High-quality Rate Research Articles

Temporomandibular Disorders in Psychiatric Outpatients: A Hidden Epidemic?

ABSTRACTBackgroundTemporomandibular disorders (TMD) are a multimodal group of orofacial pain syndromes that rank behind only chronic low back pain in the list of most prevalent musculoskeletal conditions causing pain and disability. Previous studies have recorded high rates of comorbid anxiety, depression, and poor sleep quality among TMD patients.MethodsEighty five outpatients recruited from Rhode Island Hospital's Latino and Portuguese Mental Health Programs completed the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and the Pittsburgh Sleep Quality Index questionnaire (PSQI). The latest meta‐analysis of TMD prevalence in the general population was used for the reference population (n = 3159).ResultsThe most prevalent psychiatric disorders were depressive disorders (75.3%), anxiety disorders (57.6%), and sleep–wake disorders (47.1%). Fifty patients (58.8%) met criteria for TMD, versus 29.3% in the reference population (p < 0.001). In our sample, the PSQI cut‐off for poor sleep was crossed in 96.2% of patients with TMD and 82.9% of those without TMD (p = 0.041).ObjectivesWe sought to establish the prevalence of TMD in a significant sample of psychiatric outpatients, considering their psychiatric diagnoses and sleep quality.ConclusionThe very high prevalence of TMD among patients with depression, anxiety, and sleep disorders reinforces their association and alerts us to the possibility of TMD constituting a widespread, though largely ignored, comorbidity of psychiatric outpatients that may be impacting their mental health outcomes. Further studies are needed to clarify the value of screening this population for TMD and to establish which cases merit treatment.

Tunable and real-time automatic interventional x-ray collimation from semi-supervised deep feature extraction.

The use of endovascular procedures is becoming increasingly popular across multiple clinical domains. These procedures are generally performed under image guidance using an interventional c-arm x-ray system. Radiation exposure to both patients and interventional staff due to use of fluoroscopy is a health and occupational concern, but modifications to the interventional workflow to address radiation may come at the cost of procedure time orquality. Interventional x-ray collimation is a crucial task for improving image quality as well as reducing radiation exposure to both patients and operators who work in the x-ray domain. However, collimation is heavily underutilized due to its cumbersome nature and the difficulty of manually manipulating multiple parameters during fast-paced interventional procedures. Additionally, the widely varying collimation preferences of interventionalists across different procedure types, procedure phases, and anatomies makes the standardizing of collimation challenging for radiation technologist supportstaff. Automating collimation has the potential to bridge this gap, freeing up mental bandwidth for interventionalists and technologists and improving outcomes for patients. Here, we propose a tunable algorithm for automatic collimation based on a region-of-interest optimizer driven by a combination of image, system, device, and radiation based features and we illustrate its efficacy across varying personal preferences. Critically, we devise a method with a simple and easily understandable mapping between algorithm parameters and practicaloutcomes. We show a real-time implementation of this algorithm using deep feature extraction by a convolutional neural network and evaluate its performance in a custom dataset of simulated fluoroscopy and recorded fluoroscopy from clinical radial access procedures. We evaluate the effects of a practically implemented mixed supervision training strategy on model performance and show potential for radiation reduction in simulation. An uncertainty analysis indicates that the algorithm is robust to noise and anatomical variation across our clinical dataset. Clinical acceptability and quality is evaluated through a reader study with expert neuro-interventional radiologists, with participants indicating 100% clinical acceptability, high quality ratings, and improved radiation protection over their typicalpractice. The algorithm's modular design ensured that users' collimation requirements were met without disruption to the interventional workflow or procedure time, while exhibiting strong potential to reduce radiation risk to patients and operators. Evaluation in more varied clinical settings could support translation of this technology into theclinic.

