Feasibility and Acceptability of Mindfulness-Based Cognitive Therapy Compared with Mindfulness-Based Stress Reduction and Treatment as Usual in People with Depression and Cardiovascular Disorders: A three-arm Randomised Controlled Trial

This is the author accepted manuscript. The final version is available from Springer via the DOI in this record.Depression co-occurs in 20 % of people with cardiovascular disorders, can persist for years, and predicts worse physical health outcomes. While psychosocial treatments have been shown to treat acute depression effectively in those with comorbid cardiovascular disorders, to date, there has been no evaluation of approaches aiming to prevent relapse and treat residual depression symptoms in this group. Consequently, the current study aimed to examine the feasibility and acceptability of a randomised controlled trial design evaluating an adapted version of mindfulness-based cognitive therapy (MBCT) designed specifically for people with co-morbid depression and cardiovascular disorders. A 3-arm feasibility randomised controlled trial was conducted, comparing MBCT adapted for people with cardiovascular disorders plus treatment as usual (TAU), mindfulness-based stress reduction (MBSR) plus TAU, and TAU alone. Participants completed a set of selfreport measures of depression severity, anxiety, quality of life, illness perceptions, mindfulness, self-compassion and affect and had their blood pressure taken immediately before, after, and three months following the intervention. Those in the adapted-MBCT arm additionally underwent a qualitative interview to gather their views about the adapted intervention. 3,400 potentially eligible participants were approached when attending an outpatient appointment at a cardiology clinic or via a GP letter following a case note search. 242 (7.1 %) were interested in taking part, 59 (1.7 %) were screened as being suitable, and 33 (<1 %) were eventually randomised to the three groups. Of 11 participants randomised to adapted MBCT, seven completed the full course, levels of home mindfulness practice were high, and positive qualitative feedback about the intervention was given. Twenty-nine out of 33 randomised participants completed all the assessment measures at all three-time points. The means PHQ-9 scores for the MBCT-HeLM group were lower at post-intervention and at the three-month follow-up compared to the MBSR and TAU groups. The sample was heterogeneous in terms of whether they reported current depression or had a history of depression and the time since the onset of cardiovascular disorders (one to 25 years). The adapted MBCT intervention was feasible and acceptable to participants, however, certain aspects of the trial design were not. In particular, low recruitment rates were achieved and there was a high withdrawal rate between screening and randomisation. Moreover, the heterogeneity in the sample was high, meaning the adapted intervention was unlikely to be well tailored to all the participants needs. This suggests that if the decision is made to move to a definitive trial, study recruitment procedures will need to be revised to recruit a target sample that optimally matches the adapted intervention.This research was, in part, supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Also, the research was carried out as part of a PhD funded by King Saud University, Saudi Arabian Ministry of Higher Education

Developing a simulated intelligent instrument to measure user behavior toward cybersecurity policies

Institutions struggle to protect themselves from threats and cybercrime. Therefore, they devote much attention to improving information security infrastructures. Users’ behaviors were explored via a traditional questionnaire research instrument in a data collocate process. The questionnaire explores users’ behaviors theoretically, so the respondents’ answers to the questionnaire are insufficiently reliable, and the responses might not reflect actual behavior based on the human bias when facing theoretical problems. This study aims to solve unreliable responses to the questionnaire by developing a simulated intelligent instrument to measure users’ behaviors toward cybersecurity policies in an experimental study using gamification

A systematic review of postgraduate training programmes directed at pharmacists entering primary care

This systematic review explores the international postgraduate education and training programmes designed to provide or develop knowledge or skills focused on enabling pharmacists to work in a general practice setting. Four thousand, eight hundred and seventy-one (4,871) articles were identified from database searches of SCOPUS, EMBASE, Medline, CINAHL, IPA, Web of Science and ERIC. After removal of duplicates and article screening, seven articles were included. Educational content, setting, contact time and methods of assessment varied across all studies. There is paucity of published literature relating to the development and evaluation of education programmes directed at pharmacists entering into general practice. A combination of work and classroom-based education provided by general practitioners and pharmacists already working in primary care is deemed most beneficial coupled with systematic debriefing sessions at the completion of training courses. The findings suggest future training should focus on specific disease states.</jats:p

Isolation and identification of allergens and biogenic amines of Prosopis juliflora genotypes

