Clinical pharmacology is a multidisciplinary function playing a critical role in the monoclonal antibody development. Besides the requirements of understanding pharmacology, pharmacokinetics, model simulation, biostatistics and immunogenicity, wisely implementation of tactics and strategies to fulfill the agencies' requirements per guidance documents are critical. In this review, clinical pharmacology studies categorized as required, target dependent, development strategy dependent, and not usually needed are discussed. The review ends with the outlook of recent initiations in the clinical pharmacology such as the application of QSP with the integration of AI and machine learning technologies.
{"title":"Clinical pharmacology to support monoclonal antibody drug development","authors":"Sharon Lu","doi":"10.3934/medsci.2022014","DOIUrl":"https://doi.org/10.3934/medsci.2022014","url":null,"abstract":"Clinical pharmacology is a multidisciplinary function playing a critical role in the monoclonal antibody development. Besides the requirements of understanding pharmacology, pharmacokinetics, model simulation, biostatistics and immunogenicity, wisely implementation of tactics and strategies to fulfill the agencies' requirements per guidance documents are critical. In this review, clinical pharmacology studies categorized as required, target dependent, development strategy dependent, and not usually needed are discussed. The review ends with the outlook of recent initiations in the clinical pharmacology such as the application of QSP with the integration of AI and machine learning technologies.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"37 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84669711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Information regarding acute kidney injury (AKI) is scarce among Nigerian children with nephrotic syndrome (NS). This study describes the prevalence, risk factors and outcomes of AKI among children with NS at the University of Abuja Teaching Hospital (UATH), Abuja, Nigeria. Materials and methods This is a review of children with NS, from January 2016 to October 2021 at the UATH. AKI was classified by the paediatric RIFLE criteria. Results Of the 75 children with NS, aged 13 months to 18 years, with a mean age of 10 ± 18 years, and majorly (64, 85.3%) males. AKI occurred in 19 of 75 (25.3%) subjects comprising Failure in 15 (78.9%), Injury in 3 (15.8%) and Risk in 1 (5.3%). Regarding risk factors of AKI at hospital admission; subjects with no sepsis were at reduced odds of AKI (OR = 0.01, 95% CI = 0.02–0.06, p < 0.001); and the risk of AKI was reduced among subjects without gross haematuria (OR = 0.07, 95% CI = 0.01–0.66, p = 0.004). The likelihood of AKI increased in the presence of peritonitis (OR = 7.91, 95% CI = 2.15–29.15, p < 0.001) and urinary tract infections (UTIs) (OR = 2.55, 95% CI = 1.39–4.66, p < 0.001). Subjects with historical exposure to nephrotoxic medications (NTM) were also at risk of AKI (OR = 1.79, 95% CI = 1.13–2.84, p = 0.001). The only 2 deaths (2.6%) observed in the short term was among those with AKI (2/19, 10.5%) but full renal recovery occurred in the majority (16/19, 84.2%). Conclusions AKI is common in our children with NS. Sepsis, gross haematuria, peritonitis, UTIs and NTM were its identified risk factors. It is prudent to have a suspicion of AKI among children with NS with these risk factors in our setting.
