Self-Guided Smartphone Application to Manage Chronic Musculoskeletal Pain: A Randomized, Controlled Pilot Trial

OBJECTIVE: The goal of this study is to evaluate the feasibility and efficacy of an auricular point acupressure smartphone app (mAPA) to self-manage chronic musculoskeletal pain. METHODS: A prospective, longitudinal, randomized, controlled pilot trial was conducted using a three-group design (self-guided mAPA ( RESULTS: After a 4-week APA intervention, participants in the in-person mAPA group had improved physical function of 32% immediately post-intervention and 29% at the 1M follow-up. Participants in the self-guided mAPA group had higher improvement (42% at post-intervention and 48% at the 1M follow-up). Both mAPA groups had similar degrees of pain intensity relief at post-intervention (45% for in-person and 48% for the self-guided group) and the 1M follow-up (42% for in-person and 45% for the self-guided group). Over 50% of the participants in each group reached at least 30% reduced pain intensity at post-intervention, and this was sustained in the mAPA groups at the 1M follow-up. Approximately 80% of the participants in both mAPA groups were satisfied with the treatment outcomes and adhered to the suggested APA practice; however, participants in the self-guided group had higher duration and more frequency in APA use. The attrition rate was 16% at the 1M follow-up. No adverse effects of APA were reported, and participants found APA to be beneficial and the app to be valuable. CONCLUSIONS: The study findings indicate that participants effectively learned APA using a smartphone app, whether they were self-guided or received in-person training. They were able to self-administer APA to successfully manage their pain. Participants found APA to be valuable in their pain self-management and expressed satisfaction with the intervention using the app

Catheter-directed thrombolysis for patients with acute lower extremity deep vein thrombosis: a meta-analysis

Objetivos: Evaluar estudios de series de casos y evaluar cuantitativamente los efectos de la trombólisis dirigida por catéter (TDC) y comparar la eficacia entre la TDC y anticoagulación en pacientes con trombosis venosa profunda (TVP) aguda de las extremidades inferiores para el tratamiento futuro. Métodos: Se realizaron búsquedas en bases de datos relevantes, incluyendo PubMed, Embase, Cochrane, Ovid MEDLINE y Scopus hasta enero de 2017. Los criterios de inclusión se aplicaron a pacientes seleccionados con TVP aguda de extremidad inferior tratados con TDC o comparados con TDC y anticoagulación. En estudios de series de casos, las estimaciones agrupadas de los resultados de eficacia para la tasa de patencia, la lisis completa, la retrombosis y el síndrome postrombótico (SPT) se calcularon a través de los estudios. En estudios que compararon la TDC con la anticoagulación, se calculó el resumen de las razónes de posibilidades (RP). Resultados: 25 artículos (seis que comparan TDC con anticoagulación y 19 series de casos) que incluyeron 2254 pacientes qienes cumplieron los criterios de elegibilidad. En los estudios de series de casos, los resultados agrupados fueron: tasa de patencia 0,87 (IC 95%: 0,85; 0,89), lisis completa 0,58 (IC 95%: 0,40; 0,75), retrombosis 0,11 (IC 95%: 0,06; 17,0), SPT 0,10 (IC 95%: 0,08; 0,12). Seis estudios que compararon los resultados de eficacia entre la TDC y anticoagulación mostraron que la TDC se asoció con una reducción de SPT (RP 0,38; IC 95%: 0,26; 0,55; pObjectives: To evaluate case series studies that quantitatively assess the effects of catheter-directed thrombolysis (CDT) and compare the efficacy of CDT and anticoagulation in patients with acute lower extremity deep vein thrombosis (DVT). Methods: Relevant databases, including PubMed, Embase, Cochrane, Ovid MEDLINE and Scopus, were searched through January 2017. The inclusion criteria were applied to select patients with acute lower extremity DVT treated with CDT or with anticoagulation. In the case series studies, the pooled estimates of efficacy outcomes for patency rate, complete lysis, rethrombosis and post-thrombotic syndrome (PTS) were calculated across the studies. In studies comparing CDT with anticoagulation, summary odds ratios (ORs) were calculated. Results: Twenty-five articles (six comparing CDT with anticoagulation and 19 case series) including 2254 patients met the eligibility criteria. In the case series studies, the pooled results were a patency rate of 0.87 (95% CI: 0.85-0.89), complete lysis 0.58 (95% CI: 0.40-0.75), rethrombosis 0.11 (95% CI: 0.06-0.17) and PTS 0.10 (95% CI: 0.08-0.12). Six studies comparing the efficacy outcomes of CDT and anticoagulation showed that CDT was associated with a reduction of PTS (OR 0.38, 95%CI 0.26-0.55, pObjetivos: Avaliar os estudos de séries de casos e avaliar quantitativamente os efeitos da trombólise dirigida por cateter (TDC) e comparar a eficácia entre TDC e anticoagulação nos pacientes com trombose venosa profunda aguda das extremidades inferiores (TVP) para tratamento futuro. Métodos: Foram pesquisadas as seguintes bases de dados relevantes: PubMed, Embase, Cochrane, Ovid MEDLINE e Scopus​. Os critérios de inclusão foram aplicados para pacientes selecionados com TVP aguda de extremidades inferiores tratados com TDC comparada a TDC com anticoagulação. Nos estudos de série de casos, as estimativas agrupadas de resultados de eficácia para a taxa de permeabilidade, lise completa, retrombose e síndrome pós-trombótica (SPT) foram calculadas em todos os estudos. Em estudos comparando TDC com anticoagulação, foi calculada a razão de chance de resumo (summary odds ratio - OR). Resultados: Vinte e cinco artigos (seis comparando TDC com anticoagulação e 19 séries de casos), incluindo 2.254 pacientes, preencheram os critérios de elegibilidade. Nos estudos da série de casos, os resultados agrupados foram: taxa de permeabilidade 0,87 (IC95%: 0,85-0,89), lise completa 0,58 (IC95%: 0,40-0,75), e retrombose 0,11 (IC95%: 0,06-0,17), SPT 0,10 (IC95%: 0,08-0,12). Seis estudos que compararam os resultados de eficácia entre TDC e anticoagulação mostraram que TDC foi associada à redução da SPT (OR 0,38; IC95%: 0,26-0,55;

