Interleukin-1 as a mediator of fatigue in disease: a narrative review

Fatigue is commonly reported in a variety of illnesses, and it has major impact on quality of life. Previously, it was thought that fatigue originates in the skeletal muscles, leading to cessation of activity. However, more recently, it has become clear that the brain is the central regulator of fatigue perception. It has been suggested that pro-inflammatory cytokines, especially interleukin-1 alpha (IL-1α) and interleukin-1 beta (IL-1β), play a prominent role in the development of central fatigue, and several studies have been performed to elucidate the connection between inflammation and these central processes.In this narrative review, mechanisms of action of IL-1 are described, with special attention to its effect on the central nervous system. In addition, we present a summary of studies that (i) investigated the relationship between circulating IL-1α and IL-1β and fatigue severity and/or (ii) evaluated the effect of inhibiting IL-1 on fatigue. We aim to improve the understanding of fatigue in both inflammatory and non-inflammatory illnesses, which could help develop strategies to treat fatigue more effectively.Reviewing the studies that have been performed, it appears that there is a limited value of measuring circulating IL-1. However, inhibiting IL-1 has a positive effect on severe fatigue in most studies that have been conducte

Developing entrustable professional activities for university teachers in the health professions

Purpose: There is a widely recognized need to improve teacher professional development as well as recognition of teaching expertise in health professions education (HPE). This study aimed to develop Entrustable Professional Activities (EPAs) for university teachers in HPE as foundations for systems of training, certification, and career opportunities. Method: A local expert consultation using a two-round Delphi study at a Dutch academic medical center (round 1: n = 23; round 2: n = 13) was conducted to reach a consensus on an initial set of EPAs developed by the researchers. Subsequently, an international expert consultation was conducted using a survey (n = 21) and a focus group discussion (n = 7) to explore their international value. Results: Local consensus for all nine EPAs was reached in the second round of the Delphi study. The international survey showed a consensus for relevance and usefulness of all but one EPA but not for clarity and comprehensiveness of the EPAs. The international expert consultation revealed a need to tailor the EPA specifications to local contexts. Conclusion: We found international consensus for the relevance and usefulness of EPAs for university teachers in HPE but local tailoring for each EPA is needed to acknowledge contextual differences

Connecting academics’ disciplinary knowledge to their professional development as university teachers: a conceptual analysis of teacher expertise and teacher knowledge

Disciplinary knowledge lies at the heart of academic work. However, connecting academics’ disciplinary knowledge to their professional development as teachers has been a longstanding challenge for (research-intensive) universities. This is reflected in criticism of the practices that aim to support the professional development of university teachers. In order to create better connections, a deeper understanding is needed of how academics’ disciplinary knowledge relates to the development of their teaching. In this paper, we therefore aim to advance theoretical insights about how academics’ disciplinary knowledge connects to their professional development as university teachers. We do so by providing a conceptual analysis of teacher expertise and teacher knowledge perspectives. Literature discussed as part of the teacher expertise perspective provides insights into how knowledge is structured in order to perform teacher tasks. In our discussion of the teacher knowledge perspective, we include bodies of literature about teachers’ knowledge base to explore the role of disciplinary knowledge in how to teach and about powerful knowledge to explore the role of disciplinary knowledge in what to teach. Insights from these bodies of literature can, from a teacher knowledge perspective, offer theoretical underpinnings for connecting academics’ disciplinary knowledge to their professional development as university teachers. Adaptive expertise and practical knowledge are identified as concepts that include elements of both teacher expertise and teacher knowledge perspectives. Based on the conceptual analysis, we identify and discuss three aspects related to supporting the professional development of university teachers where attention to connection with teachers’ disciplinary knowledge is important

Connecting academics’ disciplinary knowledge to their professional development as university teachers: a conceptual analysis of teacher expertise and teacher knowledge

Disciplinary knowledge lies at the heart of academic work. However, connecting academics’ disciplinary knowledge to their professional development as teachers has been a longstanding challenge for (research-intensive) universities. This is reflected in criticism of the practices that aim to support the professional development of university teachers. In order to create better connections, a deeper understanding is needed of how academics’ disciplinary knowledge relates to the development of their teaching. In this paper, we therefore aim to advance theoretical insights about how academics’ disciplinary knowledge connects to their professional development as university teachers. We do so by providing a conceptual analysis of teacher expertise and teacher knowledge perspectives. Literature discussed as part of the teacher expertise perspective provides insights into how knowledge is structured in order to perform teacher tasks. In our discussion of the teacher knowledge perspective, we include bodies of literature about teachers’ knowledge base to explore the role of disciplinary knowledge in how to teach and about powerful knowledge to explore the role of disciplinary knowledge in what to teach. Insights from these bodies of literature can, from a teacher knowledge perspective, offer theoretical underpinnings for connecting academics’ disciplinary knowledge to their professional development as university teachers. Adaptive expertise and practical knowledge are identified as concepts that include elements of both teacher expertise and teacher knowledge perspectives. Based on the conceptual analysis, we identify and discuss three aspects related to supporting the professional development of university teachers where attention to connection with teachers’ disciplinary knowledge is important

Relationship between vasospasm, cerebral perfusion, and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

