Search

Copyright of Ars Pharmaceutica is the property of Facultad de Farmacia de Granada and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The effectiveness of eLearning in enhancing healthcare professionals' capacity has received substantial attention globally. This review sought to synthesis evidence on the effectiveness of various types of eLearning programmes, and the facilitators and barriers to its use. Methods: The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four main databases (PubMed, Web of Science, JSTOR, and Scopus) in July 2023 and 44 articles met the eligibility criteria and were included in the review. The JBI critical appraisal checklist was used to appraise the methodological quality of the studies. The data were examined using narrative review to determine the effectiveness of the intervention as well as the barriers and facilitators to its use. Results: This review found that asynchronous, synchronous, blended, and self-learning methodologies are effective eLearning approaches for continuous professional development. Previous positive experiences, user-friendly interfaces and relevance of the eLearning content to daily practice are critical elements that facilitate eLearning usage. Poor computer competence and literacy, lack of personal computers and high family duties were the main personal factors that hindered eLearning use. Some systemic barriers included; heavy workloads, shortage of specialised eLearning facilitators poor management involvement, and technical inadequacies within the ICT departments. Environmental issues such as poor infrastructure, including limited internet and frequent power outages acted as barriers. Conclusion: The review highlights the effectiveness of various eLearning approaches among health professionals and presents the disparities between developing and developed economies in relation to the facilitators and barriers. [ABSTRACT FROM AUTHOR]

Background: Competency in the use of information science and technology (IST) is essential for medical students. This study identified learning objectives and competencies that correspond with low self-assessment related to use of IST and factors that improve such self-assessment among medical students. Methods: A questionnaire was administered to sixth-year medical students across 82 medical schools in Japan between November 2022 and February 2023. Results: Three learning objectives were identified as difficult for the students to achieve: (1) provide an overview of the regulations, laws, and guidelines related to IST in medicine; (2) discuss ethical issues, such as social disparities caused by the digital divide that may arise in the use of IST in medicine; and (3) understand IST related to medical care. Further, problem-based learning, engaging with IST beyond class, and learning approach impacted the students' acquisition of competencies related to IST. Furthermore, it was recognized that the competencies required by medical students may change over the course of an updated medical school curriculum. Conclusions: It is important for medical students to recognize the significance of learning, establishing active learning methods, and gaining experience in practically applying these competencies. [ABSTRACT FROM AUTHOR]

Background: Concussions are a public health concern. Underdiagnosis and mismanagement negatively impact patients, risking in persistent symptoms and permanent disability. Objective: This scoping review consolidates the heterogeneous and inconsistent concussion research and identifies key areas for medical education curriculum design to focus on for effective knowledge acquisition and bolstering competency in family physician residency. We analyze the literature on concussion education spanning various healthcare disciplines in North America. Methods: PRISMA-Sc was followed and MEDLINE and EMBASE Classic + EMBASE in the OvidSP search platform were used to find terms for brain concussion AND medical education OR specific education until 2021. Results: There are significant knowledge gaps about concussions, increased clinical exposure is required for competency which bolster physical examination skills and streamlined concussion guidelines are required for family medicine specialists that filter undifferentiated symptoms25% of participants improved adherence to concussion guidelines after an educational intervention and knowledge increased after concussion workshop and clinics. Conclusions: Multifaceted teaching improves concussion diagnosis and management. More research is needed to examine concussion competency and, more importantly, whether these interventions improve patient outcomes. [ABSTRACT FROM AUTHOR]

By 2060, an estimated one in four Americans will be elderly. Consequently, the prevalence of osteoporosis and fragility fractures will also increase. Presently, no available intervention definitively prevents or manages osteoporosis. This study explores whether Pool 7 Compound 3 (P7C3) reduces progressive bone loss and fragility following the onset of ovariectomy (OVX)‐induced osteoporosis. Results confirm OVX‐induced weakened, osteoporotic bone together with a significant gain in adipogenic body weight. Treatment with P7C3 significantly reduced osteoclastic activity, bone marrow adiposity, whole‐body weight gain, and preserved bone area, architecture, and mechanical strength. Analyses reveal significantly upregulated platelet derived growth factor‐BB and leukemia inhibitory factor, with downregulation of interleukin‐1 R6, and receptor activator of nuclear factor kappa‐B (RANK). Together, proteomic data suggest the targeting of several key regulators of inflammation, bone, and adipose turnover, via transforming growth factor‐beta/SMAD, and Wingless‐related integration site/be‐catenin signaling pathways. To the best of the knowledge, this is first evidence of an intervention that drives against bone loss via RANK. Metatranscriptomic analyses of the gut microbiota show P7C3 increased Porphyromonadaceae bacterium, Candidatus Melainabacteria, and Ruminococcaceae bacterium abundance, potentially contributing to the favorable inflammatory, and adipo‐osteogenic metabolic regulation observed. The results reveal an undiscovered, and multifunctional therapeutic strategy to prevent the pathological progression of OVX‐induced bone loss. [ABSTRACT FROM AUTHOR]

