Positive Reaction Research Articles

Walk to recovery: an evaluation of adventure therapy in an early intervention for psychosis service

ABSTRACT Background It was considered useful to describe service-users’ and staff’s experience of Adventure Therapy (AT) in an Early Intervention for Psychosis (EIP) service, exploring the impact on personal wellbeing and feasibility of use. Method Focus groups were conducted with 14 participants, immediately following, and three months after a four day hiking trip. Transcripts were analysed using inductive thematic analysis. Questionnaires were administered pre and post trip to describe service-users’ physical activity, recovery and personal goals. Results A majority of participants reported progress towards personal goals on the AT trip and improvements in confidence and connectedness. Questionnaire items did not show improvements in physical activity and recovery measures at 3- and 6-month follow-up. Four key themes emerged from the focus groups. The themes centred around the social experience of being in relation to others and a more personal emotional experience: (a) social connectedness, (b) challenging perceptions of self-capabilities, (c) positive reaction to new experiences and (d) motivation for more. Discussion AT was positively experienced by both staff and service-users. Key areas of benefit were recognised and considered for utilisation in services in different ways. Further studies are warranted exploring maintaining and supporting benefits gained following AT.

Tuberculin Skin Test Reactivity among Health Care Workers in the Abia State University Teaching Hospital, Aba South-east Nigeria

Background Tuberculosis is one of the infections targeted for eradication and is still under surveillance. Hospital workers in Nigeria take little or no precautions against tuberculosis while attending to patients. Objectives This research aimed to study the prevalence of the reactivity of positive Tuberculin Skin Tests among healthcare workers in a Nigerian University Teaching Hospital. Methods Ethical approval and informed consent were obtained from the participants. Two hundred and ten consented participants were recruited for this study, while 185 contributed till the end. The Tuberculin Skin Test was conducted following the standard operating procedures. The chi-square test was used to compare the variable at a significant level of P < 0.05. Of those who received a BGC vaccine < 3 years, 4.8% were excluded from the analyses. Results Mean ± SD of participants’ age was approximately 30 ± 8 years. Participants comprised 87 (47%) males and 98 (53%) females. The modal age group was 21-25 years. Most participants were clinical medical students, 93(50.3%), while doctors, 7 (3.8%), were second to least. The prevalence of positive reactivity to the Tuberculin Skin Test was 29.9%. There was no significant difference observed regarding sexes and positive reactivity. A significant difference was found in reactivity ≥ 10 mm between those who didn’t receive BCG and those who received BCG vaccine ≥ 10 years before the study. Conclusion Healthcare workers can be potential active TB patients and reservoirs. We recommend highly sensitive and specific periodic TB screening, prophylactic treatment, and re-vaccination of Health Care Workers in Nigeria.

Brain Metabolite Differences in Fetuses With Cytomegalovirus Infection: A Magnetic Resonance Spectroscopy Study.

Cytomegalovirus (CMV) is the most common intrauterine infection and may be associated with unfavorable outcomes. While some CMV-infected fetuses may show gross or subtle brain abnormalities on MRI, their clinical significance may be unclear. Conversely, normal development cannot be guaranteed in CMV-infected fetuses with normal MRI. To assess brain metabolite differences in CMV-infected fetuses using magnetic resonance spectroscopy (MRS). Retrospective. Out of a cohort of 149 cases, 44 with maternal CMV infection, amniocentesis results, and good-quality MRS were included. CMV-infected fetuses with positive polymerase chain reaction (PCR) (N = 35) were divided based on MRI results as follows: typical brain abnormalities (gross findings, N = 8), exclusive white matter hyperintense signal (WMHS) on T2-weighted images (subtle findings, N = 7), and normal MRI (N = 20). Uninfected fetuses (negative PCR) with normal MRI were included as controls (N = 9). 3 T, T2-weighted half Fourier single-shot turbo spin-echo (HASTE), T2-weighted true fast imaging with steady-state free precession (TrueFISP), T1- and T2*-weighted fast low angle shot (FLASH), and 1H-MRS single-voxel point resolved spectroscopy (PRESS) sequences. MRI findings were assessed by three radiologists, and metabolic ratios within the basal ganglia were calculated using LCModel. Analysis of covariance test with Bonferroni correction for multiple comparisons was used to compare metabolic ratios between groups while accounting for gestational age. A P-value <0.05 was deemed significant. MRS was successfully acquired in 63% of fetuses. Substantial agreement was observed between radiologists (Fleiss' kappa [k] = 0.8). Infected fetuses with gross MRI findings exhibited significantly reduced tNAA/tCr ratios (0.64 ± 0.08) compared with infected fetuses with subtle MRI findings (0.85 ± 0.19), infected fetuses with normal MRI (0.8 ± 0.14) and controls (0.81 ± 0.15). No other significant differences were detected (P ≥ 0.261). Reduced tNAA/tCr within the apparently normal brain tissue was detected in CMV-infected fetuses with gross brain abnormalities, suggesting extensive brain damage. In CMV-infected fetuses with isolated WMHS, no damage was detected by MRS. 3 TECHNICAL EFFICACY: Stage 3.

