INTELLIGENTLY LEVERAGING MENTAL WELLNESS STATE IN COGNITIVE COLLABORATION WORKFLOWS

A person\u27s mental wellness plays a critical role in determining how efficiently a complex task that requires cognitive abilities is successfully completed. However, current solutions do not offer a mechanism for detecting an individual’s mental wellness in a real-time and proactive manner. To address that lack, techniques are presented herein that leverage a range of information including electroencephalography (EEG) signals (e.g., as captured from an EEG headset); real-time health parameters such as heart rate, blood pressure, etc. (e.g., as captured from health monitoring devices such as wearable physical fitness monitors); etc. Such information may be processed by an online communication and collaboration facility at a network edge and may be shared to different trusted business applications. Further aspects of the presented techniques may encompass a model that comprises artificial intelligence (AI) and machine learning (ML). Such a model may incorporate different parameters, may include a training mode, and may be used to predict the mental state of an individual. By employing the presented techniques, proactive mental health insight data may be fed into a work routing system’s mechanism so that the assignment of new or existing work that requires a higher level of focus (such as handling a Priority 1 or a Priority 2 technical support case, performing financial transactions, providing virtual medical consultation, etc.) may depend upon a person\u27s mental readiness rather than just their physical availability

Rapid versus Delayed Stimulation of Feeding by the Endogenously Released AgRP Neuron Mediators GABA, NPY, and AgRP

SummaryAgouti-related peptide (AgRP) neurons of the hypothalamus release a fast transmitter (GABA) in addition to neuropeptides (neuropeptide Y [NPY] and Agouti-related peptide [AgRP]). This raises questions as to their respective functions. The acute activation of AgRP neurons robustly promotes food intake, while central injections of AgRP, NPY, or GABA agonist results in the marked escalation of food consumption with temporal variance. Given the orexigenic capability of all three of these neuroactive substances in conjunction with their coexpression in AgRP neurons, we looked to unravel their relative temporal role in driving food intake. After the acute stimulation of AgRP neurons with DREADD technology, we found that either GABA or NPY is required for the rapid stimulation of feeding, and the neuropeptide AgRP, through action on MC4 receptors, is sufficient to induce feeding over a delayed yet prolonged period. These studies help to elucidate the neurochemical mechanisms of AgRP neurons in controlling temporally distinct phases of eating

Endoscopy in Management of Portal Hypertension

Portal hypertension (PH) is a serious consequence of several disease states affecting prehepatic, intrahepatic, or posthepatic portal circulation. Backpressure caused by PH transmits through the collaterals to form varices at various sites. PH also leads to hyperdynamic congestion and altered gastrointestinal mucosal immune response, resulting in portal hypertensive gastropathy (PHG), portal hypertensive enteropathy (PHE), and portal colopathy (PC). These PH associated phenomena may lead to torrential life-threatening bleed or chronic blood loss leading to debilitating chronic anemia. Endoscopy plays a pivotal role in the management of these patients both for diagnostic and therapeutic purpose. The choice of therapeutic strategy depends on many factors: severity of the disease, patient’s clinical performance, and whether it is done as an emergency or as a prophylactic approach. In this chapter, we evaluate the endoscopic management of patients with the gastrointestinal complications of PH

An Evidence-Based Approach to Identify Student Success Strategies: Focus on Individualized Reassessment

Objectives Describe a process for engaging faculty in evaluating the feasibility of and designing and implementing evidence-based strategies to improve student success. Highlight one successful outcome of this process: IR.https://jdc.jefferson.edu/pharmacyposters/1026/thumbnail.jp

Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System

Background/Aims To evaluate patients with portal hypertension (PH) of varied etiologies for portal hypertensive enteropathy (PHE) using the PillCam SB3 capsule endoscopy (CE) system. Methods Consecutive patients with PH presenting with unexplained anemia and/or occult gastrointestinal bleeding were evaluated using the PillCam SB3 CE system. Abnormal findings were categorized as vascular or non-vascular. The patients with ongoing bleeding caused by PHE were treated. The correlation of the CE scores of PHE with the clinical, laboratory, and endoscopic features was determined. Results Of the 43 patients included in the study, 41 (95.3%) showed PHE findings. These included varices (67.4%), red spots (60.5%), erythema (44.2%), villous edema (46.5%), telangiectasia (16.3%), and polyps (16.3%). The CE scores varied from 0 to 8 (mean±standard deviation, 4.09±1.8). Five patients (11.6%) showed evidence of ongoing or recent bleeding due to PHE. Three of these five patients underwent endotherapy, and one patient underwent radiological coil placement. Conclusions The PillCam SB3 CE system revealed a high prevalence of PHE in the patients with PH. Using this system, evidence of bleeding due to PHE was found in a small but definite proportion of the patients