Background: Information and communication technologies (ICTs) improve quality and efficiency of healthcare, but effective practices for implementing new ICTs are unknown. From 2019 to 2021, the Veterans Health Administration (VHA) implemented FLOW3, an ICT that facilitates prosthetic limb care. The goal of this study was to compare the impact of two facilitation strategies on FLOW3 adoption, implementation, and sustainment. Methods: FLOW3 is a computerized workflow management system comprised of three applications that facilitate the three steps for prosthesis authorization. During VHA's implementation of FLOW3, we randomized 60 VHA sites to basic or enhanced facilitation groups. Basic facilitation included a manualized training toolkit and office hours. Enhanced facilitation included basic facilitation plus monthly learning collaboratives and site-specific performance reports. Outcomes included time to adoption of FLOW3 and complete FLOW3 utilization rates during implementation and sustainment periods. We compared outcomes between sites assigned to basic versus enhanced facilitation groups. Results were calculated using both intent-to-treat (ITT) and dose–response analyses. The dose–response analysis used a per-protocol approach and required sites in the enhanced facilitation group to join two of six learning collaboratives; sites that attended fewer were reassigned to the basic group. Results: Randomization assigned 30 sites to enhanced facilitation and 30 to basic. Eighteen of 30 randomized sites were included in the enhanced facilitation group for dose–response analysis. During the implementation period, enhanced facilitation sites were significantly more likely to completely utilize FLOW3 than basic facilitation sites (HR: 0.17; 95% CI: 1.18, 4.53, p = 0.02) based on ITT analysis. In the dose–response analysis, the enhanced group was 2.32 (95% CI: 1.18, 4.53) times more likely to adopt FLOW3 than basic group (p = 0.014). Conclusions: Enhanced facilitation including a learning collaborative and customized feedback demonstrated greater likelihood for sites to complete a prosthetics consult using FLOW3 throughout our study. We identified statistically significant differences in likelihood of adoption using the dose–response analysis and complete utilization rate using ITT analysis during the implementation period. All sites that implemented FLOW3 demonstrated improvement in completion rate during the sustainment period, but the difference between facilitation groups was not statistically significant. Further study to understand sustainability is warranted. [ABSTRACT FROM AUTHOR]

Background: In May of 2022, an mpox (formerly known as monkeypox) outbreak was reported from countries where the disease is not endemic, rising worldwide concern. Malta, the smallest European Union member state, faced unique challenges, with high infection rates compared to the rest of Europe. The aim of the study is to describe the clinical characteristics, diagnostic challenges, and unique demographics of mpox patients diagnosed in Malta. Methods: This is a retrospective analysis of medical records of all mpox cases recorded from May to September 2022. Demographic data, sexual behaviors and practices, travel history, comorbidities, and HIV status were investigated. Results: In the study period, we recorded 33 mpox cases, 97% of them were male, in the age group 30–39 (39%). Ninety percent were gay or bisexual men and 76% non‐Maltese. The most common clinical presentations included skin rash (78%), lymphadenopathy (71%), anogenital lesions (67%), and fever (67%). Twenty‐seven percent of the patients were people living with HIV. In terms of coinfection with STIs, 27% of patients tested positive for gonorrhea, 12% for syphilis, 15% for chlamydia, 9% for herpes simplex virus, and 3% for hepatitis C virus. Conclusion: The results shed light on unique challenges faced by the local sexual health clinic and call for more resources in response to the global emerging of infectious diseases. [ABSTRACT FROM AUTHOR]

The cultivation of energy crops is an important component of renewable bioenergy, which pursues the goal of reducing greenhouse gas emissions and determines the effective management of fertility and land use of marginal lands and disturbed areas of various nature. As a result of the conducted research, convincing relationships were established between the application of sewage sludge with a compensatory dose of mineral fertilizers and the productivity of grassy energy crops. The greatest increase in green mass is provided by the application of SS (SS - 40 t/ha + N10P14K58) for all studied crops. Applying sewage sludge with the addition of mineral fertilizers is an effective way to increase the productivity of green mass by 57-64% for such energy crops as Jerusalem artichoke, Silphium perfoliatum L, Miscanthus giganteus, and switchgrass (Panicum virgatum L). [ABSTRACT FROM AUTHOR]