背景:尼日利亚儿童肾病综合征(NS)中关于急性肾损伤(AKI)的信息很少。本研究描述了尼日利亚阿布贾阿布贾大学教学医院(UATH) NS患儿AKI的患病率、危险因素和结局。材料和方法这是一项对2016年1月至2021年10月在UATH患有NS的儿童的综述。AKI按照儿科RIFLE标准进行分类。结果75例NS患儿，年龄13个月~ 18岁，平均年龄(10±18岁)，男性居多(64例，85.3%)。75名受试者中有19人(25.3%)发生AKI，其中15人失败(78.9%)，3人受伤(15.8%)，1人有风险(5.3%)。住院时AKI危险因素探讨无脓毒症的受试者发生AKI的几率降低(OR = 0.01, 95% CI = 0.02-0.06, p < 0.001);无明显血尿的受试者发生AKI的风险降低(OR = 0.07, 95% CI = 0.01-0.66, p = 0.004)。存在腹膜炎(OR = 7.91, 95% CI = 2.15-29.15, p < 0.001)和尿路感染(OR = 2.55, 95% CI = 1.39-4.66, p < 0.001)时AKI的可能性增加。既往暴露于肾毒性药物(NTM)的受试者也有AKI的风险(OR = 1.79, 95% CI = 1.13-2.84, p = 0.001)。短期内观察到的仅有2例死亡(2.6%)是AKI患者(2/ 19,10.5%)，但大多数患者肾脏完全恢复(16/ 19,84.2%)。结论aki在NS患儿中较为常见。脓毒症、肉眼血尿、腹膜炎、尿路感染和NTM是其确定的危险因素。在我们的环境中，有这些危险因素的NS患儿有AKI的怀疑是谨慎的。
{"title":"Acute kidney injury in children with nephrotic syndrome at the University of Abuja Teaching Hospital, Abuja, Nigeria: 2016 to 2021","authors":"E. Anigilaje, Ishola Ibraheem","doi":"10.3934/medsci.2022004","DOIUrl":"https://doi.org/10.3934/medsci.2022004","url":null,"abstract":"Background Information regarding acute kidney injury (AKI) is scarce among Nigerian children with nephrotic syndrome (NS). This study describes the prevalence, risk factors and outcomes of AKI among children with NS at the University of Abuja Teaching Hospital (UATH), Abuja, Nigeria. Materials and methods This is a review of children with NS, from January 2016 to October 2021 at the UATH. AKI was classified by the paediatric RIFLE criteria. Results Of the 75 children with NS, aged 13 months to 18 years, with a mean age of 10 ± 18 years, and majorly (64, 85.3%) males. AKI occurred in 19 of 75 (25.3%) subjects comprising Failure in 15 (78.9%), Injury in 3 (15.8%) and Risk in 1 (5.3%). Regarding risk factors of AKI at hospital admission; subjects with no sepsis were at reduced odds of AKI (OR = 0.01, 95% CI = 0.02–0.06, p < 0.001); and the risk of AKI was reduced among subjects without gross haematuria (OR = 0.07, 95% CI = 0.01–0.66, p = 0.004). The likelihood of AKI increased in the presence of peritonitis (OR = 7.91, 95% CI = 2.15–29.15, p < 0.001) and urinary tract infections (UTIs) (OR = 2.55, 95% CI = 1.39–4.66, p < 0.001). Subjects with historical exposure to nephrotoxic medications (NTM) were also at risk of AKI (OR = 1.79, 95% CI = 1.13–2.84, p = 0.001). The only 2 deaths (2.6%) observed in the short term was among those with AKI (2/19, 10.5%) but full renal recovery occurred in the majority (16/19, 84.2%). Conclusions AKI is common in our children with NS. Sepsis, gross haematuria, peritonitis, UTIs and NTM were its identified risk factors. It is prudent to have a suspicion of AKI among children with NS with these risk factors in our setting.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"6 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82196934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Darenskaya, D. A. Stupin, A. Semendyaev, S. Kolesnikov, N. Semenova, L. Kolesnikova
Pelvic venous insufficiency (PVI) in women is widespread and is closely associated with the risk of reproductive disorders (in 15–25% of patients) and a high rate of the disease recurrence after treatment. The factors involved in venous wall damage include atherogenic stimuli and chronic endotoxin aggression due to inflammatory processes. The changes in the initial stages of the disease are usually minor and selective. There is currently an urgent need to identify initial markers of these changes to develop preventive measures for their correction. Therefore, the aim of this study was to determine the cytokine profile parameters' levels, as well as the activity of lipid peroxidation (LPO) and antioxidant defense (AOD) reactions in women with initial manifestations of PVI. Thirty-nine female patients with PVI (mean age 37.4 ± 9.1 years old) were the subjects of the study. The diagnosis was verified by clinical and instrumental examination including ultrasound angioscanning of the pelvic veins and therapeutic and diagnostic laparoscopy, and it was finally confirmed histologically. The control group included 30 nearly healthy women (mean age 33.5 ± 6.3 years old) who underwent surgical sterilization by laparoscopic access. Spectrophotometric, fluorometric and immunoassay methods were used in the study. The cytokine profile in female patients with PVI, as compared to the control group, was characterized by an increased concentration of proinflammatory (interleukin (IL) (IL-6) and IL-8) and anti-inflammatory cytokines (IL-4 and IL-10) and higher ratio values (IL-6/IL-10). The level of primary LPO products, conjugated dienes, was significantly increased and level of final products TBARs values was decreased in comparison to the control. The AOD system main enzyme activity, superoxide dismutase (SOD), was decreased, while the catalase activity increased. In patients with PVI, the glutathione reduced form concentration was lower than in the control group. The results of the study in women with PVI suggest negative changes in the cytokine profile and multidirectional changes in the indicators of the LPO system state in the initial stages of the disease. The control of these changes in patients with PVI should probably be an important component of preventive measures in the initial stages of the disease.