A prospective study of fully covered self-expandable metal stents for refractory benign pancreatic duct strictures

Background/Aims Fully covered self-expanding metal stents (FCSEMSs) are a relatively novel option for treating painful main pancreatic duct refractory strictures in patients with chronic pancreatitis. Herein, we aimed to assess the efficacy, feasibility, and safety of FCSEMSs in this patient group. Methods This prospective single-center study included patients who underwent endoscopic retrograde pancreatography with FCSEMS placement. The primary endpoints were the technical and clinical success rates. A reduction in visual analog scale pain score of >50% compared with that before stent placement was defined as clinical success. Secondary endpoints were resolution of pancreatic strictures on fluoroscopy during endoscopic retrograde pancreatography and the development of stent-related adverse events. Results Thirty-six patients were included in the analysis. The technical success rate was 100% (n=36) and the clinical success rate was 86.1% (n=31). There was a significant increase in stricture diameter from 1.7 mm to 3.5 mm (p<0.001) after stent removal. The mean visual analog scale pain score showed statistically significant improvement. At 19 months of follow-up, 55.6% of the patients were asymptomatic. Stent migration (16.7%), intolerable abdominal pain (8.3%), development of de novo strictures (8.3%), and mild pancreatitis (2.8%) were the most common adverse events. Conclusions FCSEMS placement showed good technical and clinical success rates for achieving pain relief in patients with refractory main pancreatic duct strictures

Topical clobetasol propionate 0.025%: a therapeutic dermatologic asset

Over several decades, topical corticosteroids (TCs) have been used in the treatment of various dermatoses such as psoriasis, contact dermatitis, and eczema, among others. The TCs act by reducing inflammation and irritation after topical application. The therapeutic effect of TCs is bestowed through their diverse biologic properties such as anti-inflammatory, antiproliferative, vasoconstrictive, and antimitotic activity, and its role in the reduction of lymphocyte reactivity, modulation of Langerhans cell expression, cellular and lysosomal membrane stabilization, reduction of recruitment of neutrophils and monocytes, reduction of mast cell density and reactivity, and sensitization of immunoglobulin E. Clobetasol propionate (CP) 0.025% is a class I TC available as a cream formulation. The cream formulation contains half the concentration of conventional CP (0.025%), without the loss of therapeutic potency. The lack of additives such as penetration enhancers (propylene glycol) further prevents cutaneous microbiome alteration. This comprehensive case series covers the potent efficacy and safety of ImpoyzTM (CP) Cream 0.025% in the management of various dermatological disorders

A Prospective Open Trial of Guanfacine in Children with Pervasive Developmental Disorders

Objective: A common complaint for children with pervasive developmental disorder (PDD) is hyperactivity. The purpose of this pilot study was to gather preliminary information on the efficacy of guanfacine in children with PDD and hyperactivity. Methods: Children with PDD accompanied by hyperactivity entered the open-label trial if there was a recent history of failed treatment with methylphenidate or the child did not improve on methylphenidate in a multisite, placebo-controlled trial. Results: Children (23 boys and 2 girls) with a mean age of 9.03 (±3.14) years entered the open-label trial. After 8 weeks of treatment, the parent-rated Hyperactivity subscale of the Aberrant Behavior Checklist (ABC) went from a mean of 31.3 (±8.89) at baseline to 18.9 (±10.37) (effect size = 1.4; p < 0.001). The teacher-rated Hyperactivity subscale decreased from a mean of 29.9 (±9.12) at baseline to 22.3 (±9.44) (effect size = 0.83; p < 0.01). Twelve children (48%) were rated as Much Improved or Very Much Improved on the Clinical Global Impressions– Improvement. Doses ranged from 1.0 to 3.0 mg/day in two or three divided doses. Common adverse effects included irritability, sedation, sleep disturbance (insomnia or midsleep awakening), and constipation. Irritability led to discontinuation in 3 subjects. There were no significant changes in pulse, blood pressure, or electrocardiogram. Conclusions: Guanfacine may be useful for the treatment of hyperactivity in children with PDD. Placebocontrolled studies are needed to guide clinical practice