The human brain is an exceptionally complex organ that is comprised of billions of neurons. Therefore, when a traumatic event such as a concussion occurs, somatic, cognitive, behavioral, and sleep impairments are the common outcome. Each concussion is unique in the sense that the magnitude of biomechanical forces and the direction, rotation, and source of those forces are different for each concussive event. This helps to explain the unpredictable nature of post-concussion symptoms that can arise and resolve. The purpose of this narrative review is to connect the anatomical location, healthy function, and associated post-concussion symptoms of some major cerebral gray and white matter brain regions and the cerebellum. As a non-exhaustive description of post-concussion symptoms nor comprehensive inclusion of all brain regions, we have aimed to amalgamate the research performed for specific brain regions into a single article to clarify and enhance clinical and research concussion assessment. The current status of concussion diagnosis is highly subjective and primarily based on self-report of symptoms, so this review may be able to provide a connection between brain anatomy and the clinical presentation of concussions to enhance medical imaging assessments. By explaining anatomical relevance in terms of clinical concussion symptom presentation, an increased understanding of concussions may also be achieved to improve concussion recognition and diagnosis. [ABSTRACT FROM AUTHOR]

Cyathea dregei (CD) is a weed plant that is rarely consumed. This study investigated the impact of Enterococcus faecalis as an agent of 3–5-day fermentation, thus stimulating the edible properties of the leaves from CD using Talinum fruticosum as the control. The proximate content, biochemical, antioxidant properties, and phytochemical constituents of the unfermented and fermented leaves were examined. The lactate dehydrogenase activity (LDH) activity significantly increased (p < 0.05) due to the fermentation, which peaked on the third day. The fat, ash, and crude fiber constituents of the fermented CD leaves were significantly higher (p < 0.05), especially on day 3, compared to the unfermented leaves of CD. The leaves of CD naturally possess significantly higher (p < 0.05) values of calcium, selenium, magnesium potassium, sodium, zinc, and vitamin C but significantly lower (p < 0.05) values of vitamins A and E compared to those of water leaf. The fermentation aided the synthesis of caffeic acid (61.71 mg/10 g extract), eleven other bioactive phytochemicals (0.14–60.24 mg/10 g extract), two unexplored saponins (P-Scd, 52.05 mg/10 g extract), and a phenolic compound (P-Pcd, 0.23 mg/10 g extract). Four novel intermediary compounds and six other established compounds were freshly identified with fermentation. The leaves of C. dregei are naturally rich in bioactive nutrients and phytochemicals that trigger their strong antioxidant qualities, which were improved by this fermentation technique. E. faecalis is most likely to engage LDH in driving the fermentation transforming the C. dregei into a potential edible vegetable. [ABSTRACT FROM AUTHOR]

Background: Monkeypox is a zoonotic viral infection first reported in May 2022. Monkeypox cases present with prodromal symptoms, rash, and/or systemic complications. This study systematically reviews the monkeypox cases presented with any cardiac complications. Methods: A systematic literature search was done to locate papers that discuss any cardiac complications associated with monkeypox; then, data were analyzed qualitatively. Results: Nine articles, including the 13 cases that reported cardiac complications of the disease, were included in the review. Five cases previously had sex with men, and two cases had unprotected intercourse, which reveals the importance of the sexual route in disease transmission. All cases have a wide spectrum of cardiac complications, such as acute myocarditis, pericarditis, pericardial effusion, and myopericarditis. Conclusion: This study clarifies the potential for cardiac complications in monkeypox cases and provides avenues for future research to determine the underlying mechanism. Also, we found that the cases with pericarditis were treated with colchicine, and those with myocarditis were treated with supportive care or cardioprotective treatment (Bisoprolol and Ramipril). Furthermore, Tecovirimat is used as an antiviral drug for 14 days. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus Disease-2019 (COVID-19) lockdown was an opportunity for starting online medical education in Kerala, India. It was a challenge to teach the core competency biostatistics online considering the unfamiliarity and possible network issues. Aim: To assess the learning and student satisfaction of biostatistics teaching, by comparing Google classroom module and online lecture, while teaching phase-2 MBBS students. Materials and Methods: This was a randomised educational interventional study done in the Department of Community Medicine, Government Medical College, Manjeri, Kerala, India, from December 2020 to September 2021. A total of 89 students of phase-2 MBBS were randomly divided into two groups as online lecture group and Google classroom group and five sessions were conducted. For the lecture group, classes were conducted via Google Meet using PowerPoint presentations and for the other group, PowerPoint with audio and workedout examples were provided in Google classroom. Immediate and retention scores of academic performance and satisfaction level were assessed using Multiple Choice Questions (MCQs). Mann-Whitney U test using Statistical Package for the Social Sciences (SPSS) software version 28.0 were done for analysis. Results: Of total 89 students participated, the mean age of the study population was 21.2±0.73, and there were 62 (69.7%) females and 37 (30.3%) males. Academic performance was similar for both groups in most of the immediate assessments, except activity on making graphs (p-value=0.001). In delayed assessment using median scores, the Google classroom group (110, IQR: 100-140) performed significantly better compared to the online lecture (100, IQR: 60-130) with (p-value=0.042). Regarding satisfaction, 68.3% of Google classroom students were satisfied, compared to 52.4% of the online lecture group. The flexibility to learn at own place, pace, and time was the main advantage of the Google classroom, while the need for self-motivation was the disadvantage. Direct interaction was the advantage of online lectures and inability for simultaneous doubt clarification and to attend at fixed timing was the disadvantage. Conclusion: Online teaching of biostatistics was effective and student satisfaction level was good. Google classroom module can be considered as a supplement for traditional teaching. [ABSTRACT FROM AUTHOR]