TransMVAN: Multi-view Aggregation Network with Transformer for Pneumonia Diagnosis.

Automated and accurate classification of pneumonia plays a crucial role in improving the performance of computer-aided diagnosis systems for chest X-ray images. Nevertheless, it is a challenging task due to the difficulty of learning the complex structure information of lung abnormality from chest X-ray images. In this paper, we propose a multi-view aggregation network with Transformer (TransMVAN) for pneumonia classification in chest X-ray images. Specifically, we propose to incorporate the knowledge from glance and focus views to enrich the feature representation of lung abnormality. Moreover, to capture the complex relationships among different lung regions, we propose a bi-directional multi-scale vision Transformer (biMSVT), with which the informative messages between different lung regions are propagated through two directions. In addition, we also propose a gated multi-view aggregation (GMVA) to adaptively select the feature information from glance and focus views for further performance enhancement of pneumonia diagnosis. Our proposed method achieves AUCs of 0.9645 and 0.9550 for pneumonia classification on two different chest X-ray image datasets. In addition, it achieves an AUC of 0.9761 for evaluating positive and negative polymerase chain reaction (PCR). Furthermore, our proposed method also attains an AUC of 0.9741 for classifying non-COVID-19 pneumonia, COVID-19 pneumonia, and normal cases. Experimental results demonstrate the effectiveness of our method over other methods used for comparison in pneumonia diagnosis from chest X-ray images.

Neurological manifestations of Varicella zoster infection: A case series

Introduction: Varicella zoster virus (VZV) causes infection of the central nervous system, which manifests as various neurological syndromes. In this case series, we discuss three different clinical presentations of VZV reactivation (herpes zoster). The main clinical feature of herpes zoster is a pruritic vesicular rash, present in a dermatomal distribution, which occurs after reactivation of the virus because of immunosuppression.Patients presentation: We report on three individual cases of complicated herpes zoster that resulted in various neurological pathologies. The patients described in this case series each received a lumbar puncture with cerebrospinal fluid analysis, which showed a positive varicella zoster polymerase chain reaction test (VZV PCR).Management and outcome: All three patients received intravenous acyclovir as their core component of treatment. In addition to this, some received other adjunctive treatments, mainly corticosteroids. Two patients achieved disease resolution while one patient demised.Conclusion: The case series highlights the various ways in which VZV can affect the central nervous system (CNS) such as meningitis, encephalitis, myelitis and arteritis.Contribution: This is a brief overview of the clinical manifestations of VZV affecting the CNS in patients presenting to a regional hospital within the Western Cape province in South Africa.