A randomized clinical trial of auricular point acupressure for chronic low back pain: a feasibility study

Objectives. This prospective, randomized clinical trial (RCT) was designed to investigate the feasibility and effects of a 4-week auricular point acupressure (APA) for chronic low back pain (CLBP). Methods. Participants were randomized to either true APA (true acupoints with taped seeds on the designated ear points for CLBP) or sham APA (sham acupoints with taped seeds but on different locations than those designated for CLBP). The duration of treatment was four weeks. Participants were assessed before treatment, weekly during treatment, and 1 month following treatment. Results. Participants in the true APA group who completed the 4-week APA treatment had a 70% reduction in worst pain intensity, a 75% reduction in overall pain intensity, and a 42% improvement in disability due to back pain from baseline assessment. The reductions of worst pain and overall pain intensity in the true APA group were statistically greater than participants in the sham group (P<0.01) at the completion of a 4-week APA and 1 month followup. Discussion. The preliminary findings of this feasibility study showed a reduction in pain intensity and improvement in physical function suggesting that APA may be a promising treatment for patients with CLBP

Auricular Point Acupressure Smartphone Application to Manage Chronic Musculoskeletal Pain: A Longitudinal, One-Group, Open Pilot Trial

Background: Chronic musculoskeletal pain (CMP) is the most common self-reported chronic pain condition. Current treatment for CMP is limited. Methods: This was a two-phase study. In Phase 1, three auricular point acupressure (APA)-naïve participants were recruited to explore their experiences of APA and a smartphone app was developed based on their feedback. In Phase 2, a prospective longitudinal study was used to examine the effectiveness of the smartphone app to self-manage CMP. Results: Phase 1 resulted in the successful development of the APA smartphone app. In Phase 2, after four weeks of APA, participants reported reduced pain intensity (30%), pain interference (35%), and disability (40%), as well as improved physical function (47%). The mean score for the participants’ perception of treatment efficacy was 4.94 (SD = 2.08, scale of 0–7) indicating that approximately 70% of participants rated global improvements with noticeable changes. The majority (88%, n = 22) of the participants were satisfied with the treatment: 32% [8] were very satisfied and 56% [n = 14] were somewhat satisfied. The average frequency of pressing APA seeds per day was 2.93 times (SD = 2.27, range 0–10) and 1.60 minutes per time (SD = 2.64, range 0–10); the participants were able to adhere to the suggested pressing time per day, although they only pressed the ear points about 53% of the suggested time. Conclusion: It is feasible for individuals to learn APA from the smartphone app and successfully self-administer APA to manage their pain. Participants found the app useful and were satisfied with the information provided through the app