Cutaneous adverse effects of imatinib are common and well documented in the literature. However, imatinib‐induced lichen planus is an uncommon side effect with only four reported cases. In addition, reactivation of hepatitis B is an extremely rare association. We report two cases of imatinib‐induced lichen planus, one of which is associated with hepatitis B reactivation, and one case of lichenoid eruption caused by imatinib. The aim of our report is to make physicians aware of this rare association between lichen planus and imatinib. We also recommend screening for hepatitis B virus before starting treatment with imatinib to avoid serious complications. [ABSTRACT FROM AUTHOR]

Patient education is an integral part of physiotherapy practice. The use of patient education and the adoption of a patient-centered approach to education has not been examined in a European setting. To explore the frequency and perceived importance of patient education practices of physiotherapists in Iceland. A convergent mixed methods study design was utilized. A cross-sectional, web-based survey was completed by 216 physiotherapists (35.1% response rate). Transformed qualitative data played a secondary role to quantitative results measuring frequencies of use and perceived importance of a spectrum of patient education practices. Providing exercise and diagnostic information had the highest rated frequency and importance. Advising on social support and having the patient explain why their home exercises were important were rated lowest. A large difference was reported between frequency and importance when collaborating with patients on goal-setting. Therapists reported delivering education through discussions and physical demonstrations, while relying on visual cues and return demonstrations to evaluate education effectiveness. Patient-specific education, including preferred learning style, was not always considered. The highest-rated barriers to patient education were patient characteristics that were psychosocial in nature. Results regarding readiness for education indicated needs to assess patient motivation while managing external barriers. The results indicate that physiotherapists engage in a wide variety of patient education activities that they consider important. Barriers to patient education identified by therapists may be managed by further skill development in a collaborative patient-centered approach to patient education. [ABSTRACT FROM AUTHOR]

Solenostemon monostachyus is an underutilized plant that is yet to be explored for consumption. This study assessed the biochemical impacts of a probiotic Enterococcus faecalis as an agent of fermentation, promoting the edible properties of the leaves from S. monostachyus using either an unfermented water leaf or S. monostachyus. The results with p < 0.05 were considered statistically significant. The α-amylase activity, proteins, carbohydrates, and ash, iron, and copper contents significantly increased (p < 0.05), while fats, crude fiber, cadmium, and manganese contents of the fermented S. monostachyus leaves were significantly reduced (p < 0.05), compared to the control (unfermented water leaves). The total phenol and saponin contents of the leaves were 1.98 ± 0.03 and 2.77 ± 0.04 mg GAE/mL for the S. monostachyus, 2.20 ± 0.01 and 2.39 ± 0.51 mgGAE/mL for water leaf, respectively on Day 5. Spirostanol (20.7343 mg/10 g) and two possible yet-to-be-identified saponin compounds P-S1 (33.5773 mg/10 g) and P-S2 (23.5718 mg/10 g) were newly synthesized along with one possible novel volatile compound by the fermentation process. Furostanol (19.873–29.420), gallic acid (88.111–98.949 mg/10 g), luteolin (0.954–11.712 mg/10 g) were retained, and aescin (69.510 mg/10 g) was completely consumed by the fermentation process. E. faecalis derived some micronutrients to drive the α-amylase catalyzed biotransformation of phytochemicals to improve the health benefits in the leafy vegetable. [ABSTRACT FROM AUTHOR]