{"title":"Cytokine profile and oxidative stress parameters in women with initial manifestations of pelvic venous insufficiency","authors":"M. Darenskaya, D. A. Stupin, A. Semendyaev, S. Kolesnikov, N. Semenova, L. Kolesnikova","doi":"10.3934/medsci.2022020","DOIUrl":"https://doi.org/10.3934/medsci.2022020","url":null,"abstract":"Pelvic venous insufficiency (PVI) in women is widespread and is closely associated with the risk of reproductive disorders (in 15–25% of patients) and a high rate of the disease recurrence after treatment. The factors involved in venous wall damage include atherogenic stimuli and chronic endotoxin aggression due to inflammatory processes. The changes in the initial stages of the disease are usually minor and selective. There is currently an urgent need to identify initial markers of these changes to develop preventive measures for their correction. Therefore, the aim of this study was to determine the cytokine profile parameters' levels, as well as the activity of lipid peroxidation (LPO) and antioxidant defense (AOD) reactions in women with initial manifestations of PVI. Thirty-nine female patients with PVI (mean age 37.4 ± 9.1 years old) were the subjects of the study. The diagnosis was verified by clinical and instrumental examination including ultrasound angioscanning of the pelvic veins and therapeutic and diagnostic laparoscopy, and it was finally confirmed histologically. The control group included 30 nearly healthy women (mean age 33.5 ± 6.3 years old) who underwent surgical sterilization by laparoscopic access. Spectrophotometric, fluorometric and immunoassay methods were used in the study. The cytokine profile in female patients with PVI, as compared to the control group, was characterized by an increased concentration of proinflammatory (interleukin (IL) (IL-6) and IL-8) and anti-inflammatory cytokines (IL-4 and IL-10) and higher ratio values (IL-6/IL-10). The level of primary LPO products, conjugated dienes, was significantly increased and level of final products TBARs values was decreased in comparison to the control. The AOD system main enzyme activity, superoxide dismutase (SOD), was decreased, while the catalase activity increased. In patients with PVI, the glutathione reduced form concentration was lower than in the control group. The results of the study in women with PVI suggest negative changes in the cytokine profile and multidirectional changes in the indicators of the LPO system state in the initial stages of the disease. The control of these changes in patients with PVI should probably be an important component of preventive measures in the initial stages of the disease.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"22 1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88094358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erin M. Long, J. Ruiz, J. Foglia, K. Valchanov, A. Meikle
Perioperative anaphylaxis events are allergic reactions which occur in the perioperative period when patients are exposed to a multitude of agents, received anesthesia, and undergo a procedure. These reactions are rare and can be life-threatening, with the common signs being hypotension, hypoxia, elevated airway pressures and urticaria. Perioperative anaphylaxis can be mediated by immunoglobulin E (IgE) or non-IgE mechanisms. Globally, the incidence of reactions and frequency of specific triggers varies considerably. Perioperative anaphylaxis events often result in discontinuation of surgery, extended hospital stays, unanticipated intensive care admissions and increased morbidity and mortality. Common causative agents include neuromuscular blocking agents (NMBA's), beta-lactam antibiotics, chlorhexidine, and latex. The primary treatment of perioperative anaphylaxis is removal of the offending agent, epinephrine, and adequate fluid resuscitation. Post-operative workup involves serial serum tryptase measurements, skin testing, in-vitro testing and challenges to determine the culprit agent. Several countries including the UK, Spain, France, Australia, and New Zealand have established guidelines, reporting systems, and specialized clinics dedicated to perioperative hypersensitivity reactions. Future efforts should address diagnostic challenges as well as increasing awareness of other perioperative anaphylaxis triggers. This narrative review will provide an overview of the epidemiology, diagnosis, management, and prevention of perioperative anaphylaxis events.