Pyrazole compound BPR1P0034 with potent and selective anti-influenza virus activity

<p>Abstract</p> <p>Background</p> <p>Influenza viruses are a major cause of morbidity and mortality around the world. More recently, a swine-origin influenza A (H1N1) virus that is spreading via human-to-human transmission has become a serious public concern. Although vaccination is the primary strategy for preventing infections, influenza antiviral drugs play an important role in a comprehensive approach to controlling illness and transmission. In addition, a search for influenza-inhibiting drugs is particularly important in the face of high rate of emergence of influenza strains resistant to several existing influenza antivirals.</p> <p>Methods</p> <p>We searched for novel anti-influenza inhibitors using a cell-based neutralization (inhibition of virus-induced cytopathic effect) assay. After screening 20,800 randomly selected compounds from a library from ChemDiv, Inc., we found that BPR1P0034 has sub-micromolar antiviral activity. The compound was resynthesized in five steps by conventional chemical techniques. Lead optimization and a structure-activity analysis were used to improve potency. Time-of-addition assay was performed to target an event in the virus life cycle.</p> <p>Results</p> <p>The 50% effective inhibitory concentration (IC₅₀) of BPR1P0034 was 0.42 ± 0.11 μM, when measured with a plaque reduction assay. Viral protein and RNA synthesis of A/WSN/33 (H1N1) was inhibited by BPR1P0034 and the virus-induced cytopathic effects were thus significantly reduced. BPR1P0034 exhibited broad inhibition spectrum for influenza viruses but showed no antiviral effect for enteroviruses and echovirus 9. In a time-of-addition assay, in which the compound was added at different stages along the viral replication cycle (such as at adsorption or after adsorption), its antiviral activity was more efficient in cells treated with the test compound between 0 and 2 h, right after viral infection, implying that an early step of viral replication might be the target of the compound. These results suggest that BPR1P0034 targets the virus during viral uncoating or viral RNA importation into the nucleus.</p> <p>Conclusions</p> <p>To the best of our knowledge, BPR1P0034 is the first pyrazole-based anti-influenza compound ever identified and characterized from high throughput screening to show potent (sub-μM) antiviral activity. We conclude that BPR1P0034 has potential antiviral activity, which offers an opportunity for the development of a new anti-influenza virus agent.</p

Determinants of condom use intention in the prevention of HIV/AIDS among Chinese college students

The purpose of this exploratory study was to investigate Chinese junior college students\u27 condom use intentions to prevent HIV/AIDS. The following research question was addressed: How is knowledge about HIV/AIDS risk, attitudes, subjective norms, self-efficacy, prevention expectancies, and prior condom use related to condom use intention among college students? Questionnaires and semi-structured interviews were employed in this study. Variables for the survey were selected from the Theory of Reasoned Action and the Self-Efficacy Theory. A questionnaire was modified and translated from an English instrument and back-translated to ensure cultural relevance and sensitivity. In addition, twenty students were purposely selected for interviewing among those who indicated they had had sexual encounters. Of all the students in the survey sample, 29% males and 9% females admitted having sexual experiences. Data analysis was based on the subsample (N = 302) who had sexual experience. The subjects\u27 knowledge of AIDS-related risk behavior produced an average score of 68% correct responses based on true-false questions. Knowledge, however, was not significantly related to any of the other variables. Logistic regression analysis was employed to analyze students\u27 intentions for condom use to prevent HIV/AIDS. For all students, prior condom use was the most important determinant of intention for future condom use. For male students, the estimated odds ratio of prior condom use and self-efficacy were significantly associated with intention to use condoms. This finding suggests that the actual practice to master the skill of condom use is critical. For female students, prior condom use and attitudes significantly predicted the intention for condom use. Themes from the interview data were students\u27 general HIV/AIDS knowledge, sources of sex education, perceived risk of acquiring HIV/AIDS, strategies for managing risk, discussion content and the influences of parents, siblings, friends, and sexual partners on students\u27 personal norms. The implication from the interview data was that prevention of pregnancy was the most important factor for students to use condoms, rather than fear of contracting STDs or HIV/AIDS. Thus, suggestions for education programs are discussed

Use of Information and Communication Technologies to Enhance Self-Acupressure: a Literature Review