A hyperspectral image provides fine details about the scene under analysis, due to its multiple bands. However, the resulting high dimensionality in the feature space may render a classification task unreliable, mainly due to overfitting and the Hughes phenomenon. In order to attenuate such problems, one can resort to dimensionality reduction (DR). Thus, this paper proposes a new DR algorithm, which performs an unsupervised band selection technique following a clustering approach. More specifically, the data set was split into a predefined number of clusters, after which the bands were iteratively selected based on the parameters of a separating hyperplane, which provided the best separation in the feature space, in a one-versus-all scenario. Then, a fine-tuning of the initially selected bands took place based on the separability of clusters. A comparison with five other state-of-the-art frameworks shows that the proposed method achieved the best classification results in 60% of the experiments. [ABSTRACT FROM AUTHOR]

Skeletal muscle is a plastic tissue that regenerates ad integrum after injury and adapts to raise mechanical loading/contractile activity by increasing its mass and/or myofiber size, a phenomenon commonly refers to as skeletal muscle hypertrophy. Both muscle regeneration and hypertrophy rely on the interactions between muscle stem cells and their neighborhood, which include inflammatory cells, and particularly macrophages. This review first summarizes the role of macrophages in muscle regeneration in various animal models of injury and in response to exercise‐induced muscle damage in humans. Then, the potential contribution of macrophages to skeletal muscle hypertrophy is discussed on the basis of both animal and human experiments. We also present a brief comparative analysis of the role of macrophages during muscle regeneration versus hypertrophy. Finally, we summarize the current knowledge on the impact of different immunomodulatory strategies, such as heat therapy, cooling, massage, nonsteroidal anti‐inflammatory drugs and resolvins, on skeletal muscle regeneration and their potential impact on muscle hypertrophy. [ABSTRACT FROM AUTHOR]

Background: Mobile health tools can support shared decision-making. We developed a computer-based decision aid (DA) to help pregnant women and their partners make informed, value-congruent decisions regarding prenatal screening for trisomy. Objective: This study aims to assess the usability and usefulness of computer-based DA among pregnant women, clinicians, and policy makers. Methods: For this mixed methods sequential explanatory study, we planned to recruit a convenience sample of 45 pregnant women, 45 clinicians from 3 clinical sites, and 15 policy makers. Eligible women were aged >18 years and >16 weeks pregnant or had recently given birth. Eligible clinicians and policy makers were involved in prenatal care. We asked the participants to navigate a computer-based DA. We asked the women about the usefulness of the DA and their self-confidence in decision-making. We asked all participants about usability, quality, acceptability, satisfaction with the content of the DA, and collected sociodemographic data. We explored participants' reactions to the computer-based DA and solicited suggestions. Our interview guide was based on the Mobile App Rating Scale. We performed descriptive analyses of the quantitative data and thematic deductive and inductive analyses of the qualitative data for each participant category. Results: A total of 45 pregnant women, 14 clinicians, and 8 policy makers participated. Most pregnant women were aged between 25 and 34 years (34/45, 75%) and White (42/45, 94%). Most clinicians were aged between 35 and 44 years (5/14, 36%) and women (11/14, 79%), and all were White (14/14, 100%); the largest proportion of policy makers was aged between 45 and 54 years (4/8, 50%), women (5/8, 62%), and White (8/8, 100%). The mean usefulness score for preparing for decision-making for women was 80/100 (SD 13), and the mean self-efficacy score was 88/100 (SD 11). The mean usability score was 84/100 (SD 14) for pregnant women, 77/100 (SD 14) for clinicians, and 79/100 (SD 23) for policy makers. The mean global score for quality was 80/100 (SD 9) for pregnant women, 72/100 (SD 12) for clinicians, and 80/100 (SD 9) for policy makers. Regarding acceptability, participants found the amount of information just right (52/66, 79%), balanced (58/66, 88%), useful (38/66, 58%), and sufficient (50/66, 76%). The mean satisfaction score with the content was 84/100 (SD 13) for pregnant women, 73/100 (SD 16) for clinicians, and 73/100 (SD 20) for policy makers. Participants thought the DA could be more engaging (eg, more customizable) and suggested strategies for implementation, such as incorporating it into clinical guidelines. Conclusions: Pregnant women, clinicians, and policy makers found the DA usable and useful. The next steps are to incorporate user suggestions for improving engagement and implementing the computer-based DA in clinical practice. [ABSTRACT FROM AUTHOR]