{"title":"Recognition, treatment, and prevention of perioperative anaphylaxis: a narrative review","authors":"Erin M. Long, J. Ruiz, J. Foglia, K. Valchanov, A. Meikle","doi":"10.3934/medsci.2022005","DOIUrl":"https://doi.org/10.3934/medsci.2022005","url":null,"abstract":"Perioperative anaphylaxis events are allergic reactions which occur in the perioperative period when patients are exposed to a multitude of agents, received anesthesia, and undergo a procedure. These reactions are rare and can be life-threatening, with the common signs being hypotension, hypoxia, elevated airway pressures and urticaria. Perioperative anaphylaxis can be mediated by immunoglobulin E (IgE) or non-IgE mechanisms. Globally, the incidence of reactions and frequency of specific triggers varies considerably. Perioperative anaphylaxis events often result in discontinuation of surgery, extended hospital stays, unanticipated intensive care admissions and increased morbidity and mortality. Common causative agents include neuromuscular blocking agents (NMBA's), beta-lactam antibiotics, chlorhexidine, and latex. The primary treatment of perioperative anaphylaxis is removal of the offending agent, epinephrine, and adequate fluid resuscitation. Post-operative workup involves serial serum tryptase measurements, skin testing, in-vitro testing and challenges to determine the culprit agent. Several countries including the UK, Spain, France, Australia, and New Zealand have established guidelines, reporting systems, and specialized clinics dedicated to perioperative hypersensitivity reactions. Future efforts should address diagnostic challenges as well as increasing awareness of other perioperative anaphylaxis triggers. This narrative review will provide an overview of the epidemiology, diagnosis, management, and prevention of perioperative anaphylaxis events.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"61 8","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72412575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Scheduling urgent, orthopaedic trauma cases has long been a challenge for health care institutions. Traditionally, these cases are scheduled for an operating room (OR) slot in the middle of the night, by “bumping” elective cases to later in the day, by adding a case on after-hours, or by delaying the case for several days until an OR becomes available. As a solution to the challenges facing traditional scheduling modules, trauma centers around the country have instituted the use of a dedicated orthopaedic trauma room (DOTR). While there are multiple studies analyzing the effects of DOTRs on various outcomes, there is not a centralized review of these studies. This paper will serve as a review of the various models of the DOTR as well as the effect of the DOTR on after-hours procedures, time to surgery (TTS), duration of surgery (DOS), length of stay (LOS), cost, and surgical complications. An extensive review of the literature was performed through PubMed and Embase. 17 studies were found to meet eligibility criteria. This review suggests that DOTRs have favorable effects on after-hours procedures, cost, and surgical complications. There is variability in the data regarding the effect on TTS, DOS, and LOS.