P078 Poor sleep quality in Australia: The role of disturbing dreams, nightmares, and psychological distress

Abstract Introduction Disturbing dreams and nightmares can cause night-time awakenings and disrupt sleep. Despite high rates of poor sleep quality in Australia, there has been little investigation into the impact of disturbing dreams and nightmares on sleep quality. This study aimed to determine the relationship between disturbing dreams and nightmares and sleep quality in Australia while also examining the contribution of psychological distress. Methods Four hundred and thirty-nine Australian adults (310 females, average age: 44.9 years) completed an online survey investigating sleep, dreams, nightmares, and mental health. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), nightmares were assessed with the Disturbing Dreams and Nightmares Severity Index (DDNSI), and psychological distress was assessed using the Depression Anxiety Stress Scale (DASS-21) total score. Two linear regression models (adjusted for age and sex) examined the contribution of DDNSI and DASS-21 on PSQI scores. Results In the first model, disturbing dreams and nightmares were a significant predictor of PSQI scores (p < 0.001), explaining 10% of the variance. Once psychological distress was added to the model, both disturbing dreams and nightmares (p = 0.004) and psychological distress (p < 0.001) significantly predicted PSQI scores. The final model explained 22% of the variance in PSQI scores. Discussion Disturbing dreams and nightmares contribute to poor sleep quality in Australia. Psychological distress also plays a key role. Sleep health researchers, therefore, need to include validated measures of disturbing dreams, nightmares, and psychological distress when investigating factors contributing to poor sleep quality in Australia.

Evaluating audio quality ratings and scene analysis performance of hearing-impaired listeners for multi-track music.

This study assessed musical scene analysis (MSA) performance and subjective quality ratings of multi-track mixes as a function of spectral manipulations using the EQ-transform (% EQT). This transform exaggerates or reduces the spectral shape changes in a given track with respect to a relatively flat, smooth reference spectrum. Data from 30 younger normal hearing (yNH) and 23 older hearing-impaired (oHI) participants showed that MSA performance was robust to changes in % EQT. However, audio quality ratings elicited from yNH participants were more sensitive to % EQT than those of oHI participants. A significant positive correlation between MSA performance and quality ratings among oHI showed that oHI participants with better MSA performances gave higher-quality ratings, whereas there was no significant correlation for yNH listeners. Overall, these data indicate the complementary virtue of measures of MSA and audio quality ratings for assessing the suitability of music mixes for hearing-impaired listeners.

Perceived Quality of Binaural Rendering from Baffled Microphone Arrays Evaluated Without an Explicit Reference

The authors present a perceptual evaluation of the binaural rendering quality of signals from several types of baffled microphone arrays. They employ the multi-stimulus category rating (MuSCR) paradigm that does not require a reference stimulus. The tested conditions also comprise a very high numerical accuracy stimulus, given the highest quality rating in approximately half of the multi-stimulus trials. A comparison with the literature on spherical microphone arrays (SMAs) shows that MuSCR allows for drawing representative conclusions regarding the dependency of the perceived quality on the array and rendering parameters as in previous experiments with an explicit high-fidelity reference. The authors applied the MuSCR paradigm to evaluate the perceived reproduction quality of equatorial microphone arrays (EMAs) with microphones only along the equator of the spherical baffle and of equatorial arrays with a nonspherical baffle (XMAs). The results endorse the observations from SMAs that an increasing spherical harmonic order leads to improved perceived quality. The authors also confirm that EMAs lead to the same perceived quality as SMAs despite the substantial difference in the number of microphones. Magnitude equalization of artifacts from spatial undersampling can be very effective for XMAs the raw solution deviates significantly from the other array types at high frequencies.

Treatment of intracranial aneurysms using the Tubridge flow diverter.