Prevalence Studies on Brucellosis in Buffalo Population in Nearby Region of Hyderabad, Telangana

Background: Brucellosis in India is highly endemic in many states and reported as the most prevalent disease in dairy cattle. Brucellosis is a highly contagious bacterial disease caused by various Brucella species mainly affecting wide range of different species of animals like cattle, sheep, goat and pigs. The present study was undertaken to ascertain the prevalence of brucellosis in suspected buffalo population showing reproductive disorders in selected dairy farms residing nearby region of Hyderabad, Telangana. Methods: Total number of 204 vaginal swab samples were collected aseptically from suspected buffaloes in nearby private dairy farms and were screened by employing various diagnostic methods. Enzyme Linked Immuno Sorbent Assay (ELISA), Lateral Flow Assay (LFA) and molecular identification through Polymerase Chain Reaction (PCR) were conducted. The sensitivity of tests was recorded considering PCR as gold standard method. Result: Screening of 204 vaginal swab samples and prevalence of brucellosis were recorded by ensuring the positive reactions and also depicting the sensitivity of various diagnostic tests namely ELISA, LFA and PCR accounting 92(45.1%), 87 (42.64%) and 113(55.4%) samples respectively. The specificity of both LFA and ELISA were recorded 100% when compared to PCR assay.

The Implementation of Caning Law in Aceh Province, Indonesia: An Overview of The Human Rights Perspectives

Initially, caning in Aceh was conducted openly in public areas, including the courtyard of the mosque. However, this approach provoked both positive and negative reactions. Many viewed public caning as a form of torture and raised concerns about its potential negative impact on children who witnessed the punishment. Subsequently, the Aceh government introduced Governor's Regulation No. 5/2018, which mandated the implementation of caning punishment within correctional institutions. Despite this move, the implementation of caning punishment, whether in public or correctional institutions, continues to be criticized as a violation of human rights. However, the Rome Statute of 1998 and Law No. 5 of 1998 on the Ratification of the Convention against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment stipulate that legally imposed punishments, including caning, do not constitute torture as long as they are in accordance with existing legislation.

Study and transient neutronics analysis of a 10kWth space heat pipe reactor based on a new dual protection control scheme with control annulus and movable radial reflector

This paper mainly focusses on a new dual protection control scheme based on the control annulus and movable radial reflector for a 10kWth space heat pipe reactor. Through the radial reflector, reactive coarse adjustment can be achieved, while reactive fine adjustment can be achieved through B4C control annulus. Both control schemes allow for independent control. Firstly, the steady-state neutron analysis method is conducted to evaluate the critical safety performance of different core control schemes when the reactor falls into sand or water. The first control scheme uses a movable radial reflector, which can still enable the reactor to maintain a keff below 0.85 when the reactor is soaked into the sand or water. The second control scheme uses an independent B4C control annulus, which enables the reactor to maintain a keff below 0.95 when the reactor is soaked into the sand or water. Through the dual protection control scheme, it can ensure the critical safety for the reactor when the launch or drop accident occurs. Moreover, a transient neutronics analysis is conducted to evaluate the operating characteristics and transient neutronics performance for the reactor. The results showed that compared to the control scheme of Kilopower, when the positive reactivity is introduced, the transient neutron dynamics parameters of this dual protection control scheme are superior to that of Kilopower. And it showed that the dual protection control scheme provides an improved control design for the further design and optimization of control scheme for the space reactors.

Loop-mediated isothermal amplification (LAMP) assay coupled with gold nanoparticles for colorimetric detection of Trichoderma spp. in Agaricus bisporus cultivation substrates

One of the significant challenges in organic cultivation of edible mushrooms is the control of invasive Trichoderma species that can hinder the mushroom production and lead to economic losses. Here, we present a novel loop-mediated isothermal amplification (LAMP) assay coupled with gold nanoparticles (AuNPs) for rapid colorimetric detection of Trichoderma spp. The specificity of LAMP primers designed on the tef1 gene was validated in silico and through gel-electrophoresis on Trichoderma harzianum and non-target soil-borne fungal and bacterial strains. LAMP amplification of genomic DNA templates was performed at 65 °C for only 30 min. The results were rapidly visualized in a microplate format within less than 5 min. The assay is based on salt-induced aggregation of AuNPs that is being prevented by the amplicons produced in case of positive LAMP reaction. As the solution color changes from red to violet upon nanoparticle aggregation can be observed with the naked eye, the developed LAMP-AuNPs assay can be easily operated to provide a simple initial screening for the rapid detection of Trichoderma in button mushroom cultivation substrate.