A port system is a system of two or more ports, located in proximity within a given area. In literature, various geographical and functional scales have been identified ranging from complete coastlines to the notions of a 'range' and a 'multi-port gateway region'. Not only does the spatial scale create confusion on the true functional delineation of port systems, but it also complicates a clear understanding of the relational mechanisms at stake within these port systems. This paper revisits existing approaches to and empirical delineations of port systems. Maritime network analysis techniques are deployed to understand hierarchies and interdependencies among nodes of container port systems and sub-systems in North Europe and Northeast Asia. The results provide additional insights on how ports interact from a maritime services' perspectives and demonstrate whether or not ports which are traditionally considered as belonging to the same port system can in reality be considered forming a fully integrated port system. [ABSTRACT FROM AUTHOR]

Arthroscopic partial meniscectomy (APM) is one the most common orthopedic surgical procedures. The most common indication for APM is a degenerative meniscal tear (DMT). High-quality evidence suggests that APM does not provide meaningful benefits in patients with DMTs and may even be harmful in the longer term. This narrative review focuses on a fundamental question: considering the history and large number of these surgeries, has APM ever actually worked in patients with DMT? A truly effective treatment needs a valid disease model that would biologically and plausibly explain the perceived treatment benefits. In the case of DMT, effectiveness requires a credible framework for the pain-generating process, which should be influenced by APM. Basic research, pathoanatomy, and clinical evidence gives no support to these frameworks. Moreover, treatment of DMT with an APM does not align with the traditional practice of medicine since DMT is not a reliable diagnosis for knee pain and no evidence-based indication exists that would influence patient prognosis from APM. A plausible and robust explanation supported by both basic research and clinical evidence is that DMTs are part of an osteoarthritic disease process and do not contribute to the symptoms independently or in isolation and that symptoms are not treatable with APM. This is further supported by the fact that APM as an intervention is paradoxical because the extent of procedure and severity of disease are both inversely associated with outcome. We argue that arthroscopic treatment of DMT is largely based on a logical fallacy: post hoc ergo propter hoc. [ABSTRACT FROM AUTHOR]

Recently, the whole world has faced the deadliest and dangerous consequences due to the transmission of infectious novel coronavirus (nCov). With the outbreak of COVID-19, the education learners, practitioners, and other stakeholders were at the sake of a loss, as it causes the suspension of physical classes and physical interaction of the learners. In these circumstances, Electronic learning (E-learning), Online learning, and the use of Information and Communications Technology (ICT) tools came in handy. It helped the learners in the dissemination of ideas, conducting online classes, making online discussion forums, and taking online examinations. Like the government of each country, the Indian government was also caught off-guard but the existing E-learning infrastructure was able to leverage on while devising plans to tailor them to new situations and launching new ones. The initiatives at the forefront of this noble battle launched by the Department of School Education and Literacy, Ministry of Human Resources Development (MHRD) includes Diksha, Swayam Prabha Channel, Shiksha Van, E-Pathshala, and National Repository of Open Educational Resources (NROER). It worth noting that apart from the Indian central government efforts, each state has various online education initiatives that are tailored to their needs. This research evaluated each of these initiatives commenced by central and state governments and present a detailed analysis of most of the relevant initiatives. Additionally, a survey is conducted to get insights of learners in concern to online learning. Despite the issues raised in this learning, the outcomes come to be satisfactorily favoring online learning. [ABSTRACT FROM AUTHOR]

Robotics is a rapidly growing field, and the innovative idea to scale down the size of robots to the nanometer level has paved a new way of treating human health. Nanorobots have become the focus of many researchers aiming to explore their many potential applications in medicine. This paper focuses on manufacturing techniques involved in the fabrication of nanorobots and their associated challenges in terms of design architecture, sensors, actuators, powering, navigation, data transmission, followed by challenges in applications. In addition, an overview of various nanorobotic systems addresses different architectures of a nanorobot. Moreover, multiple medical applications, such as oncology, drug delivery, and surgery, are reviewed and summarized. [ABSTRACT FROM AUTHOR]

