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1.
Int J Mol Sci ; 25(5)2024 Mar 06.
Article in English | MEDLINE | ID: mdl-38474320

ABSTRACT

Recent mechanistic studies have indicated that combinations of radiotherapy (RT) plus immunotherapy (via CSF-1R inhibition) can serve as a strategy to overcome RT resistance and improve the survival of glioma mice. Given the high mortality rate for glioma, including low-grade glioma (LGG) patients, it is of critical importance to investigate the mechanism of the combination of RT and immunotherapy and further translate the mechanism from mouse studies to improve survival of RT-treated human glioma patients. Using the RNA-seq data from a glioma mouse study, 874 differentially expressed genes (DEGs) between the group of RT-treated mice at glioma recurrence and the group of mice with combination treatment (RT plus CSF-1R inhibition) were translated to the human genome to identify significant molecular pathways using the KEGG enrichment analysis. The enrichment analysis yields statistically significant signaling pathways, including the phosphoinositide 3-kinase (PI3K)/AKT pathway, Hippo pathway, and Notch pathway. Within each pathway, a candidate gene set was selected by Cox regression models as genetic biomarkers for resistance to RT and response to the combination of RT plus immunotherapies. Each Cox model is trained using a cohort of 295 RT-treated LGG patients from The Cancer Genome Atlas (TCGA) database and validated using a cohort of 127 RT-treated LGG patients from the Chinese Glioma Genome Atlas (CGGA) database. A four-DEG signature (ITGB8, COL9A3, TGFB2, JAG1) was identified from the significant genes within the three pathways and yielded the area under time-dependent ROC curve AUC = 0.86 for 5-year survival in the validation set, which indicates that the selected DEGs have strong prognostic value and are potential intervention targets for combination therapies. These findings may facilitate future trial designs for developing combination therapies for glioma patients.


Subject(s)
Brain Neoplasms , Glioma , Radiation Oncology , Humans , Animals , Mice , Phosphatidylinositol 3-Kinases , Phosphatidylinositol 3-Kinase , Immunotherapy
2.
Sci China Life Sci ; 67(2): 258-273, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37837531

ABSTRACT

Advancements in genomics have dramatically accelerated the research on medicinal plants, and the development of herbgenomics has promoted the "Project of 1K Medicinal Plant Genome" to decipher their genetic code. However, it is difficult to obtain their high-quality whole genomes because of the prevalence of polyploidy and/or high genomic heterozygosity. Whole genomes of 123 medicinal plants were published until September 2022. These published genome sequences were investigated in this review, covering their classification, research teams, ploidy, medicinal functions, and sequencing strategies. More than 1,000 institutes or universities around the world and 50 countries are conducting research on medicinal plant genomes. Diploid species account for a majority of sequenced medicinal plants. The whole genomes of plants in the Poaceae family are the most studied. Almost 40% of the published papers studied species with tonifying, replenishing, and heat-cleaning medicinal effects. Medicinal plants are still in the process of domestication as compared with crops, thereby resulting in unclear genetic backgrounds and the lack of pure lines, thus making their genomes more difficult to complete. In addition, there is still no clear routine framework for a medicinal plant to obtain a high-quality whole genome. Herein, a clear and complete strategy has been originally proposed for creating a high-quality whole genome of medicinal plants. Moreover, whole genome-based biological studies of medicinal plants, including breeding and biosynthesis, were reviewed. We also advocate that a research platform of model medicinal plants should be established to promote the genomics research of medicinal plants.


Subject(s)
Plants, Medicinal , Plants, Medicinal/genetics , Plant Breeding , Genomics/methods , Whole Genome Sequencing , Crops, Agricultural/genetics , Genome, Plant/genetics
3.
J Public Health Policy ; 44(4): 658-673, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38017149

ABSTRACT

The Targeted Translation Research Accelerator program was created to address cardiovascular disease and diabetes in Australia. To maximise the impact of the considerable investment in this program, a structured prioritisation project was undertaken to determine the highest priority health and medical unmet needs in cardiovascular disease and diabetes. The project was led by Monash University's Behaviour Works Australia in collaboration with Australian National University, Research Australia, and MTPConnect. We conducted an online survey with 318 experts and community representatives to generate a 'long list' of unmet needs for (1) cardiovascular disease; (2) diabetes; and (3) interactions in the pathogenesis of Type 1 diabetes, Type 2 diabetes, and cardiovascular disease. We then convened roundtables of clinical, research, and community leaders to discuss survey results. They prioritised unmet needs against six predefined criteria then discussed results. We present the final priority areas for funding. We demonstrate how a feasible, reproducible, and collaborative prioritisation methodology can be used when designing research funding programs. Such approaches can ensure that funding is directed towards projects that are valuable to the community and reflective of expert opinion.