The Influence of Aerobic Exercise on Hippocampal Glial Cells and Inflammatory Factor Expression in the Aging Process of Rats

The objective is to analyze the impact of aerobic exercise on the activation of hippocampal glial cells and the expression of inflammatory factors in the aging process of rats. Methods: Thirty male SPF (Specific Pathogen Free) rats at 10 weeks of age were selected and divided into three groups: the sedentary group (A), the aging group (B), and the aging exercise group (C), with 10 rats in each group. The sedentary group (A) was raised for 6 weeks without exercise or aging intervention; the aging group (B) was continuously injected with D-galactose for 6 weeks without exercise intervention; the aging exercise group (C) was continuously injected with D-galactose for 6 weeks while simultaneously implementing exercise intervention, with 60 minutes of unassisted swimming per day, three times a week (swimming pool size 0.5m x 0.8m, water temperature 35±2°C). All groups were harvested at the end of 6 weeks. Compared with the sedentary group, the GFAP immunohistochemical staining in the hippocampal area of the brain was stronger in both the aging group and the aging exercise group, with more GFAP expression, darker positive reaction color, and higher average fluorescence intensity than the sedentary group; compared with the aging group, the aging exercise group had less GFAP expression, lighter positive reaction color, and lower average fluorescence intensity. All differences were significant (P&lt;0.05). In the comparison of GSH levels in the hippocampal tissue of rats, the aging group had the lowest levels, indicating a decrease in the activation level of glial cells in the hippocampus, while the aging exercise group had higher GSH levels than the aging group, proving that exercise intervention in the aging process can effectively improve the activation level of hippocampal glial cells in rats.

Lack of VEGFA/KDR Signaling in Conventional Renal Cell Carcinoma Explains the Low Efficacy of Target Therapy and Frequent Adverse Events

It is acknowledged that conventional renal cell carcinoma (cRCC), which makes up 85% of renal malignancies, is a highly vascular tumor. Humanized monoclonal antibodies were developed to inhibit tumor neo-angiogenesis, which is driven by VEGFA/KDR signaling. The results largely met our expectations, and in several cases, adverse events occurred. Our study aimed to analyze the expression of VEGFA and its receptor KDR by immunohistochemistry in tissue multi-array containing 811 cRCC and find a correlation between VEGFA/KDR signaling and new vessel formation. None of the 811 cRCC displayed VEGFA-positive immunostaining. However, each glomerulus in normal kidney showed VEGFA-positive endothelial cells. KDR expression in endothelial meshwork was found in only 9% of cRCC, whereas 2% of the cRCC displayed positive KDR reaction in the cytoplasm of tumor cells. Our results disclose the involvement of VEGFA/KDR signaling in the neo-vascularization of cRCC and explain the frequent resistance to drugs targeting the VEGFA/KDR signaling and the high frequency of adverse events.

The Possible Protective Role of Resveratrol against Zinc Oxide Nanoparticles Induced Hepatic Tissue Injury in Adult Albino Rat