The Tubridge flow diverter (TFD) was recently developed to treat intracranial aneurysm (IA). In this study, we aimed to assess the safety and efficacy of this novel device. A retrospective cohort of consecutive patients with IA was recruited between June 2017 and February 2022. The studied outcomes were perioperative complications, clinical quality of life, and angiographic IA occlusion. Multivariate logistic regression was performed to explore the potential predictors of perioperative stroke events and IA occlusion. A comprehensive literature review was conducted across five databases for evidence synthesis. Among the patients with IA in our cohort, 144 underwent successful TFD implantation. Postoperative stroke was observed in 11 (7.6%) patients, and 130 (90.3%) patients were discharged with modified Rankin scales (mRS) of ≤2. In the last clinical follow-up (mean, 16.9months), 96.6% of the patients reported a satisfactory quality of life (mRS ≤2). IA occlusion was observed in 84.6% of the patients at the last angiographic follow-up (mean, 10.4months). Aneurysmal subarachnoid hemorrhage [odds ratio (OR), 6.98; 95% confidence interval (CI), 1.11-43.91] and giant IA (OR, 5.63; 95% CI, 1.15-27.48) were associated with perioperative stroke events. The evidence synthesis found high rates of satisfactory quality of life (rate, 98.8%; 95% CI, 97.1-99.9%) and IA obliteration (rate, 78.5%; 95% CI, 74.0-82.7%) after TFD treatment. The pooled complication rate was 13.6% (95% CI, 10.9-16.5%). This study identified a high rate of IA occlusion in patients who received TFD treatment. These patients also reported a satisfactory quality of life. Further studies in larger prospective cohorts with longer follow-up periods are warranted to verify our findings. Key message What is already known on this topic Flow diverter (FD) devices are an optimal tool to modify hemodynamics and treat intracranial aneurysms (IAs). However, the safety and efficacy of a novel self-expanding FD, namely the Tubridge flow diverter (TFD), remain to be fully established owing to the short-term follow-up periods and limited sample size of existing studies. What this study adds In our cohort of patients who received TFD treatment, 96.6% of patients reported satisfactory quality of life at the last clinical follow-up (mean, 16.9months); and 84.6% of IAs were successfully occluded at the last angiographic follow-up (mean, 10.4months). Our comprehensive review and evidence synthesis of existing studies on TFD found high rates of satisfactory quality of life (98.8%; 97.1-99.9%) and IA obliteration (78.5%; 74.0-82.7%). How this study might affect research, practice or policy TFD demonstrated satisfactory performance in the treatment of IAs in our cohort. Studies with larger prospective cohorts and longer follow-up periods are warranted to further investigate this promising novel approach.

Effect of Age and Gender on Nasalance Across the Lifespan: A Systematic Review.

The Nasometer® is a widely used clinical and research tool with diagnosis and outcome measurement utility. The objective of this study was to systematically examine the effect of age and gender on nasalance across the lifespan. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews (PRISMA 2020). University. Children, adolescents, adults, and older adults. Covidence Better Systematic Review Management; Scottish Intercollegiate Guidelines Network Methodology (SIGN) Checklist 3 for risk of bias; Levels of evidence, Oxford Centre for Evidence-Based Medicine Levels of Evidence hierarchy; and effect size calculations using G*Power 3. Nasalance (%) from the Nasometer™. 50 studies (from N = 1884) were included in the review. All were Level 3 (non-randomized controlled cohort) observational-analytic type studies. Only 10 (20%) of studies met a High Quality (low risk of bias) rating. Effect sizes were moderate for adults versus children ( d = 0.717) and adults versus adolescents ( d = 0.521) for oral text/passage. Gender differences were clinically significant for adolescent males and females with a moderate effect size ( d = 0.545) for oronasal text/passage. The systematic review provides objective and defined evidence as to the effects of age and gender on nasalance. Separate normative databases are implicated for specific age subgroups across the lifespan and for gender, particularly in adolescence. Review findings are applicable to other clinical groups where acquisition and/or progression occurs in adulthood/older adulthood.

РАЗРАБОТКА ТЕХНОЛОГИИ ФУНКЦИОНАЛЬНЫХ МОЛОЧНЫХ ПРОДУКТОВ СО СПЕЦИЯМИ

The use of dairy products with herbs and spices is an innovative solution in the field of food technology, opening up new opportunities for the development of unique healthy food products, attracting the attention of consumers around the world. The purpose of research is to develop a technology for functional dairy drinks with antioxidant properties based on biologically active substances of plant raw materials, aimed at improving the health and longevity of people for the purpose of potential use in the food industry. The inclusion of turmeric and ginger in the composition of dairy drinks determines a wide range of unique properties, enhancing the biological value, functionality of dairy drinks and expanding the range of products for various groups of the population. The chemical composition of plant ingredients contains a number of active groups of flavonoids and polyphenols with strong antioxidant properties that affect the human body by neutralizing free radicals, enhancing the human immune system and ensuring longevity. The object of the study was milk drinks enriched with biologically active substances of raw materials of plant origin. To achieve the objectives, experimental studies were conducted to develop a recipe for fresh milk drinks with spices and herbs. Based on the results of the examination of experimental samples for physicochemical and organoleptic indicators, the best samples with high quality ratings were established. Recipes for 8 types of functional milk drinks with spices Zdorov'e were developed with a justification for the dose of plant ingredients, the stage of their introduction, technological modes of milk pasteurization and features of the preparation of spices for introduction into the milk base were worked out. The data on the shelf life of the new line of fresh milk drinks were obtained. The recommended shelf life is 14 days at a storage temperature of 2 ±1 °C. The new technology does not require specialized equipment, the duration of the technological process is similar to classical technologies.