Subject(s)
Cardiovascular Diseases , Diabetes Mellitus, Type 2 , Humans , Cardiovascular Diseases/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Australia , Health Priorities , Surveys and Questionnaires
4.
Chin Med ; 18(1): 146, 2023 Nov 08.
Article in English | MEDLINE | ID: mdl-37941061

ABSTRACT

Network pharmacology can ascertain the therapeutic mechanism of drugs for treating diseases at the level of biological targets and pathways. The effective mechanism study of traditional Chinese medicine (TCM) characterized by multi-component, multi-targeted, and integrative efficacy, perfectly corresponds to the application of network pharmacology. Currently, network pharmacology has been widely utilized to clarify the mechanism of the physiological activity of TCM. In this review, we comprehensively summarize the application of network pharmacology in TCM to reveal its potential of verifying the phenotype and underlying causes of diseases, realizing the personalized and accurate application of TCM. We searched the literature using "TCM network pharmacology" and "network pharmacology" as keywords from Web of Science, PubMed, Google Scholar, as well as Chinese National Knowledge Infrastructure in the last decade. The origins, development, and application of network pharmacology are closely correlated with the study of TCM which has been applied in China for thousands of years. Network pharmacology and TCM have the same core idea and promote each other. A well-defined research strategy for network pharmacology has been utilized in several aspects of TCM research, including the elucidation of the biological basis of diseases and syndromes, the prediction of TCM targets, the screening of TCM active compounds, and the decipherment of mechanisms of TCM in treating diseases. However, several factors limit its application, such as the selection of databases and algorithms, the unstable quality of the research results, and the lack of standardization. This review aims to provide references and ideas for the research of TCM and to encourage the personalized and precise use of Chinese medicine.

5.
Nurse Educ Pract ; 72: 103741, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37677991

ABSTRACT

AIM: Synthesize and present peer-reviewed evidence of interventions that enhance the research productivity of academics in Schools of Nursing in Higher Education Institutions. BACKGROUND: Pressures on academics in Schools of Nursing worldwide to increase or maintain high research productivity persist and numerous Higher Education Institutions across the world have developed interventions to increase productivity. Given evidence that the COVID-19 pandemic has resulted in a withdrawal from research, understanding which interventions best support and improve research productivity is urgent. Increasing research capacity is crucial but only one element in increasing productivity. No recent attempt has been made to synthesise the knowledge gained from these more wide-ranging initiatives. DESIGN: A mixed-methods systematic review, registered in PROSPERO, searching four academic databases (CINAHL, ERIC, MEDLINE, PsycINFO) from 1/01/2010-20/04/2022. All primary research studies of relevant interventions were included if they described the intervention, reported its outcomes and were published in the English language in peer-reviewed journals. RESULTS: 1637 studies were assessed against eligibility criteria, resulting in 20 included studies. No studies were excluded based on quality. Data pertaining to understandings of 'research productivity', barriers to research productivity, interventions and outcomes of interventions were extracted. The most often used measures were the frequency or staff-output ratio of funding, publications and presentations, while the less commonly used were the number of conference abstracts submitted/accepted and awards. Subjective measures were less commonly used. Barriers to research productivity fell into three broad categories: resource constraints, lack of priority for research and barriers related to the attitudes, knowledge and skills of School of Nursing academics. Interventions covered nine broad areas. Half of the interventions were multi-stranded, including a wide range of components to increase research productivity while the other half comprised one component only, such as writing groups and mentoring. All interventions had a positive impact on research productivity, however, heterogeneity in the measurement of impact, the duration of interventions, sources of comparative data and research design made comparison of interventions challenging. CONCLUSIONS: The review identified a need for future research to explore the barriers among under-represented groups of academics in Schools of Nursing across a broader geographical area; and what works for various sub-groups of academics. It also identified a need for a valid, standardised tool to assess the effectiveness of interventions to increase research productivity of academics in Schools of Nursing.


