Mentoring in palliative medicine in the time of covid-19: a systematic scoping review : Mentoring programs during COVID-19.

IntroductionThe redeployment of mentors and restrictions on in-person face-to-face mentoring meetings during the COVID-19 pandemic has compromised mentoring efforts in Palliative Medicine (PM). Seeking to address these gaps, we evaluate the notion of a combined novice, peer-, near-peer and e-mentoring (CNEP) and interprofessional team-based mentoring (IPT) program.MethodsA Systematic Evidence Based Approach (SEBA) guided systematic scoping review was carried out to study accounts of CNEP and IPT from articles published between 1st January 2000 and 28th February 2021. To enhance trustworthiness, concurrent thematic and content analysis of articles identified from structured database search using terms relating to interprofessional, virtual and peer or near-peer mentoring in medical education were employed to bring together the key elements within included articles.ResultsFifteen thousand one hundred twenty one abstracts were reviewed, 557 full text articles were evaluated, and 92 articles were included. Four themes and categories were identified and combined using the SEBA's Jigsaw and Funnelling Process to reveal 4 domains - characteristics, mentoring stages, assessment methods, and host organizations. These domains suggest that CNEP's structured virtual and near-peer mentoring process complement IPT's accessible and non-hierarchical approach under the oversight of the host organizations to create a robust mentoring program.ConclusionThis systematic scoping review forwards an evidence-based framework to guide a CNEP-IPT program. At the same time, more research into the training and assessment methods of mentors, near peers and mentees, the dynamics of mentoring interactions and the longitudinal support of the mentoring relationships and programs should be carried out

Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence study

Introduction: Consensus criteria for pediatric severe sepsis have standardized enrollment for research studies. However, the extent to which critically ill children identified by consensus criteria reflect physician diagnosis of severe sepsis, which underlies external validity for pediatric sepsis research, is not known. We sought to determine the agreement between physician diagnosis and consensus criteria to identify pediatric patients with severe sepsis across a network of international pediatric intensive care units (PICUs). Methods: We conducted a point prevalence study involving 128 PICUs in 26 countries across 6 continents. Over the course of 5 study days, 6925 PICU patients <18 years of age were screened, and 706 with severe sepsis defined either by physician diagnosis or on the basis of 2005 International Pediatric Sepsis Consensus Conference consensus criteria were enrolled. The primary endpoint was agreement of pediatric severe sepsis between physician diagnosis and consensus criteria as measured using Cohen's ?. Secondary endpoints included characteristics and clinical outcomes for patients identified using physician diagnosis versus consensus criteria. Results: Of the 706 patients, 301 (42.6 %) met both definitions. The inter-rater agreement (? ± SE) between physician diagnosis and consensus criteria was 0.57 ± 0.02. Of the 438 patients with a physician's diagnosis of severe sepsis, only 69 % (301 of 438) would have been eligible to participate in a clinical trial of pediatric severe sepsis that enrolled patients based on consensus criteria. Patients with physician-diagnosed severe sepsis who did not meet consensus criteria were younger and had lower severity of illness and lower PICU mortality than those meeting consensus criteria or both definitions. After controlling for age, severity of illness, number of comorbid conditions, and treatment in developed versus resource-limited regions, patients identified with severe sepsis by physician diagnosis alone or by consensus criteria alone did not have PICU mortality significantly different from that of patients identified by both physician diagnosis and consensus criteria. Conclusions: Physician diagnosis of pediatric severe sepsis achieved only moderate agreement with consensus criteria, with physicians diagnosing severe sepsis more broadly. Consequently, the results of a research study based on consensus criteria may have limited generalizability to nearly one-third of PICU patients diagnosed with severe sepsis

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Investigation of host factors involved in Legionella pneumophila virulence