Relationship between carotid intima-media thickness and white matter hyperintensities in non-stroke adults: a systematic review.

Literature suggests a common pathophysiological ground between carotid atherosclerosis (CAS) and white matter alterations in the brain. However, the association between carotid intima-media thickness (CIMT) and white matter hyperintensities (WMH) has not been conclusively reported. The current systematic review explores and reports the relationship between CIMT and WMH among asymptomatic/non-stroke adults. A recent literature search on PubMed, SCOPUS, and Web of Science databases was conducted in compliance with the PRISMA protocol. The pre-defined Population-Intervention-Comparison-Outcome-Study (PICOS) criteria included observational studies investigating the CIMT-WMH association among non-stroke adults undergoing magnetic resonance imaging and carotid ultrasound. Out of 255 potential results, 32 studies were critically assessed for selection, and finally, 10 articles were included, comprising 5,116 patients (females = 60.2%; males = 39.8%) aged between 36-71 years. The included studies earned high quality ratings (6-9) based on the Newcastle-Ottawa-Scale criteria. Qualitative synthesis showed a significantly parallel relationship between increased CIMT and greater WMH burden in 50% of the studies. In addition, significant risk factors related to the CIMT-WMH association included older age, hypertension, depression, migraine, Hispanic ethnicity, and apolipoprotein E (ɛ4) in postmenopausal women. Overall, the cumulative evidence showed a consistent CIMT-WMH association in asymptomatic middle-aged and older non-stroke adults, indicating that CAS may contribute to the progression of pathologically hyperintense white matter in the brain. However, further research is warranted to infer the plausible relationship between CIMT and WMH in the absence of stroke.

Analyzing the packaging design evaluation based on image emotion perception computing

Nowadays, a wide variety of labels of items are widely available, and human consumption is increasingly tailored to meet their individual needs. So, many businesses are starting to focus on improving the functionality of modern packaging. Sensorial paradigms and emotional reactions could change during the user-product interaction lifecycle. The designer's emotional imagination and past experiences are the backbone of conventional product package design, which has limitations due to unmanageable content and an absence of professional advice—the majority of previous research on emotional image analysis aimed to forecast the most common viewer emotions. Since the feelings a picture evokes are quite individual and vary from viewer to viewer, this overarching feeling isn't always enough for practical uses. The research presented an approach to packaging design evaluation based on image emotion perception computing (PDE-IEPC), which combines emotion perception technology with a deep LSTM (Long short-term model), resulting in an immersive and dynamic experience for the human senses. Emotion Perception Computing's Dynamic Multi-task Hypergraph Learning (DMHL) approach considers graphical data, social context, spatial evolution, and location, among other criteria, to evaluate packaging designs efficiently based on their emotional impact. Image-Emotion-Social-Net is a large dataset used to evaluate multidimensional and categorical attitude representation. The dataset is sourced from Flickr and contains over 1 million images presented by over 9000 users. Personalized emotion categorization is an area where research on this dataset shows that the suggested strategy outperforms many modern techniques. The experimental results show that the proposed method achieves a high packaging design quality rate of 94.1 %, a performance success rate of 97.5 %, and a mean square error rate of 2 % compared to other existing methods.

Fumos: Neural Compression and Progressive Refinement for Continuous Point Cloud Video Streaming.

