192 research outputs found
Accelerator irradiations of minerals - Implications for track formation mechanisms and for studies of lunar and meteoritic materials
Radiation effects of accelerated heavy ions in minerals characteristic of meteorite
Design and formative evaluation of a virtual voice-based coach for problem-solving treatment: Observational study
BACKGROUND: Artificial intelligence has provided new opportunities for human interactions with technology for the practice of medicine. Among the recent artificial intelligence innovations, personal voice assistants have been broadly adopted. This highlights their potential for health care-related applications such as behavioral counseling to promote healthy lifestyle habits and emotional well-being. However, the use of voice-based applications for behavioral therapy has not been previously evaluated.
OBJECTIVE: This study aimed to conduct a formative user evaluation of Lumen, a virtual voice-based coach developed as an Alexa skill that delivers evidence-based, problem-solving treatment for patients with mild to moderate depression and/or anxiety.
METHODS: A total of 26 participants completed 2 therapy sessions-an introductory (session 1) and a problem-solving (session 2)-with Lumen. Following each session with Lumen, participants completed user experience, task-related workload, and work alliance surveys. They also participated in semistructured interviews addressing the benefits, challenges and barriers to Lumen use, and design recommendations. We evaluated the differences in user experience, task load, and work alliance between sessions using 2-tailed paired t tests. Interview transcripts were coded using an inductive thematic analysis to characterize the participants\u27 perspectives regarding Lumen use.
RESULTS: Participants found Lumen to provide high pragmatic usability and favorable user experience, with marginal task load during interactions for both Lumen sessions. However, participants experienced a higher temporal workload during the problem-solving session, suggesting a feeling of being rushed during their communicative interactions. On the basis of the qualitative analysis, the following themes were identified: Lumen\u27s on-demand accessibility and the delivery of a complex problem-solving treatment task with a simplistic structure for achieving therapy goals; themes related to Lumen improvements included streamlining and improved personalization of conversations, slower pacing of conversations, and providing additional context during therapy sessions.
CONCLUSIONS: On the basis of an in-depth formative evaluation, we found that Lumen supported the ability to conduct cognitively plausible interactions for the delivery of behavioral therapy. Several design suggestions identified from the study including reducing temporal and cognitive load during conversational interactions, developing more natural conversations, and expanding privacy and security features were incorporated in the revised version of Lumen. Although further research is needed, the promising findings from this study highlight the potential for using Lumen to deliver personalized and accessible mental health care, filling a gap in traditional mental health services
Pharmacokinetics of nalbuphine hydrochloride extended release tablets in hemodialysis patients with exploratory effect on pruritus
Genes of cell-cell interactions, chemotherapy detoxification and apoptosis are induced during chemotherapy of acute myeloid leukemia
<p>Abstract</p> <p>Background</p> <p>The molecular changes <it>in vivo </it>in acute myeloid leukemia cells early after start of conventional genotoxic chemotherapy are incompletely understood, and it is not known if early molecular modulations reflect clinical response.</p> <p>Methods</p> <p>The gene expression was examined by whole genome 44 k oligo microarrays and 12 k cDNA microarrays in peripheral blood leukocytes collected from seven leukemia patients before treatment, 2–4 h and 18–24 h after start of chemotherapy and validated by real-time quantitative PCR. Statistically significantly upregulated genes were classified using gene ontology (GO) terms. Parallel samples were examined by flow cytometry for apoptosis by annexin V-binding and the expression of selected proteins were confirmed by immunoblotting.</p> <p>Results</p> <p>Significant differential modulation of 151 genes were found at 4 h after start of induction therapy with cytarabine and anthracycline, including significant overexpression of 31 genes associated with p53 regulation. Within 4 h of chemotherapy the BCL2/BAX and BCL2/PUMA ratio were attenuated in proapoptotic direction. FLT3 mutations indicated that non-responders (5/7 patients, 8 versus 49 months survival) are characterized by a unique gene response profile before and at 4 h. At 18–24 h after chemotherapy, the gene expression of p53 target genes was attenuated, while genes involved in chemoresistance, cytarabine detoxification, chemokine networks and T cell receptor were prominent. No signs of apoptosis were observed in the collected cells, suggesting the treated patients as a physiological source of pre-apoptotic cells.</p> <p>Conclusion</p> <p>Pre-apoptotic gene expression can be monitored within hours after start of chemotherapy in patients with acute myeloid leukemia, and may be useful in future determination of therapy responders. The low number of patients and the heterogeneity of acute myeloid leukemia limited the identification of gene expression predictive of therapy response. Therapy-induced gene expression reflects the complex biological processes involved in clinical cancer cell eradication and should be explored for future enhancement of therapy.</p
Cost-Effectiveness of New Cardiac and Vascular Rehabilitation Strategies for Patients with Coronary Artery Disease