© 2017 Dr Sze Ying OngLegionella pneumophila is an environmental organism that can become accidental bacterial pathogen when inhaled into the lungs of humans. On entering the lungs, L. pneumophila is phagocytosed by alveolar macrophages. However, instead of being removed accordingly by the host immune system, the bacteria rapidly establish a Legionella-containing vacuole (LCV) and replicate intracellularly. The ability to establish the LCV relies on a type IV secretion system, also known as the Dot/Icm system. The Dot/Icm system is essential for virulence and delivers a large repertoire (> 300) of effector proteins into infected host cells. These effector proteins modulate a wide range of host processes such as vesicle trafficking, host protein translation, regulation of GTPases and apoptosis. Despite the phenomenal number (one of the highest among known bacterial pathogens) of effector proteins translocated by L. pneumophila into host cells, effector secretion is not detected until the bacterium contacts a host cell. This is in contrast to other bacterial pathogens such as enteropathogenic Escherichia coli or Salmonella sp., which can be induced to secrete effector proteins via a type III secretion system into liquid bacteriological cultures. The interactions that occur between the host cells and L. pneumophila in order to activate the Dot/Icm system are poorly understood. In this study, we used an RNAi approach to screen for host factors that contribute to Dot/Icm effector protein translocation. A genome-wide siRNA screen was performed that individually silenced each protein-coding gene in the human genome (~ 18 000 genes) and monitored for any changes in translocation of the prototypic effector protein, RalF, after L. pneumophila infection. This screen identified 119 genes whose silencing resulted in increased translocation of RalF while knockdown of 321 genes resulted in decreased translocation. Strikingly, we found that genes in the ubiquitination pathway were significantly over-represented among the factors that contribute to the efficiency of RalF translocation during L. pneumophila infection. We further showed these ubiquitination factors also influence translocation of another effector protein, SidB. This suggested that the host ubiquitination pathway was important in mediating Dot/Icm effector protein translocation. Interestingly, we also found that two of the host ubiquitination factors that facilitated effector protein translocation were also important for L. pneumophila intracellular replication. These were UBE2E1 and CUL7; an E2-conjugating enzyme and E3 ligase respectively. On top of host ubiquitination factors, this screen also identified many other host factors that were not previously appreciated as having possible roles in Dot/Icm mediated effector protein translocation. Given the finding that ubiquitination is important for Dot/Icm effector protein translocation and that the LCV is an ER-like compartment, we hypothesised that this process occurred in a manner equivalent to retrotranslocation, a process that moves ubiquitinated protein substrates from within the ER into the cytoplasm. Unfortunately, we were not able to conclude this as silencing gene expression of the ATPase, p97, which drives this process, resulted in significant host cell death. To this end, the significance of ubiquitination pathways on Dot/Icm mediated effector protein translocation is yet to be elucidated. Nevertheless, this study has contributed significantly to our understanding of host-Legionella interactions and provided much new information about the plausible interplay between the host cell and the Dot/Icm system. Finally, we demonstrated the utility of genome-wide high-throughput screening in human cells to study L. pneumophila pathogenesis

Understanding dementia

This paper presents Understanding Dementia, a public health campaign promoting dementia awareness, initiated by four final year students from the Wee Kim Wee School of Communication and Information, Nanyang Technological University. The campaign aimed to educate adults aged 25 to 50 years old on the warning signs of dementia and the importance and benefits of early diagnosis. The paper reviews primary and secondary research that contributed to the formulation of the campaign’s objectives and strategies. Our primary research showed that the target audience was not well informed of the symptoms of dementia, and that they generally held the misconception that these symptoms were part of normal ageing. Qualitative interviews also showed that only a small percentage of dementia cases were diagnosed in the early stage. To mitigate these problems, storytelling, public education and the use of social media were the key strategies developed to convey the campaign messages effectively. The team achieved success in meeting its informational and behavioural objectives. Post-campaign evaluation showed that the target audience was more informed about the symptoms of dementia and the benefits of early diagnosis. They would also take appropriate action should they suspect an elderly person of having dementia. With Singaporeans being more informed about the symptoms of dementia, this campaign helped lay the foundation for the creation of a dementia-friendly Singapore. In the long run, the campaign’s promotion of early diagnosis will help improve the quality of life of both persons with dementia and their caregivers.Bachelor of Communication Studie

Visual supports to optimize COVID-19-related healthcare encounters for young/preschool children

10.1016/j.pedneo.2022.01.007PEDIATRICS AND NEONATOLOGY634420-42

Degradation kinetics of carpaine and antioxidant properties of dried Carica papaya leaves as affected by drying methods

Carpaine in papaya leaves has the potential to treat dengue fever and it also contains antioxidants which could prevent or inhibit oxidation processes in the human body. Studies were conducted on the effects of storage on carpaine retention and antioxidant properties of dried papaya leaves. Results showed that the Weibull model could predict well the degradation kinetics of carpaine in all samples (freeze drying and hot air drying at 60 °C and 70 °C) except for hot air dried samples at 80 °C and shade dried samples (first order model). Generally, freeze dried samples showed the highest half-life whereas total polyphenols content and antioxidant properties (ABTS and DPPH free radical scavenging activities) of all dried samples decreased with storage period. An increasing trend in total colour difference (ΔE * ) was observed in all samples possibly due to chlorophyll degradation. It is thus recommended to select freeze dried samples for storage purpose due to better stability as indicated by the lowest rate constant (k = 0.0135 1/month) and the highest half-life (t1/2 = 51.2 months)