Subject(s)
COVID-19 , Mentoring , Humans , Pandemics , Attitude , Schools
6.
J Foot Ankle Res ; 16(1): 32, 2023 Jun 02.
Article in English | MEDLINE | ID: mdl-37268962

ABSTRACT

Evidence-based practice provides the foundation for high quality patient care, and in the NHS, research is seen as vital to enable service transformation and improve outcomes. Research is one of the four pillars of enhanced and advanced clinical practice and is therefore a fundamental part of podiatric surgery services. In order to meet the UK health research strategies, the most recent being 'Saving and Improving Lives: The Future of UK Clinical Research Delivery' (2021), the Faculty of Podiatric Surgery in the UK agreed to support the development of research priorities in order to inform a future research strategy.The Podiatric Surgery Research Strategy Group was set up and embarked on a project with the aim of engaging its members in formulating and agreeing national research priorities. The initial stage included a national research scoping survey to identify key themes, topic, and research questions. The final stage consisted of developing and enabling a live consensus vote conducted at the 2022 national Faculty of Podiatric Surgery Conference. At the end of the vote, the top five research topics that met the agreement criteria were: 1. Surgical treatment - forefoot, 2. Patient reported outcome measures, 3. Post-operative management, 4. Surgical treatment - midfoot and 5. Service delivery. The top five research questions that met the criteria were1. How does quality of life improve following elective foot surgery? 2. How does podiatric surgery benefit the health of the population? 3. How does podiatric surgery benefit the health of the population in the at-risk foot? 4. What is the most effective Lapidus fixation option? and 5. What is the benefit of utilising PASCOM-10 to improve large scale outcome data? These will inform the initial UK podiatric surgery research priorities in the next three to five years.


Subject(s)
Foot , Quality of Life , Humans , Research Design , Lower Extremity , United Kingdom
7.
Open Res Afr ; 6: 1, 2023.
Article in English | MEDLINE | ID: mdl-36852379

ABSTRACT

The evidence is clear that climate change is the greatest challenge facing mankind today. Africa is disproportionately burdened by multiple direct and cascading impacts of the climate crisis. Global investments for climate change adaptation, however, have not prioritized Africa adequately and there is a significant knowledge gap in understanding the context and science of climate change and sustainable solutions for the continent's adaptation. Solutions for adaptation and resilience are made complex by an urgent need for accelerated economic growth, rapid population expansion and urbanization, habitat and biodiversity loss and dwindling financing.  There are also challenges in matching policies, wavering commitments and actions with good science that focuses on sustainable lives, livelihoods and ecosystem preservation. The solutions must come from where the impacts are felt. The Science for Africa Foundation supports African researchers and institutions to lead in the science that addresses African priority development areas and has set climate change as a strategic priority. This call to action, by the SFA Foundation, outlines key areas that its strategy addresses through programs that support African scientific excellence, leadership and the best of Africa's research to understand the science of climate change and its impacts; collate and assess evidence for policy; grow high level technical capacity on the continent; and create innovative priority actions for Africa.

8.
Radiography (Lond) ; 29(2): 416-420, 2023 03.
Article in English | MEDLINE | ID: mdl-36796147

ABSTRACT

OBJECTIVE: - This paper sought to explore the value of case reports in diagnostic radiography with regards to current usage, relevance to evidence-based radiography, and educational benefits. KEY FINDINGS: Case reports are short accounts of novel pathologies, trauma or treatment with a critical review of relevant literature. Examples within diagnostic radiography include the appearances of COVID-19 alongside examination-level scenarios involving image artefacts, equipment failure and patient incidents in radiology. With greatest risk of bias and lowest generalisability, they are considered as low-quality evidence with generally poor citation rates. Despite this, there are examples of significant discoveries or developments initiated with case reports with important patient care implications. Furthermore, they offer educational development for both reader and author alike. Whereas the former learns about an unusual clinical scenario, the latter develops scholarly writing skills, reflective practice and may generate further, more complex, research. Radiography-specific case reports could capture the diverse imaging skills and technological expertise currently under-represented in traditional case reports. Potential avenues for cases are broad and may include any imaging modality where patient care or safety of other persons may illicit a teaching point. This encapsulates all stages of the imaging process, before, during and after patient interaction. CONCLUSION: Despite being low-quality evidence, case reports contribute to evidence-based radiography, add to the knowledge base, and foster a research culture. However, this is contingent upon rigorous peer-review and adherence to ethical treatment of patient data. IMPLICATIONS FOR PRACTICE: With the drive to increase research engagement and output at all levels in radiography (student to consultant), case reports may act as a realistic grass-root activity for a burdened workforce with limited time and resources.