Abstract Background Zinc oxide nanoparticles (ZnO NPs) are widely used in industries and medications. This may elevate the probability of their existence in the environment, which may have harmful side effects on different body organs, especially on the liver. So it became mandatory to search for natural hepatoprotective elements such as Resveratrol. Aim of the Work The aim of the present work was to determine the effect of zinc oxide nanoparticles on the histological structure and biochemical markers of the liver of adult male albino rats and to evaluate the possible protective role of Resveratrol. Material and Methods 40 adult male albino rats aged 3-6 months, were divided randomly into four groups; Group I (Control group), which consisted of 10 male albino rats with free access to food (rat chew) and water; Group II (ZnO NPs group), which included 10 male albino rats, which received a dose of 50 mg/kg body weight ZnO NPs through oral gavage daily for 4 weeks; Group III (Resveratrol group) was composed of 10 male albino rats which received a dose of 20 mg/kg body weight Resveratrol through oral gavage daily for 4 weeks, and Group IV (ZnO NPs + Resveratrol group) included 10 male albino rats which were co-administered with a combination of ZnO NPs at a dose of 50mg/kg body weight and Resveratrol at a dose of 20 mg/kg body weight dose through oral gavage daily for 4 weeks. At the end of the experiment, blood samples were collected for serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP). All the animals were sacrificed, and the liver was extracted and processed into paraffin blocks for light microscopic examination. A morphometric study and a statistical analysis were done. Results The present work demonstrated that liver sections obtained from adult male albino rats that received ZnO NPs showed disorganized hepatic architecture, severe affection of the hepatocytes, which had small darkly stained nuclei, and deep acidophilic cytoplasm. The hepatocytes sometimes showed extensive cytoplasmic vacuolations. Most hepatocytes had small apoptotic nuclei and were surrounded by clear halos. While some hepatocytes lost their cell boundaries and coalesced together. Central veins were dilated, distorted, and congested with areas of epithelial lining detachment. Most of the blood sinusoids appeared congested with marked inflammatory cell infiltration. The portal tracts showed vascular congestion, dilatation, and proliferation of the bile ducts. There was a marked increase in the collagen deposition around the portal tracts, central veins, and in-between hepatocytes. Marked depletion of glycogen content with sporadic positive PAS reactions within the cytoplasm of the hepatocytes was also noticed. Hepatocyte apoptosis was evident by a significant increase in caspase-3 expression compared to the control group. On the other hand, ZnO NP +Resveratrol group showed the restoration of normal hepatic lobules with few areas of subcapsular haemorrhage. Most hepatocytes appeared polygonal in shape, with acidophilic cytoplasm and central rounded vesicular nuclei. While few hepatocytes appeared degenerated with dark stained pyknotic nuclei and cytoplasm showed hydropic degeneration. Most of the blood sinusoids returned to their normal sizes with flattened endothelial cells. However, sometimes they were congested, dilated, and contained Kupffer cells. Some central veins appeared congested. The portal tract also returned to its normal size with a marked decrease in inflammatory cell infiltration and showed apparent minimal collagen fiber deposition. Another finding in the present work was that Resveratrol restored the glycogen content of the hepatocytes which were depleted in ZnO NPs group. This was marked by a strong PAS positive reaction in the cytoplasm of most hepatocytes, with few hepatocytes with weak PAS reaction. Resveratrol co-treatment with ZnO NPs significantly reduced the degeneration and necrosis of hepatocytes. This was evident in our study by the apparent negative Caspase-3 reaction in the cytoplasm of most hepatocytes. Clear deterioration of liver function tests was observed in ZnO NPs group compared with the control, with marked improvement in the group treated with ZnO NPs and Resveratrol together. Conclusion The present study demonstrated the degenerative and hepatotoxic effects of ZnO NPs on the histological structure and function of the liver and the hepatoprotective role of Resveratrol against these effects.

A Comparative Histological Study Between the Protective and the Therapeutic Effect of Probiotic on Cisplatin Induced Nephrotoxicity in Adult Male Albino Rat