{"title":"Associated outcomes of various iterations of the dedicated orthopaedic trauma room: a literature review","authors":"K. Biddle, K. Pagidas","doi":"10.3934/medsci.2022024","DOIUrl":"https://doi.org/10.3934/medsci.2022024","url":null,"abstract":"Scheduling urgent, orthopaedic trauma cases has long been a challenge for health care institutions. Traditionally, these cases are scheduled for an operating room (OR) slot in the middle of the night, by “bumping” elective cases to later in the day, by adding a case on after-hours, or by delaying the case for several days until an OR becomes available. As a solution to the challenges facing traditional scheduling modules, trauma centers around the country have instituted the use of a dedicated orthopaedic trauma room (DOTR). While there are multiple studies analyzing the effects of DOTRs on various outcomes, there is not a centralized review of these studies. This paper will serve as a review of the various models of the DOTR as well as the effect of the DOTR on after-hours procedures, time to surgery (TTS), duration of surgery (DOS), length of stay (LOS), cost, and surgical complications. An extensive review of the literature was performed through PubMed and Embase. 17 studies were found to meet eligibility criteria. This review suggests that DOTRs have favorable effects on after-hours procedures, cost, and surgical complications. There is variability in the data regarding the effect on TTS, DOS, and LOS.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"78 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81506211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Eshel, Baruch Harash, maayan ben sasson, A. Minerbi, S. Vulfsons
Introduction The “Know Pain 50” questionnaire, a well-known and validated questionnaire used to examine medical staff's knowledge in pain medicine, was translated and validated into Hebrew for Israeli medical staff. The questionnaire consists of 50 questions: the first five assess knowledge in pain medicine alone and the other 45 assess knowledge alongside attitudes and beliefs in many aspects of pain medicine. Background There is great importance in understanding the complexity of pain medicine for patients suffering from chronic pain. Many physicians in Israel report a lack of knowledge in many aspects of pain medicine and in particular proper evaluation of pain, and treatment of chronic pain. To the best of our knowledge, there are no valid and reliable questionnaires in Israel that assess physicians' knowledge, attitudes, and beliefs regarding pain medicine. Therefore, validation of a Hebrew version of the “know pain 50” questionnaire is necessary. Methods A transcultural adaptation was performed. The Hebrew version of the questionnaire was given to 16 pain specialists, 40 family practitioners, and 41 medical interns. Family practitioners and medical interns were grouped and compared to pain specialists for analysis. Findings In the complete questionnaire alone and in all the different domains, pain specialists received higher scores (median = 3.5) than family practitioners + medical interns combined (median = 2.74), the group of family practitioners alone (median = 2.6), and the group of the medical interns alone (median = 2.9). (P-value < 0.01). Conclusions The validated Hebrew version of the “Know Pain 50” questionnaire was found suitable for the Israeli medical community. Thus, it is an appropriate tool for assessing different levels of knowledge, attitudes, and beliefs of Israeli medical teams in pain medicine.
{"title":"Validation of the Hebrew version of the questionnaire “know pain 50”","authors":"G. Eshel, Baruch Harash, maayan ben sasson, A. Minerbi, S. Vulfsons","doi":"10.3934/medsci.2022006","DOIUrl":"https://doi.org/10.3934/medsci.2022006","url":null,"abstract":"Introduction The “Know Pain 50” questionnaire, a well-known and validated questionnaire used to examine medical staff's knowledge in pain medicine, was translated and validated into Hebrew for Israeli medical staff. The questionnaire consists of 50 questions: the first five assess knowledge in pain medicine alone and the other 45 assess knowledge alongside attitudes and beliefs in many aspects of pain medicine. Background There is great importance in understanding the complexity of pain medicine for patients suffering from chronic pain. Many physicians in Israel report a lack of knowledge in many aspects of pain medicine and in particular proper evaluation of pain, and treatment of chronic pain. To the best of our knowledge, there are no valid and reliable questionnaires in Israel that assess physicians' knowledge, attitudes, and beliefs regarding pain medicine. Therefore, validation of a Hebrew version of the “know pain 50” questionnaire is necessary. Methods A transcultural adaptation was performed. The Hebrew version of the questionnaire was