Point cloud video (PCV) offers watching experiences in photorealistic 3D scenes with six-degree-of-freedom (6-DoF), enabling a variety of VR and AR applications. The user's Field of View (FoV) is more fickle with 6-DoF movement than 3-DoF movement in 360-degree video. PCV streaming is extremely bandwidth-intensive. However, current streaming systems require hundreds of Mbps bandwidth, exceeding the bandwidth capabilities of commodity devices. To save bandwidth, FoV-adaptive streaming predicts a user's FoV and only downloads point cloud data falling in the predicted FoV. But it is difficult to accurately predict the user's FoV even 2-3 seconds before playback due to 6-DoF. Misprediction of FoV or network bandwidth dips results in frequent stalls. To avoid rebuffering, existing systems would cause incomplete FoV and degraded experience, deteriorating the user's quality of experience (QoE). In this paper, we describe Fumos, a novel system that preserves interactive experience by avoiding playback stalls while maintaining high perceptual quality and high compression rate. We find a research gap in inter-frame redundant utilization and progressive mechaism. Fumos has three crucial designs, including (1) Neural compression framework with inter-frame coding, namely N-PCC, which achieves both bandwidth efficiency and high fidelity. (2) Progressive refinement streaming framework that enables continuous playback by incrementally upgrading a fetched portion to a higher quality (3) System-level adaptation that employs Lyapunov optimization to jointly optimize the long-term user QoE. Experimental results demonstrate that Fumos significantly outperforms Draco, achieving an average decoding rate acceleration of over 260×. Moreover, the proposed compression framework N-PCC attains remarkable BD-Rate gains, averaging 91.7% and 51.7% against the state-of-the-art point cloud compression methods G-PCC and V-PCC, respectively.

Implementation and Evaluation of Discharge Planning for Patients Undergoing Umbilical Cord Blood Transplantation.

BACKGROUND Umbilical cord blood transplantation (UCBT) patients have high rates of unplanned readmissions and poor quality of life (QoL). The aim of this study was to evaluate the effects of discharge planning on unplanned readmissions, self-efficacy, QoL, and clinical outcomes. MATERIAL AND METHODS Patients who received their first UCBT from April 2022 to March 2023 were included. Participants (n=72) were assigned to a control group (CG: received usual care) or an intervention group (IG: received discharge planning from admission to 100 days after UCBT). The cumulative readmission rates 30 days after discharge and 100 days after UCBT were analyzed using the log-rank test. Self-efficacy and QoL were assessed at admission and 100 days after UCBT using the General Self-Efficacy Scale and FACT-BMT version 4, clinical outcomes derived from medical records. RESULTS Sixty-six patients completed the study. Discharge planning did not reduce readmission rates 30 days after discharge (20.59% vs 31.25%, P=0.376) or 100 days after UCBT (29.41% vs 34.38%, P=0.629). However, the IG showed significantly better self-efficacy (P<0.001), and except for social and emotional well-being, all the other dimensions and 3 total scores of FACT-BMT in the IG were higher than for the controls at 100 days after UCBT (P<0.05). CONCLUSIONS The discharge planning program can improve self-efficacy and QoL of UCBT recipients. The implementation of discharge planning for patients undergoing UCBT was necessary for successful hospital-to-home transitions.

Perspective: Beyond the Mediterranean Diet—Exploring Latin American, Asian, and African Heritage Diets as Cultural Models of Healthy Eating

The Mediterranean diet is a well-studied cultural model of healthy eating, yet research on healthy models from other cultures and cuisines has been limited. This perspective article summarizes the components of traditional Latin American, Asian, and African heritage diets, their association with diet quality and markers of health, and implications for nutrition programs and policy. Though these diets differ in specific foods and flavors, we present a common thread that emphasizes healthful plant foods and that is consistent with high dietary quality and low rates of major causes of disability and deaths. In this perspective, we propose that nutrition interventions that incorporate these cultural models of healthy eating show promise, though further research is needed to determine health outcomes and best practices for implementation.

Predicting Patent Quality Based on Machine Learning Approach

The investment budget allocated by companies in R&D activities has increased due to increased competition in the market. Applications for industrial property rights by countries, investors, companies, and universities to protect inventions obtained as an outcome of investments have also increased. The selection of the patent to be invested becomes more difficult with the increasing number of applications. Therefore, predicting patent quality is quite significant for companies to be successful in the future. The level to which a patent meets the expectations of decision makers is referred to as patent quality. Patent indices represent decision makers' expectations. In this study, an approach is proposed to predict patent quality in practice. The proposed approach uses supervised learning algorithms and analytic hierarchy process (AHP) method. The proposed approach is applied to patents related to personal digital assistant technologies. The performances of individual and ensemble machine learning methods have been also analyzed to establish the prediction model. In addition, 75% split ratio and the five-fold cross-validation methods have been used to verify the prediction model. The multilayer perceptron algorithm has 76% accuracy value. The proposed prediction model is essential in directing R&D studies to the right technology areas and transferring the incentives to patent applications with a high quality rate.