Abstract Introduction Although cisplatin (CP) is one of the most effective chemotherapies, it is associated with significant nephrotoxicity (Acute kidney injury). Lactobacillus plantarum is often used as a probiotic on its own for its beneficial properties and anti-inflammatory activity. Aim to compare the protective and therapeutic role of probiotics on the microscopic structure of the kidney in a model of cisplatin-induced nephrotoxicity. Material and Methods thirty-five adult male albino rats weighing (200-220gm) were divided into 4 groups. Group I (control group), Group II (Cisplatin group): rats received intraperitoneal injection of CP (7.5 mg/kg) for 3 days. Group III (protective group): Rats received 1 mL of probiotic orally for 7 days. From the fifth day, the rats received intraperitoneal injections of CP (7.5mg/kg) for 3 days. Group IV (Therapeutic group): Rats received intraperitoneal injection of CP for 3 days. From the fourth day, the rats received probiotic L. plantarum orally at a dose of (1 mL/day) for 14 days. The concentration of probiotics in group III and group IV was 109 Colony forming units (CFU)/mL/100 g of body weight. Kidney specimens were proceeded for light microscopic examination, as well as Morphometrical and statistical analyses. Results H&amp;E-stained sections of Group II showed marked renal affection in which most glomeruli showed atrophy. Renal tubules were mostly distorted, necrotic, and degenerative with interstitial hemorrhage, congestion, and cellular infiltration. PAS-stained sections showed marked increased reaction in glomerular and tubular Basement membranes with an apparent loss of Brush borders of most of the PCTs. Masson`s trichrome-stained sections showed a marked increase in collagen fibers in renal interstitia mostly around blood vessels. Immunohistochemically stained sections showed a marked increase in positive cytoplasmic reaction to caspase -3 antibodies mostly in renal tubules. On the other hand, the renal structure of The protective group showed marked improvement which appeared nearly comparable to that of the control group while the therapeutic group showed minimal improvement. Conclusion The protective effect of probiotics on cisplatin-induced Acute Kidney Injury (Nephrotoxicity) was markedly better than the therapeutic effect as detected by microscopic, morphometric, and statistical studies.

Biodegradation Potential of Cyanide and Nitrile using Bacteria of The Genus Rhodococcus

Cyanides and nitriles, characterized by their R-CN chains, are known for their toxicity, mutagenicity, and carcinogenicity, posing significant threats to environmental and human health. This study aims to explore the biodegradation capabilities of Rhodococcus sp. in breaking down cyanide and nitrile bonds. Rhodococcus pyridinivorans strain I-benzo was isolated from tanning waste and cultured in mineral media with a 20 mM benzonitrile substrate. The activity of this strain was tested using substrates such as benzonitrile, acetonitrile, acrylonitrile, benzamide, acetamide, and acrylamide, revealing positive reactions of nitrile hydratase and amidase enzymes through the Nessler measurement method, which indicated the production of ammonia and carboxylic acids. Furthermore, the degradation tests showed that the Vmax values for the biodegradation of potassium cyanide and sodium cyanide were 0.56 ppm/minute and 0.21 ppm/minute, respectively. These findings highlight the potential application of Rhodococcus pyridinivorans strain I-benzo in mitigating the environmental impact of cyanide and nitrile pollutants through efficient biodegradation.

Nine years of patch testing with isocyanates in a clinic of occupational dermatology.

Isocyanates are used as starting materials of polyurethane (PU) products. They are relatively important occupational skin sensitizers. To analyse results of a large isocyanate patch test series of 19 isocyanate test substances and 4,4'-diaminodiphenylmethane (MDA), a marker of 4,4'-diphenylmethane diisocyanate (MDI) hypersensitivity. Test files were screened for positive reactions in the isocyanate series. Patients with positive reactions were analysed for occupation, exposure and diagnosis. In 2010-2019, 53 patients had positive reactions in the series (16% of 338 patients tested). MDA, the well-established screening substance for MDI allergy, was positive in 30 patients, an in-house monomeric MDI test substance in 23 patients and 3 different polymeric MDI test substances in 19-21 patients. We diagnosed 16 cases of occupational allergic contact dermatitis (OACD) from MDI including 3 pipe reliners. Hexamethylene-1,6-diisocyanate (HDI) oligomers in paint hardeners caused 5 cases of OACD, more cases than 2,4-toluene diisocyanate (TDI; n = 3) and isophorone diisocyanate (IPDI; n = 1) put together. In contrast to previous studies, polymeric MDI test substances were not superior to a monomeric MDI. Pipe reliners may get sensitised not only by epoxy products and acrylates but also by MDI in hardeners of PU pipe coatings. HDI oligomers were the second most important causes of OACD after MDI.