given to 16 pain specialists, 40 family practitioners, and 41 medical interns. Family practitioners and medical interns were grouped and compared to pain specialists for analysis. Findings In the complete questionnaire alone and in all the different domains, pain specialists received higher scores (median = 3.5) than family practitioners + medical interns combined (median = 2.74), the group of family practitioners alone (median = 2.6), and the group of the medical interns alone (median = 2.9). (P-value < 0.01). Conclusions The validated Hebrew version of the “Know Pain 50” questionnaire was found suitable for the Israeli medical community. Thus, it is an appropriate tool for assessing different levels of knowledge, attitudes, and beliefs of Israeli medical teams in pain medicine.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"47 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80481173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Digital voice assistants (DVAs) are gaining increasing popularity as a tool for accessing online mental health information. However, the quality of information provided by DVAs is not known. This study seeks to evaluate the quality of DVA responses to mental health-related queries in relation to six quality domains: comprehension ability, relevance, comprehensiveness, accuracy, understandability and reliability. Materials and methods Four smartphone DVAs were evaluated: Apple Siri, Samsung Bixby, Google Assistant and Amazon Alexa. Sixty-six questions and answers on mental health conditions (depression, anxiety, obsessive-compulsive disorder (OCD) and bipolar disorder) were compiled from authoritative sources, clinical guidelines and public search trends. Three evaluators scored the DVAs from an in-house-developed evaluation rubric. Data were analyzed by using the Kruskal-Wallis and Wilcoxon rank sum tests. Results Across all questions, Google Assistant scored the highest (78.9%), while Alexa scored the lowest (64.5%). Siri (83.9%), Bixby (87.7%) and Google Assistant (87.4%) scored the best for questions on depression, while Alexa (72.3%) scored the best for OCD questions. Bixby scored the lowest for questions on general mental health (0%) and OCD (0%) compared to all other DVAs. In terms of the quality domains, Google Assistant scored significantly higher for comprehension ability compared to Siri (100% versus 88.9%, p < 0.001) and Bixby (100% versus 94.5%, p < 0.001). Moreover, Google Assistant also scored significantly higher than Siri (100% versus 66.7%, p < 0.001) and Alexa (100% versus 75.0%, p < 0.001) in terms of relevance. In contrast, Alexa scored the worst in terms of accuracy (75.0%), reliability (58.3%) and comprehensiveness (22.2%) compared to all other DVAs. Conclusion Overall, Google Assistant performed the best in terms of responding to the mental health-related queries, while Alexa performed the worst. While the comprehension abilities of the DVAs were good, the DVAs had differing performances in the other quality domains. The responses by DVAs should be supplemented with other information from authoritative sources, and users should seek the help and advice of a healthcare professional when managing their mental health conditions.
{"title":"Quality evaluation of digital voice assistants for the management of mental health conditions","authors":"Vanessa Kai Lin Chua, L. Wong, K. Yap","doi":"10.3934/medsci.2022028","DOIUrl":"https://doi.org/10.3934/medsci.2022028","url":null,"abstract":"Background Digital voice assistants (DVAs) are gaining increasing popularity as a tool for accessing online mental health information. However, the quality of information provided by DVAs is not known. This study seeks to evaluate the quality of DVA responses to mental health-related queries in relation to six quality domains: comprehension ability, relevance, comprehensiveness, accuracy, understandability and reliability. Materials and methods Four smartphone DVAs were evaluated: Apple Siri, Samsung Bixby, Google Assistant and Amazon Alexa. Sixty-six questions and answers on mental health conditions (depression, anxiety, obsessive-compulsive disorder (OCD) and bipolar disorder) were compiled from authoritative sources, clinical guidelines and public search trends. Three evaluators scored the DVAs from an in-house-developed evaluation rubric. Data were analyzed by using the Kruskal-Wallis and Wilcoxon rank sum tests. Results Across all questions, Google Assistant scored the highest (78.9%), while Alexa scored the lowest (64.5%). Siri (83.9%), Bixby (87.7%) and Google Assistant (87.4%) scored the best for questions on depression, while Alexa (72.3%) scored the best for OCD questions. Bixby scored the lowest for questions on general mental health (0%) and OCD (0%) compared to all other DVAs. In terms of the quality domains, Google Assistant scored significantly higher