Are depression and poor sleep quality a major problem in Turkish Women receiving chemotherapy for breast cancer?

The aim of this study was to evaluate depression and sleep quality in Turkish women receiving neoadjuvant or adjuvant chemotherapy for breast cancer and investigate their relationship. This cross-sectional, descriptive, and analytical study included 183 patients who received chemotherapy for non-metastatic breast cancer. Data were collected using the Beck Depression Inventory-II, the Pittsburgh Sleep Quality Index, and a disease-related/sociodemographic information form. The mean age of the participants was 50.2 years, and 50.3% were in menopause. The mean Beck Depression Inventory-II score was 19.64±10.4. Mild depression was detected in 25.7% (n=47) of the women, and moderate or severe depression in 55.2% (n=101). The mean global score of sleep quality was found to be 8.28±2.62, and the majority of the participants (79.7%, n=146) had poor sleep quality. There was a positive correlation (p<0.001, r=0.43) between depression and sleep quality scores. While a negative correlation was found between depression scores and age (p<0.001, r=0.26), the surgical procedure performed did not significantly affect depression scores (p=0.705). Additionally, depression scores were positively correlated with sleep duration (p<0.001, r=0.42) and sleep latency (p=0.01, r=0.48). Very high rates of depression and poor sleep quality were detected among Turkish women receiving neoadjuvant or adjuvant chemotherapy for breast cancer. The entire healthcare team involved in the treatment process should take this relationship into consideration and use the necessary preventive and therapeutic methods.

Long-term outcomes of major and minor lower limb amputation: eight-year retrospective analysis from a single tertiary referral centre

Objective: Lower limb amputation is increasingly common yet outcomes are historically poor, with high rates of short-term mortality, revisions and poor quality of life. This observational study evaluates outcomes from a high-volume tertiary vascular referral centre. Methods: Retrospective electronic case note review was performed to elicit all major and minor amputations performed between 03/11/2014 and 31/05/2022 for peripheral arterial disease and diabetic foot sepsis. Cases of amputation for trauma or chronic pain were not included. Results: A total of 1,566 amputations (865 major, 701 minor) were carried out in 1,237 patients during the study period. Mortality was significantly higher for patients undergoing major amputation compared with minor amputation at 30 days (7.9%, n=61/773 vs 1.0%, n=6/575; p&lt;0.0001) and at 1 year post-procedure (23.7%, n=183/773 vs 13.6%, n=78/575, p&lt;0.0001). Revision rates were significantly lower for major amputations than for minor amputations at 30 days (2.4%, n=19/799 vs 13.2%, n=91/691; p&lt;0.0001) and at 1 year post-procedure (10.0%, n=68/677 vs 26.3%, n=163/619, p&lt;0.0001). Of the patients with major amputation fitted with a prosthesis, there was no significant difference in the numbers of patients ambulating (p=0.19) or the mean ambulatory level (p=0.08) between above-knee and below-knee amputation at 6 months post-procedure. Conclusions: Both major and minor lower limb amputations are associated with a high risk of revision and mortality within 1 year which should be discussed explicitly as part of the informed consent process.

High-frequency eddy current measurement for the characterization of graphite anode slurries in battery cell production

The global demand for lithium-ion batteries and their production in large quantities while maintaining high product quality and minimal reject rates poses new challenges for cell manufacturers. Quality control in slurry processing and electrode coating is becoming increasingly important due to high material costs. High-frequency eddy current measurement could enable characterization of the active material and reduce the reject rate by applying an inline quality measurement system. In this paper, the applicability of high-frequency eddy current measurement for characterization of graphite suspensions is investigated and its feasibility confirmed. Process parameters such as solids contents and type of graphite have been analyzed.