Monetary Policy and Stock Market Return: The Case of Saudi Arabia Interest Rates hikes and Stocks Returns

The purpose of this research is to examine whether changes in macroeconomic variables have an effect on Saudi Arabia's main index, TASI and whether Monetary policy actions produce positive, negative or no effect at all for all listed companies. Accordingly, we examine the stock price adjustment around announcements of changes in interest rates, we examine the impact of a series of interest rate hikes on the stock returns under the main stock index in the Saudi Stock Market, TASI. The data covers four events between 16 March 2021 to 5 October 2022. We use an event study approach, with an estimation window length of [-250,-11] and an event window length of [-10,7], and we apply the OLS market model for daily data. The significance of the cumulative abnormal return CAAR is tested using the t statistics. The empirical results show that TASI responds negatively to three out of four announcements of interest rate hikes. The positive reaction occurs during the July 2022 monetary action. The positive reaction is attributed to the rising oil prices during that period. Finally, the results of this research open a window for future research to examine the impact of interest rates on the Saudi stock market over the long run.

Design, implementation and usability analysis of patient empowerment in ADLIFE project via patient reported outcome measures and shared decision making

IntroductionThis paper outlines the design, implementation, and usability study results of the patient empowerment process for chronic disease management, using Patient Reported Outcome Measurements and Shared Decision-Making Processes.BackgroundThe ADLIFE project aims to develop innovative, digital health solutions to support personalized, integrated care for patients with severe long-term conditions such as Chronic Obstructive Pulmonary Disease, and/or Chronic Heart Failure. Successful long-term management of patients with chronic conditions requires active patient self-management and a proactive involvement of patients in their healthcare and treatment. This calls for a patient-provider partnership within an integrated system of collaborative care, supporting self-management, shared-decision making, collection of patient reported outcome measures, education, and follow-up.MethodsADLIFE follows an outcome-based and patient-centered approach where PROMs represent an especially valuable tool to evaluate the outcomes of the care delivered. We have selected 11 standardized PROMs for evaluating the most recent patients’ clinical context, enabling the decision-making process, and personalized care planning. The ADLIFE project implements the "SHARE approach’ for enabling shared decision-making via two digital platforms for healthcare professionals and patients. We have successfully integrated PROMs and shared decision-making processes into our digital toolbox, based on an international interoperability standard, namely HL7 FHIR. A usability study was conducted with 3 clinical sites with 20 users in total to gather feedback and to subsequently prioritize updates to the ADLIFE toolbox.ResultsUser satisfaction is measured in the QUIS7 questionnaire on a 9-point scale in the following aspects: overall reaction, screen, terminology and tool feedback, learning, multimedia, training material and system capabilities. With all the average scores above 6 in all categories, most respondents have a positive reaction to the ADLIFE PEP platform and find it easy to use. We have identified shortcomings and have prioritized updates to the platform before clinical pilot studies are initiated.ConclusionsHaving finalized design, implementation, and pre-deployment usability studies, and updated the tool based on further feedback, our patient empowerment mechanisms enabled via PROMs and shared decision-making processes are ready to be piloted in clinal settings. Clinical studies will be conducted based at six healthcare settings across Spain, UK, Germany, Denmark, and Israel.

Physico-chemical characterization of acid base disorders in patients with COVID-19: A cohort study.