Objective: Peripheral arterial disease (PAD) often hinders the cardiac rehabilitation program. The aim of this study was evaluating the relative cost-effectiveness of new rehabilitation strategies which include the diagnosis and treatment of PAD in patients with coronary artery disease (CAD) undergoing cardiac rehabilitation. Data Sources: Best-available evidence was retrieved from literature and combined with primary data from 231 patients. Methods: We developed a Markov decision model to compare the following treatment strategies: 1. cardiac rehabilitation only; 2. ankle-brachial index (ABI) if cardiac rehabilitation fails followed by diagnostic work-up and revascularization for PAD if needed; 3. ABI prior to cardiac rehabilitation followed by diagnostic work-up and revascularization for PAD if needed. Quality-adjusted-life years (QALYs), life-time costs (US 75 000 was used. Results: ABI if cardiac rehabilitation fails was the most favorable strategy with an ICER of 75 000/QALY. After sensitivity analysis, a combined cardiac and vascular rehabilitation program increased the success rate and would dominate the other two strategies with total lifetime costs of $30 246 a quality-adjusted life expectancy of 3.84 years, and an incremental NHB of 0.06 QALYs (95%CI:−0.24, 0.46) compared to current practice. The results were robust for other different input parameters. Conclusion: ABI measurement if cardiac rehabilitation fails followed by a diagnostic work-up and revascularization for PAD if needed are potentially cost-effective compared to cardiac rehabilitation only
Models of chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is a major global health problem and is predicted to become the third most common cause of death by 2020. Apart from the important preventive steps of smoking cessation, there are no other specific treatments for COPD that are as effective in reversing the condition, and therefore there is a need to understand the pathophysiological mechanisms that could lead to new therapeutic strategies. The development of experimental models will help to dissect these mechanisms at the cellular and molecular level. COPD is a disease characterized by progressive airflow obstruction of the peripheral airways, associated with lung inflammation, emphysema and mucus hypersecretion. Different approaches to mimic COPD have been developed but are limited in comparison to models of allergic asthma. COPD models usually do not mimic the major features of human COPD and are commonly based on the induction of COPD-like lesions in the lungs and airways using noxious inhalants such as tobacco smoke, nitrogen dioxide, or sulfur dioxide. Depending on the duration and intensity of exposure, these noxious stimuli induce signs of chronic inflammation and airway remodelling. Emphysema can be achieved by combining such exposure with instillation of tissue-degrading enzymes. Other approaches are based on genetically-targeted mice which develop COPD-like lesions with emphysema, and such mice provide deep insights into pathophysiological mechanisms. Future approaches should aim to mimic irreversible airflow obstruction, associated with cough and sputum production, with the possibility of inducing exacerbations
Syndrome of fetal gigantism, renal hamartomas, and nephroblastomatosis with Wilms' tumor
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The effects of relaxation techniques following acute, high intensity football training on parasympathetic reactivation
BackgroundEvidence shows relaxation techniques reactivate the parasympathetic nervous system (PNS) following physiological stressors such as exercise. As such, these techniques may be useful following exercise training of high intensity sports, like collegiate football.PurposeTo evaluate the impact of mindfulness and rest activities on PNS reactivation following training sessions, in a sample of Division-I collegiate, male football athletes.MethodsThis study employed a cross-sectional, pre-post experimental design among 38 football athletes. Following three training sessions, each separated by one week, athletes were exposed to three groups: mindfulness, rest, and no-intervention. Athletes in the mindfulness group laid supine in a darkened room, while performing 15 min of guided breathing and body scans. The rest group remained seated in a lighted room, performing 15 min of restful activities (e.g., talking). The no-intervention group was instructed to perform usual post-training activities (e.g., showering). Heart rate (HR), respiration rate (RR) and two HR variability (HRV) indices were measured via an armband monitor (Warfighter Monitor, Tiger Tech Solutions, Inc, Miami, FL) equipped with electrocardiographic and photoplethysmography capabilities. HRV indices included standard deviation of the N-N intervals (SDNN) and root mean square of successive RR interval differences (rMSSD). Within and between-group differences were determined via analysis of variance (ANOVA) and corrected for multiple comparisons familywise error.ResultsStatistically significant reductions in HR and RR were observed across all groups: −81.6, −66.4, −40.9 bpm and −31.7, −26.9, and −19.0 breaths⋅min−1, respectively. The mindfulness and rest groups exhibited a larger within-group reduction in HR and RR compared to the no-intervention group, p < 0.0000. Additionally, the mindfulness group showed a larger reduction in HR and RR compared to the rest group, p < 0.05. Post-intervention HR and RRs were significantly lower in the mindfulness group relative to the no-intervention group (77.0 vs. 120.1 bpm, respectively). Similar results were observed for RR (15.0 vs. 23.6 breaths⋅min−1, respectively) and HRV indices (SDNN: 46.9 vs. 33.1 ms and rMSSD: 17.9 vs. 13.8 ms, respectively) Athletes in the rest group showed significantly lower post-intervention HR (−30.2 bpm, 89.9 vs. 120.1 bpm, respectively), RR (−4.3 breaths⋅min−1, 19.3 vs. 23.6 breaths⋅min−1, respectively) and significantly higher HRV (SDNN: 42.9 vs. 33.1 ms and rMSSD: 16.7 vs. 13.8 ms, respectively) compared to their no-intervention counterparts.ConclusionsOur findings suggest that athletes engaging in either 15-minute guided mindfulness or rest activities (e.g., sitting) post training, may facilitate PNS reactivation. Implementing these strategies may accelerate recovery, improving performance. Longitudinal, randomized controlled trials among diverse sports are encouraged
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