The Impact of Virtual Working on Perceived Team Effectiveness in Secondary Mental Health Services During the COVID-19 Pandemic

Introduction: Working as a team is the desired approach by many industries because of the benefits it provides for service users, team members, and services. However, to make a team work, many factors must be considered. One framework that can support this process is the Input-Process-Output framework which represents the various, non-linear factors that can contribute to a team’s outcomes. For example, virtual working (VW) has been found to be a factor that can negatively impact team processes (e.g., trust, cohesion, communication) and team outputs (e.g., team effectiveness and satisfaction). With the pandemic enforcing VW, many spoke about its impact for clients using mental health services. However, little is known about the impact of VW during the pandemic on the teams providing the service. Aims: Therefore, this study aimed to explore the impact of VW during the pandemic on perceived team cohesion, trust, communication, perceived team effectiveness and job satisfaction. It also aimed to examine whether previously found correlations between these team processes and outputs could be generalised to teams who became virtual during the pandemic. Methodology: A quantitative online survey was completed by 57 NHS secondary community mental health workers. This survey consisting of six sections included variety of measures, testing team processes and outcomes. Results: There was a significant decline on perceived team cohesion, trust, and satisfaction. However, there was no statistically significant decline on team effectiveness during the pandemic. Results also confirmed previous findings regarding correlations between team processes and outcomes. Conclusion: Virtual working may have had a negative impact on secondary mental health teams during the pandemic. However, despite this, team members have expressed wishes to maintain some aspects of VW. This study adds to our growing examination of the true impact of the pandemic and provides clinical and research recommendations that could support team effectiveness, especially as hybrid ways of working are becoming the norm for many

Hybrid recommendation by incorporating the sentiment of product reviews

Hybrid recommender systems utilize advanced algorithms capable of learning heterogeneous sources of data and generating personalized recommendations for users. The data can range from user preferences (e.g., ratings or reviews) to item content (e.g., description or category). Prior studies in the field of recommender systems have primarily relied on “ratings” as the user feedback, when building user profiles or evaluating the quality of the recommendation. While ratings are informative, they may still fail to represent a comprehensive picture of actual user preferences. In contrast, there are other types of feedback data that differently or complementarily represent users and their preferences, including the reviews and the sentiments encapsulated within them. Such data can reveal important parts of a user’s profile that are not necessarily correlated with user ratings, and hence, they potentially reflect a different side of the user’s profile. In this paper, we propose a novel form of hybrid recommender system, capable of analyzing the reviews and extracting their sentiments that are incorporated into the recommendation process. We used advanced algorithms to generate recommendations for users capable of incorporating additional data, such as the review sentiment. We conducted analyses and showed that sentiments of user reviews are not always highly correlated with the ratings (e.g., in music domain). This might mean that sentiment can be indicative of a different aspect of user preferences and can be used as an alternative signal of user feedback. Hence, we have used both ratings and sentiments of reviews when evaluating our proposed hybrid recommender system. We selected two common datasets for the evaluation, Amazon Digital Music and Amazon Video Games, and showed the superior performance of the proposed hybrid recommender system compared to different baselines. The comparison were made in two evaluation scenarios, namely, when the ratings were considered the user feedback and when sentiments of the review were considered the user feedback.publishedVersio

Successful application of technetium-99m-labeled octreotide acetate scintigraphy in the detection of ectopic adrenocorticotropin-producing bronchial carcinoid lung tumor: a case report