Acid-base imbalance has been poorly described in patients with coronavirus disease 2019 (COVID-19). Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution that may have been overlooked using traditional acid-base analysis techniques. In a cohort of critically ill COVID-19 patients, we looked for an association between metabolic acidosis surrogates and worse clinical outcomes, such as mortality, renal dialysis, and length of hospital stay. To describe the acid-base disorders of critically ill COVID-19 patients using Stewart's approach, associating its variables with poor outcomes. This study pertained to a retrospective cohort comprised of adult patients who experienced an intensive care unit stay exceeding 4 days and who were diagnosed with severe acute respiratory syndrome coronavirus 2 infection through a positive polymerase chain reaction analysis of a nasal swab and typical pulmonary involvement observed in chest computed tomography scan. Laboratory and clinical data were obtained from electronic records. Categorical variables were compared using Fisher's exact test. Continuous data were presented as median and interquartile range. The Mann-Whitney U test was used for comparisons. In total, 211 patients were analyzed. The mortality rate was 13.7%. Overall, 149 patients (70.6%) presented with alkalosis, 28 patients (13.3%) had acidosis, and the remaining 34 patients (16.2%) had a normal arterial pondus hydrogenii. Of those presenting with acidosis, most had a low apparent strong ion difference (SID) (20 patients, 9.5%). Within the group with alkalosis, 128 patients (61.0%) had respiratory origin. The non-survivors were older, had more comorbidities, and had higher Charlson's and simplified acute physiology score 3. We did not find severe acid-base imbalance in this population. The analyzed Stewart's variables (effective SID, apparent SID, and strong ion gap and the effect of albumin, lactate, phosphorus, and chloride) were not different between the groups. Alkalemia is prevalent in COVID-19 patients. Although we did not find an association between acid-base variables and mortality, the use of Stewart's methodology may provide insights into this severe disease.

A Comprehensive Report on the HPLC-ESI-MS/MS Method Development and Validation for Quantifying Cabotegravir in K3EDTA-Human Plasma, Employing Cabotegravir-D5 as an Internal Standard

Aiming to comprehend the plasma concentration of cabotegravir, a meticulously crafted bioanalytical method, aligned with the guidelines set by the US Food and Drug Administration (FDA), was devised and validated. This involved the utilization of cabotegravir D5 as an isotopic internal standard. The mobile phase consisted of methanol and 5 mM ammonium acetate in water, in an 80:20 ratio, v/v—Zorbax SB-C18 (50 × 2.1 mm, 5 μm) served as the chromatographic column. Cabotegravir and cabotegravir D5 were identified using proton adducts at m/z 409.20/370.20 and 409.20/144.8, respectively, employing the positive mode multiple reaction monitoring. Cabotegravir exhibited linearity within concentration ranges of 2 to 1000 ng/mL (r2 = 0.999). The recovery of cabotegravir from plasma by Liquid-liquid extraction yielded an average %CV of 7.71 at four quality control levels. Intra-day precision displayed accuracy of 100, 106, 97, 97, and 103%, respectively, whereas accuracy for inter-day precision was 100, 103, 98, 100, and 100% across LLQC, LQC, MQC-1, MQC-2, and HQC levels. The stability of cabotegravir remained consistent under diverse conditions, including five freeze-thaw cycles, benchtop, autosampler, and short-term, and long-term storage. This evaluation verifies that the method aligns with predefined acceptance limits and positions it as an indispensable tool in bioanalysis, significantly expanding its clinical utility.

Elderly patients' reactions to gamification-based digital therapeutics (DTx): The relevance of socialization tendency seeking

The acceptance of new technologies by elderly individuals has been long debated in literature, showing barriers in their adoption. However, recent technology features such as gamification have been promising a great deal of impact on their intention to use new technology-based solutions. Particularly in the healthcare sector, gamification has been suggested to increase elderly individuals' intention to use digital therapeutics. However, in the attempt to incentivize the adoption of these new technological innovations, the importance of socialization has been advanced as a further reinforcement mechanism by improving the social interactions of elderly patients thanks to the connections with young or expert people. In this paper, we aim to investigate whether the use of gamification affects elderly patients' intention to use new digital therapeutics (DTx) trying to shed lights on the importance of socialization as a winning strategy to boost their adoption. Through an explorative research design, we conducted a study among a selected group of 168 elderly participants. Our findings reveal that these patients' perceived ease of use gamification-based digital therapeutics positively affects their intention to use, via the perceived usefulness of such new technological features. More importantly, we find that this effect increases in magnitude as elderly patients' socialization tendency seeking increases, revealing the importance of socialization-oriented strategies in stimulating elderly's positive reactions to technological tools. This results in a higher willingness to adopt new digital healthcare therapeutics. Implications for both theory and practices emerge from this research.