Objectives Everyday information and communication technologies (EICTs), involving digital services, such as online shopping, e-banking, and video calling, are perceived to be associated with youth and a modern lifestyle. On the other hand, older adults are often portrayed as technology-alienated, less willing, and incapable of using EICT. The internalization of potentially negative age stereotypes may compromise actual later life engagement and the ability to perform EICT. At the same time, low engagement in EICT may also contribute to negative self-perceptions of aging (SPA), for example, related to physical loss, social loss, and personal competence. This study was, hence, designed to evaluate the temporal reciprocal associations of SPA and older adults' EICT use. Methods The article was based on 2 waves (2014 and 2017) from the German Ageing Survey (DEAS), a nationally representative survey of middle-aged and older individuals aged 40 and older. A cross-lagged model (N = 3,600) was estimated to examine the reciprocal associations of SPA and EICT. Results The lagged effect of SPA on EICT engagement was nonsignificant, whereas the lagged effect of EICT engagement on SPA in the domain personal competence was significant, indicating that greater EICT engagement predicted more positive SPA related to personal competence 3 years later. Discussion These findings encourage researchers and policymakers to put further emphasis on the empowerment of older individuals in their EICT engagement. Interventions that promote lifelong learning and age-friendly environments can enhance a more positive aging experience. [ABSTRACT FROM AUTHOR]

The internet has become the chosen medium for professional learning. Completing professional learning can improve work performance; however, many individuals who begin online courses do not complete them. It is not well understood which influences keep individuals engaged in online professional learning. We address these issues with a systematic review. Our review of 51 studies and 9,583 participants includes a narrative synthesis and a meta-analysis that examined influences on user engagement in online professional learning. We found that course design and employers' provision of time to complete learning are key for engaging learners. Other important influences were learners' reasons for learning (e.g., intrinsic value and perceived usefulness), access to learning support, and opportunities for interaction during the learning experience. [ABSTRACT FROM AUTHOR]

To establish the current knowledge of sport-related concussion (SRC) management of clinicians in emergency departments in the North West of England. A cross-sectional, multi-center study design was used and included emergency department clinicians (EDCs) across 15 centers in the North West of England. A 22-question survey was issued with questions focused on the 5th International Conference on Concussion Consensus Statement. Absolute and percentages were presented, and comparisons in knowledge of guidelines and confidence between EDCs were made using the Kruskal-Wallis test. Of an estimated 300 EDCs, 111 (37%) responded. Thirty (27%) were aware of the guidelines, whilst 63 (57%) had heard of a graduated return-to-sport protocol. Physical rest was advised by 106 (95%) respondents, with 68 (61%) advising cognitive rest and 47 (42%) providing written advice. There was no difference (p >.05) in awareness of SRC guidelines or confidence between clinician grade, with most receiving no SRC training. There is a lack of knowledge amongst EDCs in the North West of England in managing and providing discharge advice to patients with SRC. This is likely due to the limited awareness of guidelines and training, and therefore further education delivery on SRC management guidelines is required. [ABSTRACT FROM AUTHOR]

Background: Given the context of rapid technological change and COIVD-19 pandemics, E-learning may provide a unique opportunity for addressing the challenges in traditional face-to-face continuing medical education (CME). However, the effectiveness of E-learning in CME interventions remains unclear. This study aims to evaluate whether E-learning training program can improve TB health personnel's knowledge and behaviour in China. Methods: This study used a convergent mixed method research design to evaluate the impact of E-learning programs for tuberculosis (TB) health workers in terms of knowledge improvement and behaviour change during the China-Gates TB Project (add the time span). Quantitative data was collected by staff surveys (baseline n = 555; final n = 757) and management information systems to measure the demographic characteristics, training participation, and TB knowledge. Difference-in-difference (DID) and multiple linear regression models were employed to capture the effectiveness of knowledge improvement. Qualitative data was collected by interviews (n = 30) and focus group discussions (n = 44) with managers, teachers, and learners to explore their learning experience. Results: Synchronous E-learning improved the knowledge of TB clinicians (average treatment effect, ATE: 7.3 scores/100, P = 0.026). Asynchronous E-learning has a significant impact on knowledge among primary care workers (ATE: 10.9/100, P < 0.001), but not in clinicians or public health physicians. Traditional face-to-face training has no significant impact on all medical staff. Most of the learners (57.3%) agreed that they could apply what they learned to their practice. Qualitative data revealed that high quality content is the key facilitator of the behaviour change, while of learning content difficulty, relevancy, and hardware constraints are key barriers. Conclusions: The effectiveness of E-learning in CME varies across different types of training formats, organizational environment, and target audience. Although clinicians and primary care workers improved their knowledge by E-learning activities, public health physicians didn't benefit from the interventions. [ABSTRACT FROM AUTHOR]