Introduction: The diagnostic efficacy of somatostatin receptor scintigraphy labeling with 111 indium in the localization of tumors has been assessed in a limited number of patients with contradictory outcomes. Here, we describe the case of a patient with an ectopic adrenocorticotropic hormone-producing bronchial carcinoid tumor diagnosed preoperatively using technetium-99m-labeled octreotide acetate scintigraphy. Case presentation: A 29-year-old Asian man presented to our hospital with the typical clinical features of Cushing’s syndrome, which he had had for a duration of 18 months. The results of a biochemical evaluation revealed he had adrenocorticotropic hormone-dependent Cushing’s syndrome. The results of a spiral abdominal computed tomography scan showed he had bilateral adrenal hypertrophy. A magnetic resonance image of the patient’s brain showed he had a normal hypophysis. Whole body technetium-99m-labeled octreotide acetate scintigraphy was performed to check for the presence of an ectopic adrenocorticotropic hormone-producing tumor. The scan results showed a small focal increase in uptake in the lower lobe of our patient’s right lung, just above his diaphragm. A spiral chest computed tomography scan also revealed a small non-specific lesion in the same region. A transthoracic biopsy was then performed. Pathological evaluation confirmed the diagnosis of a carcinoid tumor, of the adrenocorticotropic hormone-producing type. After surgical removal, the patient’s symptoms resolved and significant clinical improvement was achieved. Conclusions: This case report shows that technetium-99m-labeled octreotide acetate scintigraphy can effectively detect an ectopic adrenocorticotropic hormone-producing bronchial carcinoid

On-levothyroxine measurement of thyroglobulin is not a reliable test for the follow-up of patients at high risk for remnant/recurrent differentiated thyroid carcinoma

Wstęp: Obecnie najszerzej akceptowanym narzędziem używanym w badaniach kontrolnych u chorych ze zróżnicowanym rakiem tarczycy jest pomiar osoczowego stężenia tyreoglobuliny (Tg). Nierzadko zdarza się, iż pomiary stężenia Tg odbywają się, gdy chory jednocześnie przyjmuje preparaty hormonów tarczycowych. Celem niniejszego badania była ocena przydatności pomiaru osoczowego stężenia Tg w trakcie stosowania hormonów tarczycy w wykrywaniu choroby resztkowej/nawrotowej lub obecności przerzutów u chorych z wysokim ryzykiem wznowy zróżnicowanego raka tarczycy. Materiały i metody: Retrospektywnej analizie poddano dokumentację medyczną 26 pacjentów obciążonych dużym ryzykiem wystąpienia zróżnicowanego raka tarczycy. Porównano wartości pomiarów osoczowego stężenia Tg odpowiednio w trakcie stosowania hormonów tarczycy oraz po ich odstawieniu. U wszystkich badanych wykluczono obecność przeciwciał przeciwko Tg. Przyjmując pomiary stężenia Tg w okresie odstawienia hormonów tarczycy jako "złoty standard", przeanalizowano (ustalając czułość, specyficzność oraz dodatnią i ujemną wartoœæ predylekcyjną) wyniki oznaczeń stężenia Tg podczas przyjmowania hormonów tarczycy pod kątem diagnostyki resztkowej/nawrotowej choroby. Wyniki: Średnie osoczowe stężenie Tg w warunkach stosowania terapii supresyjnej za pomocą podawanych egzogennych hormonów tarczycy wynosiło 16,5 ng/ml, natomiast po zaprzestaniu stosowania tyroksyny - 95,0 ng/ml (wartość p = 0,001). U 6 chorych (23%) przyjmujących hormony tarczycy stężenie Tg nie potwierdzało wznowy procesu nowotworowego. Przy założeniu, że pomiary stężenia Tg w okresie odstawienia hormonalnych preparatów tarczycy stanowią "złoty standard", czułość, specyficzność dodatnia i ujemna wartość predylekcyjna wynosiły odpowiednio: 72,7%, 100%, 100% i 40%. Wnioski: Monitorowanie stężenia Tg w trakcie terapii tyroksyną nie jest wiarygodną metodą w wykrywaniu wznowy choroby u chorych na zróżnicowanego raka tarczycy.Introduction: At present the most widely accepted tool for follow-up management of differentiated thyroid cancer (DTC) patients is serum thyroglobulin (Tg) measurement. It is not uncommon for the serum Tg level to be measured while the patient is taking thyroid hormones (on-treatment Tg measurement). The purpose of the study was to evaluate the accuracy of on-treatment measurement of serum Tg in detecting remnant/recurrent or metastatic disease in high-risk DTC patients. Material and methods: We retrospectively analysed the medical records of 26 high-risk DTC patients and compared the on-treatment and off-treatment Tg levels of these patients. All patients were anti-Tg negative. Using off-treatment measurement of Tg as the gold standard, the results of on-treatment measurement of Tg in the diagnosis of remnant/recurrent disease were analysed for sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV). Results: The median serum Tg level under thyroid hormone suppressive therapy (on-treatment Tg) was 16.5 ng/ml and after withdrawal of thyroid hormone suppressive therapy (off-treatment Tg) was 95.0 ng/ml (P value = 0.001). In 6 patients (23%) the on-treatment Tg level missed the recurrence of the disease. Regarding the off-treatment Tg as the gold standard, the sensitivity, specificity, PPV and NPV of the on-treatment Tg measurement were 72.7%, 100%, 100%, and 40% respectively. Conclusion: Normal serum Tg level without TSH-stimulation (on-treatment) is not diagnostically reliable in the follow-up of DTC patients with a high probability of residual/recurrent or metastatic disease