Fish oil supplements for treatment of psoriasis: An overview of systematic reviews

Abstract Background: Fish oil, known for its anti-inflammatory and immunomodulatory properties, has been reported to alleviate psoriasis symptoms. However, systematic reviews (SRs) on this topic have yielded inconsistent conclusions. Objectives: The objective was to compile the existing evidence concerning the efficacy of fish oil supplements for psoriasis, explore the possible reasons behind contradictory findings, and examine potential limitations. Methods: We searched CENTRAL, MEDLINE, and Embase databases, covering the period from their respective inception to January 25, 2023. Two reviewers independently performed study selection, data extraction, and methodological quality assessment using the A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2) tool. The effects of fish oil supplements were evaluated using the psoriasis area and severity index (PASI) score, total body surface area (TBSA), erythema, scaling, infiltrations, pruritus, and any major or minor adverse events. Results: Eight SRs were included, with four demonstrating favorable improvements in psoriasis and the remaining four showing no similar benefits. Specifically, three SRs reported significant reductions in PASI score, one reported lower TBSA, two indicated improvements in either erythema, scaling, or infiltrations, and one supported a high dose of fish oil for alleviating pruritus. Three SRs highlighted the potential benefits of fish oil supplements as a combined therapy with conventional treatments. No serious adverse events were reported. Notably, none of the SRs achieved a high methodological quality rating based on AMSTAR-2. Conclusion: There is a lack of consistent evidence supporting the effectiveness of fish oil supplements for treating psoriasis. Further research is warranted to better understand the potential benefits of fish oil in managing psoriasis.

Evaluating passive physiological data collection during Spravato treatment

Spravato and other drugs with consciousness-altering effects show significant promise for treating various mental health disorders. However, the effects of these treatments necessitate a substantial degree of patient monitoring which can be burdensome to healthcare providers and may make these treatments less accessible for prospective patients. Continuous passive monitoring via digital devices may be useful in reducing this burden. This proof-of-concept study tested the MindMed Session Monitoring System™ (MSMS™), a continuous passive monitoring system intended for use during treatment sessions involving pharmaceutical products with consciousness-altering effects. Participants completed 129 Spravato sessions with MSMS at an outpatient psychiatry clinic specializing in Spravato treatment. Results indicated high rates of data quality and self-reported usability among participants and health care providers (HCPs). These findings demonstrate the potential for systems such as MSMS to be used in consciousness-altering treatment sessions to assist with patient monitoring.

Evaluating a digital hybrid training-of-trainers (TOT) approach for lay first responder trauma education in urban Nigeria during the COVID-19 pandemic

IntroductionRoad traffic injuries (RTIs) are the largest contributor to the global burden of injury, and in 2016 were among the five leading causes of global disability-adjusted life years (DALYs). In regions with limited emergency medical services (EMS), training lay first responders (LFRs) has been shown to increase availability of prehospital care for RTIs, but sustainable mechanisms to scale these programs remain unstudied. MethodsUsing a training of trainers (TOT) model, a 5.5-h LFR training program was launched in Lagos, Nigeria. The course was taught in a hybrid fashion with primary didactics using videoconferencing software and practical breakout sessions in-person concurrently. Thirty TOTs proceeded to train 350 transportation providers as LFRs over one month. A 23-question, pre- and post-assessment was administered digitally to assess knowledge acquisition. Participants responded to a five-point Likert survey assessing instruction quality and post-course confidence. ResultsTOTs scored a median of 56.5 % (IQR:43.5 %,71.7 %) and 91.3 % (IQR:88.0 %,95.7 %) on the pre- and post-assessments, respectively, with bleeding control scores increasing most (+69.4 %). LFR course trainees scored a median of 34.8 % (IQR: 26.0 %, 43.5 %) and 73.9 % (IQR: 65.2 %, 82.6 %) on the pre- and post-assessments respectively, with airway and breathing increasing the most (+48.6 %). All score increases were statistically significant with p < 0.001. All 30 TOT trainers instructed at least one training session after their initial session. LFR participants’ rated confidence in first aid skills went from 3/5 (IQR 3, 4) pre-course to 5/5 (IQR:5,5) post-course, and in emergency transportation it went from 4/5 (IQR:3, 4) to 5/5 (IQR:5, 5), (p < 0.001). LFR course participants rated the quality of education content and TOT instructors to be 5/5 (IQR:5,5). 144 responders provided emergency care in the six-months following training for a total of 351 interventions. Active responders provided a median of 2 (IQR:1,3) interventions. ConclusionsThis is the first time that a digital hybrid instruction for first responder trainers in low- and middle-income countries has been investigated. Our findings demonstrate negligible attrition, high educational quality ratings, equally effective knowledge acquisition to that of prior in-person courses, and high post-training skill usage. Future work will examine the cost-effectiveness of the training of LFRs and the effect of LFRs on trauma outcomes.