Vasospasm after aneurysmal subarachnoid hemorrhage (SAH) is thought to cause ischemia. To evaluate the contribution of vasospasm to delayed cerebral ischemia (DCI), we investigated the effect of vasospasm on cerebral perfusion and the relationship of vasospasm with DCI. We studied 37 consecutive SAH patients with CT angiography (CTA) and CT perfusion (CTP) on admission and within 14 days after admission or at time of clinical deterioration. CTP values (cerebral blood volume, cerebral blood flow (CBF) and mean transit time), degree of vasospasm on CTA, and occurrence of DCI were recorded. Vasospasm was categorized as follows: no spasm (0-25% decrease in vessel diameter), moderate spasm (25-50% decrease), and severe spasm (> 50% decrease). The correspondence of the flow territory of the most spastic vessel with the least perfused region was evaluated, and differences in perfusion values and occurrence of DCI between degrees of vasospasm were calculated with 95% confidence intervals (95% CI). Fourteen patients had no vasospasm, 16 were moderate, and seven were severe. In 65% of patients with spasm, the flow territory of the most spastic vessel corresponded with the least perfused region. There was significant CBF (milliliters per 100 g per minute) difference (-21.3; 95% CI, -37 a dagger"aEuro parts per thousand a'5.3) between flow territories of severe and no vasospasm. Four of seven patients with severe, six of 16 with moderate, and three of 14 patients with no vasospasm had DCI. Vasospasm decreases cerebral perfusion, but corresponds with the least perfused region in only two thirds of our patients. Furthermore, almost half of patients with severe vasospasm do not have DCI. Thus, although severe vasospasm can decrease perfusion, it may not result in DCI

Catecholaminergic modulation of trust decisions

Rationale: Trust is a key component of social interactions. In order to assess the trustworthiness of others, people rely on both information learned from previous encounters, as well as on implicit biases associated with specific facial features. Objective: Here, we investigated the role of catecholamine (dopamine and noradrenaline) transmission on trust decisions as a function of both experienced behavior and facial features. Methods: To increase catecholamine levels, methylphenidate (MPH, i.e., Ritalin®, 20 mg) was administered to participants (N = 24) prior to their playing a well-studied economic task, namely the Trust Game (Berg et al. 1995). We measured the amount of money invested with a variety of game partners. Across game partners, we manipulated two aspects of trust: the facial trust level (high facial trust, low facial trust, and non-social) and the likelihood of reciprocation (high, low). Results: Results demonstrated no main effect of MPH on investments, but rather a selective lowering of investments under MPH as compared with placebo with the game partners who were low on facial trustworthiness and were low reciprocators. Conclusion: These results provide evidence that MPH administration impacts social trust decision-making, but does so in a context-specific manner

Sex differences in characteristics and outcome in acute coronary syndrome patients in the Netherlands

Background Sex differences in acute coronary syndrome (ACS) have been reported, but little is known about the situation in the Netherlands. M

Electronic Portfolios Enhanced with Learning Analytics at the Workplace

This chapter shows the development of an ePortfolio environment enhanced with learning analytics, to be used at the workplace in medical, veterinary, and teacher education. Evaluation took place by means of a quasi-experimental design regarding the impact of this environment on trainees’ motivation, their assessment experience, and their use. Data gathered in four institutes for medical, veterinary, and teacher education (n = 217) showed that trainees were highly motivated for their internships and positively evaluated the perceived feedback. The use of learning analytics features varied. In general visual feedback by means of a timeline of trainees’ progress was mostly used, while trainees barely used the features with written feedback. It is concluded that the promise of learning analytics connected to ePortfolios can only be fulfilled when developed and implemented through the eyes of the users

Impact of the lockdown on acute stroke treatments during the first surge of the COVID-19 outbreak in the Netherlands

INTRODUCTION: We investigated the impact of the Corona Virus Disease 2019 (COVID-19) pandemic and the resulting lockdown on reperfusion treatments and door-to-treatment times during the first surge in Dutch comprehensive stroke centers. Furthermore, we studied the association between COVID-19-status and treatment times. METHODS: We included all patients receiving reperfusion treatment in 17 Dutch stroke centers from May 11th, 2017, until May 11th, 2020. We collected baseline characteristics, National Institutes of Health Stroke Scale (NIHSS) at admission, onset-to-door time (ODT), door-to-needle time (DNT), door-to-groin time (DGT) and COVID-19-status at admission. Parameters during the lockdown (March 15th, 2020 until May 11th, 2020) were compared with those in the same period in 2019, and between groups stratified by COVID-19-status. We used nationwide data and extrapolated our findings to the increasing trend of EVT numbers since May 2017. RESULTS: A decline of 14% was seen in reperfusion treatments during lockdown, with a decline in both IVT and EVT delivery. DGT increased by 12 min (50 to 62 min, p-value of < 0.001). Furthermore, median NIHSS-scores were higher in COVID-19 - suspected or positive patients (7 to 11, p-value of 0.004), door-to-treatment times did not differ significantly when stratified for COVID-19-status. CONCLUSIONS: During the first surge of the COVID-19 pandemic, a decline in acute reperfusion treatments and a delay in DGT was seen, which indicates a target for attention. It also appeared that COVID-19-positive or -suspected patients had more severe neurologic symptoms, whereas their EVT-workflow was not affected. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-021-02539-4