Measurement of Occupational Fatigue/exhaustion Recovery in Nurses Caring for COVID-19 Patients

Introduction: The shadow of the coronavirus phenomenon over the nursing profession is considered as a serious threat to the health of nurses and the quality of nursing care for coronavirus patients. This study intended to measure the occupational fatigue/exhaustion recovery of nurses caring for COVID-19 patients in hospitals affiliated with Mashhad University of Medical Sciences. Materials and Methods: This descriptive-analytical cross-sectional study of 203 nurses caring for coronavirus patients was conducted in 2021 using the census method. Data were collected using a 15-item Occupational Fatigue/Exhaustion Recovery (OFER-15) scale, and were analyzed by SPSS statistical software version 22 using independent t-test, one-way analysis of variance, and Tukey’s post hoc tests. The significance level was set at α = 0.05. Results: The majority of the nurses were female (51.2%), married (81.3%), and bachelor’s degree holders (86.2%). The mean occupational exhaustion score of the nurses studied was 60.20±6.13, indicating a high level. Likewise, the average score for chronic fatigue was 22.89±5.87, representing a high level. In contrast, the mean scores for acute fatigue and inter-shift recovery were 18.36±2.76 and 18.95±2.41, respectively, suggesting a moderate level. Nurses in the special coronavirus ward had a significantly higher mean score of acute fatigue than those in the general coronavirus ward (p=0.02). Conclusion: Since the mean occupational exhaustion score among nurses caring for coronavirus patients was high in this study, it is recommended that managers modify the conditions and variables that contribute to fatigue, implement the necessary controls to reduce fatigue, and formulate a strategy to boost the productivity of nurses and the satisfaction of COVID-19 patients

Applying fuzzy clustering to assess and anticipate students' educational progress in learning environments

The purpose of this paper is to propose a method to anticipate students' proceed and to enhance their learning efficiency and success in a learning environment, using data mining. Based on library and survey searching methods, as well as consulting with experts, some effective features in students' learning are identified and then using feature selection method, the most efficient ones are chosen. To clarify the relation between selected features, fuzzy clustering is applied to them. In the second phase of the research, scores of the students of Educational environment study, are predicted, using data mining. Variables taken are midterm and final scores and the average score of selected units in one semester by students studying there between 2006 (1385) and 2012 (1391). According to the achieved methods we can guide each student from the beginning of the semester in line with their effective features, and based on scores gained during the semester we can inform the student about his range of final score to receive an educational plan based on his/her abilities. These methods can be effective in streamlining learning procedure in a system. Test results show the desired accuracy (0.939) of the proposed method than previous methods (discovery of association rules, classification, and identifying the inconsistencies)