Shared Decision Making (SDM) in peri-operative medicine is increasingly encouraged as an ideal model of treatment decision making in the medical encounter. Moreover, it has the potential to improve the quality of the decision-making process for patients and ultimately, patient outcomes. This review focuses on several published literature on SDM in peri-operative medicine, its Implementation, barriers faced by Patient and the Provider, Myths regarding SDM and current scenario of SDM in India. Within the anesthetic community, patient consent is vigorously guided. However, this community suffers from lack of advancements in implementing the patient-focused rather than doctor-focused characteristics of SDM. Out of the several barriers, the most common barrier towards the implementation of SDM is the lack of time from the provider community. Within the anesthesia domain, the consultations discussed directly preceding the surgery do not pursue the customary and highly organized stages of typical outpatient consultations. Under these backgrounds and to be successfully implemented, it becomes imperative to begin the process of SDM pre-operative assessment clinic targeting both the high- and low-risk patients. It is critical to summarise that SDM does not end at the time of anesthesia for the peri-operative healthcare professional, but it gets to carry forward until patient discharge. Therefore, it is carried as the Pinnacle of Patient-Centred Care. [ABSTRACT FROM AUTHOR]

This paper argues that the cross-analysis of barriers with stakeholders provides a richer picture than analyzing the barriers on their own, as most of the literature in this area does. To test this hypothesis, we used the data from 33 interviews across 19 different types of stakeholders that were involved in a telemedicine system for the Chronically-ill Patient. Our findings show encouraging results. For instance, it was found that the group of stakeholders who are directly related to the governance and policy-making identified most of the barriers. This finding may imply that this group is more aware of the challenges when implementing HIS, or it may suggest that this group poses more resistance due to the current economic and Organizational models in health care. It was also found that some barriers are cited by all stakeholders whereas others not, suggesting that some barriers may be more relevant than others. [ABSTRACT FROM AUTHOR]

Background: A dietary supplement developed in Japan, OM-X®, is the result of extended fermentation of dozens of edible vegetables, fruits, seaweeds, mushrooms, and includes 12 strains of Lactic acid bacteria (LAB) and Bifidobacterium. The supplements powerful antioxidant, antiinflammatory properties, and regulatory effect on metabolizing liver enzymes have been reported. Senescence marker protein-30 (SMP30)/Gluconolactonase (GNL) Knockout (KO) mice, which lack the ability to biosynthesize Vitamin C (VC) in the body, were used in this study. The mice exhibited decreased antioxidant capacity in the blood, decreased liver function, and had poor hair growth due to the VC deficiency. The aim of the study was to examine the effects of oral Methods: SMP30/GNL KO and C57BL/6 (WT) mice were used in this study. The KO mice were divided into the following three groups: VC non-administration (VC minus), VC (0.15 W/V %) administration (VC plus), and no VC plus 0.6% OM-X® administration (OM-X®) groups (n = 6 per group). Mice were kept under experimental conditions until they were euthanized at week 8 (age: 16 weeks old). Body weight and plasma biochemistry levels were measured.. Metabolomic analyses of harvested livers were performed. Results: In the VC minus group, a significant decrease in body weight and significant changes in plasma biochemistry parameters compared with the WT control or VC plus groups was observed. In the OM-X® group, significant suppression or a suppressive trend was observed compared with the VC minus group. Liver metabolomic analysis showed that total adenylate levels decreased in the VC minus group, whereas OM-X® administration significantly elevated total adenylate levels. In addition, the ratios of Glutathione (GSH)/Glutathione disulfide (GSSG) and Sadenosylmethionine (SAM)/S-adenosyl-L-homocysteine (SAH) and total glutathione levels were all significantly higher in the OM-X® group than in the VC minus group. The glycerol 3-phosphate/Dihydroxyacetone phosphate (DHAP) and putrescine/spermidine ratios were elevated in the VC minus group, whereas it was significantly lower in the OM-X® group.. Conclusion: The results showed that in SMP30/GNL KO mice, some organ damage may have occurred during VC deficiency, as indicated by weight loss, hepatic injury, and changes in triglyceride-related markers. OM-X® had an effect on energy charge maintenance by elevating total adenylate levels, inducing antioxidant capacity via enhancing glutathione levels, and promoting protein synthesis, including polyamine synthesis. Altogether, the results revealed that OM-X® prevents the adverse biological changes caused by VC deficiency in SMP30/GNL KO mice. [ABSTRACT FROM AUTHOR]