Background: Prosopis, or mesquite (Prosopis juliflora (Sw.) DC.), was introduced in Saudi Arabia several decades ago and is heavily used in street, roadside, and park plantations. It shows great adaptation to the prevailing climatic conditions such as high temperature, severe drought, and salinity and spreads naturally in many parts of the Kingdom. This research was conducted to isolate allergen proteins and biogenic amines from the pollen grains of P. juliflora genotypes in Saudi Arabia from two regions, namely Al-Qassim and Eastern regions. Results: The results showed that 18 different allergen proteins were detected in P. juliflora genotypes, with molecular weight ranging from 14 to 97 kDa. Moreover, P. juliflora genotypes from the two studied regions contained eight biogenic amines, namely histamine, tyramine, tryptamine, \u3b2-phenylethylamine, butricine, codapherine, spermidine, and spermine. All genotypes from the Al-Qassim region were found to contain all eight amines, while in the Eastern region, histamine was absent in three genotypes, spermine was absent in six genotypes, and spermidine was absent in three genotypes. Genotypes B23, E20, and E21 had the lowest biogenic amine quantity. Conclusions: All identified proteins from mesquite trees from both regions (Eastern and Al-Qassim) cause allergies in patients who are sensitive to pollen grains. Bioamines, except histamine and tyramine, were recorded at varying concentrations in different genotypes

A novel digital score for abundance of tumour infiltrating lymphocytes predicts disease free survival in oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC) is the most common type of head and neck (H&N) cancers with an increasing worldwide incidence and a worsening prognosis. The abundance of tumour infiltrating lymphocytes (TILs) has been shown to be a key prognostic indicator in a range of cancers with emerging evidence of its role in OSCC progression and treatment response. However, the current methods of TIL analysis are subjective and open to variability in interpretation. An automated method for quantification of TIL abundance has the potential to facilitate better stratification and prognostication of oral cancer patients. We propose a novel method for objective quantification of TIL abundance in OSCC histology images. The proposed TIL abundance (TILAb) score is calculated by first segmenting the whole slide images (WSIs) into underlying tissue types (tumour, lymphocytes, etc.) and then quantifying the co-localization of lymphocytes and tumour areas in a novel fashion. We investigate the prognostic significance of TILAb score on digitized WSIs of Hematoxylin and Eosin (H&E) stained slides of OSCC patients. Our deep learning based tissue segmentation achieves high accuracy of 96.31%, which paves the way for reliable downstream analysis. We show that the TILAb score is a strong prognostic indicator (p = 0.0006) of disease free survival (DFS) on our OSCC test cohort. The automated TILAb score has a significantly higher prognostic value than the manual TIL score (p = 0.0024). In summary, the proposed TILAb score is a digital biomarker which is based on more accurate classification of tumour and lymphocytic regions, is motivated by the biological definition of TILs as tumour infiltrating lymphocytes, with the added advantages of objective and reproducible quantification

Mindfulness-based interventions for young offenders: a scoping review

Youth offending is a problem worldwide. Young people in the criminal justice system have frequently experienced adverse childhood circumstances, mental health problems, difficulties regulating emotions and poor quality of life. Mindfulness-based interventions can help people manage problems resulting from these experiences, but their usefulness for youth offending populations is not clear. This review evaluated existing evidence for mindfulness-based interventions among such populations. To be included, each study used an intervention with at least one of the three core components of mindfulness-based stress reduction (breath awareness, body awareness, mindful movement) that was delivered to young people in prison or community rehabilitation programs. No restrictions were placed on methods used. Thirteen studies were included: three randomized controlled trials, one controlled trial, three pre-post study designs, three mixed-methods approaches and three qualitative studies. Pooled numbers (n = 842) comprised 99% males aged between 14 and 23. Interventions varied so it was not possible to identify an optimal approach in terms of content, dose or intensity. Studies found some improvement in various measures of mental health, self-regulation, problematic behaviour, substance use, quality of life and criminal propensity. In those studies measuring mindfulness, changes did not reach statistical significance. Qualitative studies reported participants feeling less stressed, better able to concentrate, manage emotions and behaviour, improved social skills and that the interventions were acceptable. Generally low study quality limits the generalizability of these findings. Greater clarity on intervention components and robust mixed-methods evaluation would improve clarity of reporting and better guide future youth offending prevention programs

Cross-Priming Dendritic Cells Exacerbate Immunopathology After Ischemic Tissue Damage in the Heart.