for comprehension ability compared to Siri (100% versus 88.9%, p < 0.001) and Bixby (100% versus 94.5%, p < 0.001). Moreover, Google Assistant also scored significantly higher than Siri (100% versus 66.7%, p < 0.001) and Alexa (100% versus 75.0%, p < 0.001) in terms of relevance. In contrast, Alexa scored the worst in terms of accuracy (75.0%), reliability (58.3%) and comprehensiveness (22.2%) compared to all other DVAs. Conclusion Overall, Google Assistant performed the best in terms of responding to the mental health-related queries, while Alexa performed the worst. While the comprehension abilities of the DVAs were good, the DVAs had differing performances in the other quality domains. The responses by DVAs should be supplemented with other information from authoritative sources, and users should seek the help and advice of a healthcare professional when managing their mental health conditions.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"63 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86796513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. S. Nayak, K. Surapaneni, P. Sahu, Purnima Bhoi, K. Dhananjay, S. Silambanan, C. Silvia, Dhanush Nayak, K. Nagendra, M. Naidu, Akash S Nayak
The COVID-19 pandemic has resulted in dramatic challenges to healthcare systems worldwide. There has been an increased awareness to protect frontline workers from COVID-19 exposure and its consequences. To assess the prevalence of healthcare professionals in India during the COVID-19, a cross-sectional web-based survey was conducted with healthcare professionals from medical colleges and hospitals from different states across the country. The study comprised 772 healthcare professionals aged ≥18 years. The main outcome measures studied were anxiety, depression, and stress. Among the healthcare professionals, 37.17%, 33.68%, and 23.7% were reported to have anxiety, depression, and stress respectively. The physicians, female, aged population, and professionals sleeping less than 7 hours are more prone to psychological problems. The results of this study predict the high levels of anxiety, depression, and stress among healthcare professionals in different states of India. Increased COVID-19 cases, high pressure, workload, and lack of training are the main reasons for the psychological problems in healthcare professionals. Proper strategies must be followed in healthcare settings to reduce the burden of stress.
{"title":"The mental health of the health care professionals in India during the COVID-19 pandemic: a cross-sectional study","authors":"B. S. Nayak, K. Surapaneni, P. Sahu, Purnima Bhoi, K. Dhananjay, S. Silambanan, C. Silvia, Dhanush Nayak, K. Nagendra, M. Naidu, Akash S Nayak","doi":"10.3934/medsci.2022011","DOIUrl":"https://doi.org/10.3934/medsci.2022011","url":null,"abstract":"The COVID-19 pandemic has resulted in dramatic challenges to healthcare systems worldwide. There has been an increased awareness to protect frontline workers from COVID-19 exposure and its consequences. To assess the prevalence of healthcare professionals in India during the COVID-19, a cross-sectional web-based survey was conducted with healthcare professionals from medical colleges and hospitals from different states across the country. The study comprised 772 healthcare professionals aged ≥18 years. The main outcome measures studied were anxiety, depression, and stress. Among the healthcare professionals, 37.17%, 33.68%, and 23.7% were reported to have anxiety, depression, and stress respectively. The physicians, female, aged population, and professionals sleeping less than 7 hours are more prone to psychological problems. The results of this study predict the high levels of anxiety, depression, and stress among healthcare professionals in different states of India. Increased COVID-19 cases, high pressure, workload, and lack of training are the main reasons for the psychological problems in healthcare professionals. Proper strategies must be followed in healthcare settings to reduce the burden of stress.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"269 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76188801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anaphylaxis is defined as an acute, life-threatening, systemic allergic reaction associated with a broad array of clinical manifestations. Anaphylaxis typically is a type 1 (IgE mediated) hypersensitivity reaction though other mechanism may also be involved. Patients most commonly present with cutaneous symptoms followed by respiratory and gastrointestinal symptoms. Prompt recognition and treatment can be life saving. Epinephrine is the drug of choice for treatment of anaphylaxis. It is imperative that patients and their caregivers are educated on the use of epinephrine autoinjectors and provided with an emergency action plan for managing anaphylaxis.