The Neuroprotective Effects of Curcumin Nanoparticles on The Cerebral Ischemia-Reperfusion Injury in The Rats-The Roles of The Protein Kinase RNA-Like ER Kinase/Extracellular Signal-Regulated Kinase and Transcription Factor EB proteins

Objective: Reduction of cerebral ischemia-reperfusion injury (IRI)/re-oxygenation injury, is defined as the paradoxicalexacerbation of the cellular dysfunction and death, following restoration of the blood flow to previously ischemic tissues.The re-establishment of blood flow is essential to salvage the ischemic tissues. As a result, the treatment of IRI withnovel therapies, which have fewer side effects, are of great importance. Therefore, this study aimed to investigate theeffects of curcumin nanoparticle (CN) pre-treatment on the cerebral I/R rat model.Materials and Methods: In this experimental study, CN was administered to rats orally five days before the bilateralcommon carotid artery occlusion (BCCAO) and continued for three days. The intensity of oxidative stress, the activities ofantioxidant enzymes, glutathione (GSH) content, the activity of mitochondrial enzymes, including succinate dehydrogenase(SDH), malate dehydrogenase (MDH) and lactate dehydrogenase (LDH), curcumin bioavailability, pERK/ERK expressionratio and TFEB protein were studied. Data analysis was performed using Graphpad Prism V.8 software, one-way analysisof variance (ANOVA) with the statistical package for the social sciences (SPSS V.26 software).Results: Cerebral IRI-damage significantly increased the oxidative stress (P=0.0008) and decreased the activityof the antioxidant enzymes including catalase (CAT) (P<0.001), super oxide dismutase (SOD) (P<0.001), reducedGSH (P<0.001), mitochondrial enzymes, pERK/ERK expression ratio (P=0.002) and TEFB protein (P=0.005) in rats’brains. In addition, the pre-treatment of the rats with CN resulted in a decrease in the reactive oxygen species (ROS),and an increase in the activities of antioxidants and mitochondrial enzymes. This in turn up-regulated the pERK/ERKexpression ratio and TEFB expression.Conclusion: CN has neuroprotective effects on the cerebral IRI condition due to its antioxidant properties and is ableto overexpress the pERK and TFEB proteins; thus, it can be considered as a suitable treatment option during and afterthe incidence of stroke

Assessment of Health Literacy and Self-care Behaviors among Patients Discharged from COVID-19 Wards

Introduction: The rapid outbreak of the new COVID-19 virus has become an international health challenge. Confronting the prevalence of this pathogenic virus requires, in the first step, health literacy and self-care on people’s part. Materials and Methods: This descriptive cross-sectional study was carried out over three months. A total of 67 patients discharged from a COVID-19 ward were selected randomly. Data were collected using a validated researcher-made questionnaire on health literacy and self-care. The data were then analyzed using SPSS software version 16. Results: Sixty-seven patients (mean age: 45.32 ± 9.39; age range: 29 - 87) were assessed. The majority were male (64.2%), married (79.1%), illiterate (44.8%), and homemaker or unemployed (37.3%). The overall mean score of health literacy and self-care was moderate. The results of the Pearson correlation test showed a significantly positive association between overall health literacy and its components as well as the total self-care and its components among the patients studied (p &lt;.001). Conclusion: Since self-care increases with health literacy among COVID-19 patients, it demands educational interventions in this area to improve health literacy

Impact of oral administration of single strain Lactococcus lactis spp. cremoris on immune responses to keyhole limpet hemocyanin immunization and gut microbiota: A randomized placebo-controlled trial in healthy volunteers