BACKGROUND: Ischemic heart disease is a leading cause of heart failure and despite advanced therapeutic options, morbidity and mortality rates remain high. Although acute inflammation in response to myocardial cell death has been extensively studied, subsequent adaptive immune activity and anti-heart autoimmunity may also contribute to the development of heart failure. After ischemic injury to the myocardium, dendritic cells (DC) respond to cardiomyocyte necrosis, present cardiac antigen to T cells, and potentially initiate a persistent autoimmune response against the heart. Cross-priming DC have the ability to activate both CD4 METHODS: We induced type 2 myocardial infarction-like ischemic injury in the heart by treatment with a single high dose of the β-adrenergic agonist isoproterenol. We characterized the DC population in the heart and mediastinal lymph nodes and analyzed long-term cardiac immunopathology and functional decline in wild type and RESULTS: A diverse DC population, including cross-priming DC, is present in the heart and activated after ischemic injury. CONCLUSION: Activation of cytotoxic CD

Elevated concentrations of metal(loids) in seaweed and the concomitant exposure to humans

While the consumption of seaweed and seaweed-based products is very common amongst East Asian nations, forming a notable component of the daily diet, relatively very few studies have concerned the concentrations of heavy metals in these together with potential effects on human health. The present study analyses the concentrations of 17 elements in locally resourced seaweed, also assessing potential noncarcinogenic and carcinogenic risks. The samples were ground, homogenized, and quantified using the ICP-OES technique. It has been found that the essential elements K, Ca, Mg, Zn, and Na typically show concentrations somewhat greater than a number of potentially toxic metals, in particular, Cd, Pb, Ag, and As, with exceptions being Ni, Cr-VI, and Si. Statistical analysis indicates all of the latter to have similar origin, with increased concentration of these metals within the marine ecosystem. While the daily estimated intake of most metals is seen to be within the daily dietary allowance level recommended by various international organizations, the noncarcinogenic risk shows a value greater than unity, estimated via the hazard quotient. This indicates a potential for adverse effects to health arising from consumption of the sampled seaweed. The carcinogenic risk resulting from nonessential elements shows values greater than the United States Environmental Protection Agency (US-EPA) reference limit of 10−4 . Considering the nonbiodegradability of heavy metals and metalloids and their potential accumulation in seaweed, there is need for critical examination of metal levels in the seaweeds obtained from the present study locations, together with the introduction of practices of removal of heavy metals via bio-adsorbent techniques

Overview On Surgical Management Of Overactive Bladder

Overactive bladder syndrome is a persistent and incapacitating disorder that has profound medical, psychological, and social implications, greatly impacting the wellbeing of countless individuals globally. A significant number of individuals experience urine urgency, which can be extremely bothersome. The primary indicator of overactive bladder (OAB) is a sense of urgency, often accompanied by increased urine frequency and nocturia. After ruling out other medical conditions with similar symptoms, the initial approach to managing OAB is providing guidance on fluid consumption and bladder training. If needed, antimuscarinic medicines may be added as a supplement. If patients have significant distress from OAB symptoms even after maximizing medicinal treatment, they may choose to undergo invasive procedures. There is currently a limited understanding of the hierarchical structure of central nervous system control. However, the use of functional imaging is starting to reveal the difficulties that need to be addressed in this area. Current research is exploring the use of botulinum neurotoxin-A injection, oral β3-adrenergic agonists, and innovative methods for nerve stimulation as potential therapies. The inherent subjectivity of urine urgency, the absence of animal models, and the complex pathophysiology of overactive bladder (OAB) pose substantial obstacles to achieving effective clinical therapy

How Different Preparation Techniques Affect MRI-Induced Anxiety of MRI Patients: A Preliminary Study

Background: Magnetic resonance imaging (MRI) exams may cause patients to feel anxious before or during the scan, which affects the scanning outcome and leads to motion artifacts. Adequate preparation can effectively alleviate patients’ anxiety before the scan. We aimed to assess the effect of different preparation methods on MRI-induced anxiety: We conducted a prospective randomized study on MRI patients between March and May 2022. We divided 30 patients into two groups: the control group, which received routine preparation (RP), and the experimental group, which received video preparation (VP).We used the State-Trait Anxiety Inventory (STAI) to measure anxiety levels before and after the interventions. We assessed patients’ self-satisfaction after the scan: After preparation, VP (STAI mean = 10.7500) and RP (STAI mean = 12.7857), we observed a significant association between the pre- and post-STAI results in VP (p = 0.025). The effects of both methods in decreasing anxiety were more significant for first-timers (p = 0.009 in RP/0.014 in VP). We noted high satisfaction levels for both forms of preparation. The VP technique was superior in reducing patient anxiety, especially in first-time MRI patients. Hence, VP techniques can be used in different clinical settings to reduce anxiety and facilitate patients’ understanding of the instructions given