{"title":"Anaphylaxis: recognition, treatment, and outcomes","authors":"D. Seth, D. Kamat","doi":"10.3934/medsci.2022007","DOIUrl":"https://doi.org/10.3934/medsci.2022007","url":null,"abstract":"Anaphylaxis is defined as an acute, life-threatening, systemic allergic reaction associated with a broad array of clinical manifestations. Anaphylaxis typically is a type 1 (IgE mediated) hypersensitivity reaction though other mechanism may also be involved. Patients most commonly present with cutaneous symptoms followed by respiratory and gastrointestinal symptoms. Prompt recognition and treatment can be life saving. Epinephrine is the drug of choice for treatment of anaphylaxis. It is imperative that patients and their caregivers are educated on the use of epinephrine autoinjectors and provided with an emergency action plan for managing anaphylaxis.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"28 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75523104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soluble Fas ligand (sFasL, sCD95L) and its specific soluble binders, soluble Fas receptor (sFas, sCD95) and decoy receptor 3 (DcR3), have been investigated as possible clinical biomarkers in many serious diseases. The present review aimed to provide an overview of the current state of this medically promising research by extensively examining the relevant literature. The summarized results of the survey are presented after classification into six categories according to the type of targeted disease. To date, the studies have been mainly devoted to the diagnosis of disease severity states and prognosis of treatments about various types of cancers and autoimmune diseases represented by autoimmune lymphoproliferative syndrome and systemic lupus erythematosus, because these important life-threatening or intractable diseases were suggested to be most relevant to the impairment of apoptotic cell death-inducing systems, including the Fas receptor-mediated signaling system, and the mechanisms responsible for their onset. However, various more general inflammation-related diseases, including, but not limited to, other autoimmune and allergic diseases (e.g., rheumatoid arthritis and atopic asthma), infectious diseases (e.g., sepsis and chronic hepatitis), cardiovascular system-specific disorders (e.g., acute coronary syndromes and heart failure) as well as other diseases specific to the renal, hepatic, and respiratory systems, etc., have also been targeted as important fields of research. The data obtained so far demonstrated that sFas, sFasL, and DcR3 possess significant potential in the assessment of various disease states, which can contribute to the development of therapeutic interventions. Although further studies in various relevant fields are essential, it is expected that clinical translation of sFas, sFasL, and DcR3 into practical biomarkers will contribute to effective treatments of a wide variety of diseases.
{"title":"Soluble Fas ligand, soluble Fas receptor, and decoy receptor 3 as disease biomarkers for clinical applications: A review","authors":"M. Muraki","doi":"10.3934/medsci.2022009","DOIUrl":"https://doi.org/10.3934/medsci.2022009","url":null,"abstract":"Soluble Fas ligand (sFasL, sCD95L) and its specific soluble binders, soluble Fas receptor (sFas, sCD95) and decoy receptor 3 (DcR3), have been investigated as possible clinical biomarkers in many serious diseases. The present review aimed to provide an overview of the current state of this medically promising research by extensively examining the relevant literature. The summarized results of the survey are presented after classification into six categories according to the type of targeted disease. To date, the studies have been mainly devoted to the diagnosis of disease severity states and prognosis of treatments about various types of cancers and autoimmune diseases represented by autoimmune lymphoproliferative syndrome and systemic lupus erythematosus, because these important life-threatening or intractable diseases were suggested to be most relevant to the impairment of apoptotic cell death-inducing systems, including the Fas receptor-mediated signaling system, and the mechanisms responsible for their onset. However, various more general inflammation-related diseases, including, but not limited to, other autoimmune and allergic diseases (e.g., rheumatoid arthritis and atopic asthma), infectious diseases (e.g., sepsis and chronic hepatitis), cardiovascular system-specific disorders (e.g., acute coronary syndromes and heart failure) as well as other diseases specific to the renal, hepatic, and respiratory systems, etc., have also been targeted as important fields of research. The data obtained so far demonstrated that sFas, sFasL, and DcR3 possess significant potential in the assessment of various disease states, which can contribute to the development of therapeutic interventions. Although further studies in various relevant fields are essential, it is expected that clinical translation of sFas, sFasL, and DcR3 into practical biomarkers will contribute to effective treatments of a wide variety of diseases.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"51 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74347807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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