IntroductionLactococcus lactis spp. cremoris has been associated with promising immunomodulatory results in preclinical trials. The aim of this study was to investigate the pharmacodynamic (PD) effects of three monoclonal microbial formulations of L. lactis spp. cremoris (EDP1066) on the immune response to keyhole limpet hemocyanin (KLH). Potential effects on the gut microbiota were also investigated.MethodsThe trial was registered on Netherlands Trial Register (trial ID NL7519, https://trialsearch.who.int). Eighty-one healthy subjects (median 28, range 18–59 years) were randomized to 28 days of enteric-coated capsules at five doses (n = 13) (1.5 * 1012 total cells daily), freeze-dried powder at one dose (n = 12) (3.0 * 1011 total cells daily) or five doses (n = 12), minitablets at one dose (n = 12) or five doses (n = 12), or placebo (n = 20) prior to KLH immunization. Antibody responses and circulating regulatory T cells (Tregs) were measured after KLH immunization, and skin responses were evaluated after a KLH rechallenge by laser speckle contrast imaging and multispectral imaging. Ex vivo lymphocyte (phytohemagglutinin) and monocyte (lipopolysaccharide (LPS)) cytokine release assays were explored in the minitablet-treated groups only. The prevalence of L. lactis spp. cremoris in the gastrointestinal tract and the impact on the fecal microbiota were assessed by qPCR and 16S rRNA sequencing, respectively.ResultsRepeated-measures analysis of covariances revealed no significant treatment effects on the antibody responses to KLH, number of Tregs, or KLH skin rechallenge outcomes. Ex vivo LPS-driven cytokine responses in whole blood were lower in the low dose minitablet group compared to placebo: tumor necrosis factor (estimated difference (ED) from placebo: −44.2%, 95% confidence interval (CI) −65.3% to −10.3%), interleukin (IL)-1β (ED −41.4%, 95% CI −63.5% to −5.8%), and IL-6 (ED −39.2%, 95% CI −56.8% to −14.5%). The fecal presence of L. lactis spp. cremoris increased during treatment by all EDP1066 formulations and normalized 5 days after the last dose. Microbiome α-diversity did not change by the treatments compared to placebo.DiscussionThe EDP1066 formulations did not affect the immune response to KLH immunization in healthy individuals. However, exposure to L. lactis spp. cremoris in minitablet formulation impacted ex vivo whole blood LPS cytokine response. The clinical impact of these effects awaits further investigations.Netherlands Trial Registertrialsearch.who.int, trial ID NL7519

Diagnostic role of whole body bone scintigraphy in atypical skeletal tuberculosis resembling multiple metastases: a case report

<p>Abstract</p> <p>Introduction</p> <p>Osseous tuberculosis can be present with unifocal or multifocal bony involvement. Although multifocal involvement of the skeletal system in areas where tuberculosis is endemic is not a rare presentation, its exact prevalence is not well known. A case of atypical skeletal tuberculosis mimicking multiple secondary metastases on radiologic and scintigraphic imaging is presented to emphasize the contribution of bone scintigraphy in the assessment of osseous tuberculosis in typical and atypical presentations.</p> <p>Case presentation</p> <p>A 73-year-old cachectic Asian man (Iranian) presented with a general feeling of being unwell and an acute loss of vision in his left eye accompanied by a severe headache. A Tc-99 m-methylene diphosphonate bone scan demonstrated multiple regions of intense activity in the appendicular and axial skeleton, suggesting metastatic involvement. Tumor markers (PSA, CA125, CA 19-9 and AFP) were within normal ranges. Based on clinical presentation and laboratory, radiological and scintigraphic findings, a presumptive diagnosis of tuberculosis was made. Quadruple antituberculous chemotherapy was consequently started and the patient later showed marked improvement.</p> <p>Conclusion</p> <p>Scintigraphic bone scanning should be kept in mind when assessing bone pain in patients at a high risk of tuberculosis infection or reactivation. We present this unusual case of multifocal skeletal tuberculosis, and stress the related clinical and diagnostic points with the aim of stimulating a high index of suspicion that could facilitate early diagnosis and appropriate treatment.</p