS: The mean handover performance was 5.44/10 ± 2.24 which was the lowest across any performance marker. The overall global performance across any team was 6.64/10 ± 2.11. The first rotating team's global performance for each cycle was 6.44/10 ± 2.01, for the second 7.89/10 ± 2.09 and for the third 6.78/10 ± 1.64 (p = 0.099 between groups).

CONCLUSION: This is one of the first reported, high-fidelity, globally reproducible SBL settings to assess the capacity of students to work as part of a multinational team, highlighting several aspects that need to be addressed during undergraduate studies. Medical schools should consider similar efforts with the aim to incorporate assessment frameworks for individual performances of students as part of a team, which can be a stepping-stone for enhancing safety in clinical practice.

PMID:35547870 | PMC:PMC9084906 | DOI:10.2147/AMEP.S357514

J Mol Model. 2022 May 11;28(6):144. doi: 10.1007/s00894-022-05137-4.

ABSTRACT

COVID-19 has recently grown to be pandemic all around the world. Therefore, efforts to find effective drugs for the treatment of COVID-19 are needed to improve humans' life quality and survival. Since the main protease (M^pro) of SARS-CoV-2 plays a crucial role in viral replication and transcription, the inhibition of this enzyme could be a promising and challenging therapeutic target to fight COVID-19. The present study aims to identify alkaloid compounds as new potential inhibitors for SARS-CoV-2 M^pro by the hybrid modeling analyses. The docking-based virtual screening method assessed a collection of alkaloids extracted from over 500 medicinal plants and sponges. In order to validate the docking process, classical molecular dynamic simulations were applied on selected ligands, and the calculation of binding free energy was performed. Based on the proper interactions with the active site of the SARS-CoV-2 M^pro, low binding energy, few side effects, and the availability in the medicinal market, two indole alkaloids were found to be potential lead compounds that may serve as therapeutic options to treat COVID-19. This study paves the way for developing natural alkaloids as stronger potent antiviral agents against the SARS-CoV-2.

PMID:35546368 | PMC:PMC9094126 | DOI:10.1007/s00894-022-05137-4

Diabetes Technol Ther. 2022 May 11. doi: 10.1089/dia.2022.0133. Online ahead of print.

NO ABSTRACT

PMID:35544070 | DOI:10.1089/dia.2022.0133

J Undergrad Neurosci Educ. 2021 Dec 24;20(1):A100-A110. eCollection 2021 Fall.

ABSTRACT

We designed a final semester research project that allowed students to apply the electrophysiological concepts they learned in a lab course to propose and answer experimental questions without access to laboratory equipment. We created the activity based on lesson plans from Ashley Juavinett and the Allen Institute for Brain Science (AIBS) Allen SDK online examples. An interactive graphic interface was added for students to explore and easily quantify subtle neuronal voltage changes. Before starting the final project, students had experience with conventional extracellular and intracellular recording techniques to record and analyze extracellular action potential firing patterns and intracellular resting, action, and synaptic potentials. They demonstrated their understanding of neural signal transmission in required lab reports using data they gathered before the pandemic shutdown. After students left campus, they continued to analyze data and write lab reports focused on neuronal excitability in snail and fly neurons with data supplied by the instructors. For their final project, students were challenged to answer questions addressing neuronal excitability at both the single neuron and neuronal population level by analyzing and interpreting the open-access, patch clamp recording data from the Allen Cell Types Database using code we provided (Python/Jupyter Notebook). This virtual final semester project allowed students to ask real-world medical and scientific questions from "start to end". Through this project, students developed skills to navigate an extensive online database and gained experience with coding-based data analysis. They chose neuronal populations from human and mouse brains to compare passive properties and neuronal excitability between and within brain areas and across different species and disease states. Additionally, students learned to do simple manipulations of Python code, work remotely in teams, and polish their written scientific presentation skills. This activity could complement other remote learning options such as neuronal simulations. Few online sources offer such a wealth of neuroscience data that students can use for class assignments, and even for research and keystone projects. The activity extends the traditional material often taught in upper-level neuroscience courses, with or without a laboratory section, providing a deeper understanding of the range of excitability properties that neurons express.

PMID:35540944 | PMC:PMC9053425

Washington (DC): National Academies Press (US); 2022 May 11.

ABSTRACT

To take stock of lessons learned from COVID-19 around the world and in the United States, the Forum on Microbial Threats held two virtual workshops during 2021. The first workshop focused on what it means to frame the response to COVID-19 through a "syndemic" approach, and what the implications would be for global recovery. The second workshop focused more broadly on key lessons and emerging data from ongoing pandemic response efforts that can be incorporated into current health systems to improve resilience and preparedness for future outbreaks.

This workshop explored the long-term effects of COVID-19 on health equity, including considerations for mental health and social determinants of health. It also addressed uncertainties during a pandemic, such as trust, communication, and engagement and explored approaches to systematize recovery efforts to improve the ongoing responses and prepare for the next pandemic. Experts discussed possibilities for a post-pandemic world and a response strategy for stakeholders that ensures sustained community partnerships and prioritization of health equity. This Proceedings of a Workshop summarizes the presentations and discussions from the second workshop.

PMID:35593789 | Bookshelf:NBK580469 | DOI:10.17226/26556