Currently, acupressure is widely accepted as a non-pharmacological therapy for managing pain, nausea and vomiting, and mental health conditions. Since acupressure can be self-administered, clinicians and researchers’ interest in information and communication technologies (ICTs) for disseminating acupressure to manage symptoms has increased. This mini review was conducted to examine clinical studies of acupressure using ICTs, with a particular focus on self-acupressure. Through a search of MEDLINE, EMBASE, and CENTRAL, all studies of self-acupressure using ICTs published before December 31, 2021 were collected. Twelve studies met the inclusion criteria. More than half of the studies published since 2020 (4/7, 54.14%) were described as being related to COVID-19. As target conditions, musculoskeletal injuries or pain, cancer-related symptoms, dysmenorrhea, mental health issues, and obesity were considered. The most frequently used acupoints were LI4, LR3, and Shenmen. Moreover, smartphone applications were the most commonly used ICT method to support self-acupressure. In addition to the basic information of self-acupressure, other tools such as timers, reminders, and schedule checkers to facilitate its implementations have been incorporated into the smartphone applications. Recently, there have been some attempts to combine acupressure and ICTs. Although these studies mainly focus on musculoskeletal pain or injuries, recent studies related to mental health have emerged in relation to COVID-19. However, few studies have been conducted to date, making it difficult to fully grasp the trends in this field. Therefore, more studies are needed to evaluate the feasibility and efficacy of combining self-acupressure and ICTs in more diverse clinical areas

Sabbatical as a part of the academic excellence journey: A narrative qualitative study

INTRODUCTION: Sabbaticals were first offered by Harvard University in the late 17th century to provide “renewal” for faculty members. In this period of career development, a professor might learn new techniques, expand a research program, or finish off that book or pile of languishing manuscripts. This article tried to organize lived experiences of a visiting scholar from Isfahan University of Medical Sciences to Johns Hopkins University. The research aimed to study the context and conditions of the sabbatical in an alternative academic setting. METHODS: This article applies a narrative qualitative study integrated with Eisner critical and connoisseurship approach as a combined naturalistic methodology. Using narrative inquiry and reflective analysis in form of observations and audit reports, written dairy notes and memos, the content analyzed thematically and extracted the themes of lived experiences as well as lessons learned and then have been transformed into tables. RESULTS: Extracted themes from research sources are categorized into three main themes: organizational and professional experiences; teaching, instruction, and curricular experiences; and research and technology management experiences. These are resulted in the explanation of the field and events (description), discussion about them (interpretation), followed by concluding remarks (evaluation). . It also represents research questions and findings in descriptive and interpretation phases. DISCUSSION AND CONCLUSIONS: This article addresses some descriptions, interpretations, and evaluations extracted from the experiences through answering the research questions. It categorizes these practical lessons into three categories: (1) lessons about becoming a lifelong learner, (2) lessons about remaining a professor, and (3) innovative experiences

Medium-term outcomes of artificial disc replacement for severe cervical disc narrowing

Objective: To determine if the Bryan cervical disc prosthesis could relieve objective neurological symptoms, signs, and restore mobility in patients with severe cervical disc narrowing. Methods: Clinical data of thirty-two patients underwent Bryan cervical disc replacement has been collected from April 2006 to February 2010. Severe cervical disc narrowing with grade V disc degeneration were included in this study. Bryan cervical disc prostheses have been implanted through anterior approach. Japanese Orthopedics Association (JOA) score, visual analog scale, Odom's scale, and flexion-extension radiological follow-ups were applied for evaluations. Results: A total of 41 Bryan disc prostheses from 32 patients with an average follow-up duration of 33.5 months (range 23 to 44 months) were evaluated. Clinical functions of patients were significantly improved. Preoperative averaged visual analog scale score of 6.3±2.2 was decreased to 1.3±1.2 (at 36 months, P<0.001), while preoperative averaged JOA score of 14.4±1.2 was increased to 16.3±0.9 (at 36 months, P<0.001). Thirty of 32 patients received excellent to good outcomes in Odom's scale. Averaged mobility was restored to (9.9±3.2)° at the last follow-up evaluation of 36 months. No subsidence or migration of implant was identified. Conclusions: Acceptable clinical outcome for treatment of severe cervical disc narrowing with cervical disc replacement technique has been performed in current study. Most patients maintained good postoperative mobility and no significant adjacent level degeneration were found. Cervical disc replacement may be applicable in treatment of severe cervical disc narrowing; however, longer follow-ups are required for ensuring the long-term efficacy of cervical disc replacement