Subject(s)
COVID-19 , Radiology , Humans , COVID-19/diagnostic imaging , Radiography , Patient Care , Students , COVID-19 Testing
9.
Acta Pharmaceutica Sinica ; (12): 1732-1741, 2023.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-978669

ABSTRACT

Depression is a common emotional disorder that seriously affects people's life and health all over the world. The pathogenesis of depression is complex, and traditional Chinese medicine (TCM) for antidepressants has a good therapeutic effect because of its multi-component, multi-pathway, and multi-target action mode. At present, the anti-depressive mechanism of TCM has not been fully clarified, but it is clear that depression is closely related to metabolic health. Therefore, in order to further explore the anti-depressive mechanism of TCM, this paper proposes research strategies on the anti-depressive mechanism of TCM based on functional metabolomics from the perspective of metabolism, the potential biomarkers of depression are analyzed with the help of multi-omics combined analysis technology, and the functional molecules of TCM for antidepressant are studied. Molecular biology techniques are used to accurately capture the molecular interactions between biomarkers of depression and functional compounds, which identify effective drug targets and further elucidate the biochemical functions and related mechanisms involved in depression metabolic disorders. This paper systematically reviews the research strategies and applications of functional metabolomics in the anti-depressive mechanisms of TCM, expounds on the core value of functional metabolomics, and summarizes the current research status and hot issues of TCM for antidepressants in recent years, providing new methods and new ideas for the study of mechanisms of TCM with the help of functional metabolomics.

10.
Sichuan Mental Health ; (6): 385-387, 2023.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-998142

ABSTRACT

Depression constitutes the most common mental disorder with high prevalence rate, and is the leading contributor to the global burden of disease. Many factors are found to influence the development of depression, whereas either reliable biomarkers for the early diagnosis or diagnostic criteria for subtype classification currently exist for depression. Therefore, this paper gives a detailed discussion on the current status and existing challenges of depression research in the context of brain imaging, psychoneuroimmunology and electroencephalography, thus providing a new perspective for research directions and future strategies related to depression.

11.
J Emerg Med ; 63(5): 683-691, 2022 11.
Article in English | MEDLINE | ID: mdl-36517117

ABSTRACT

BACKGROUND: Logistic regression plays a fundamental role in the production of decision rules, risk assessment, and in establishing cause and effect relationships. This primer is aimed at novice researchers with minimal statistical expertise. OBJECTIVE: Introduce the logit equation and provide a hands-on example to facilitate understanding of its benefits and limitations. DISCUSSION: This primer reviews the mathematical basis of a logit equation by comparing and contrasting it with the simple straight-line (linear) equation. After gaining an understanding of the meaning of beta coefficients, readers are encouraged to download a free statistical program and database to produce a logistic regression analysis. Using this example, the narrative then discusses commonly used methods to describe model fitness, including the C-statistic, chi square, Akaike and Bayesian Information Criteria, McFadden's pseudo R2, and the Hosmer-Lemeshow test. The authors provide a how-to discussion for variable selection and estimate of sample size. However, logistic regression alone can seldom establish causal inference without further steps to explore the often complex relationship amongst variables and outcomes, such as with the use of a directed acyclic graphs. We present key elements that generally should be considered when appraising an article that uses logistic regression. This primer provides a basic understanding of the theory, hands-on construction, model analysis, and limitations of logistic regression in emergency care research. CONCLUSIONS: Logistic regression can provide information about the association of independent variables with important clinical outcomes, which can be the first step to show predictiveness or causation of variables on the outcomes of interest. © 2022 Elsevier Inc.


Subject(s)
Emergency Medical Services , Humans , Logistic Models , Bayes Theorem , Causality , Risk Assessment
12.
Glob Change Biol Bioenergy ; 14(3): 246-257, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35909989

ABSTRACT

Forest-based mitigation strategies will play a pivotal role in achieving the rapid and deep net-emission reductions required to prevent catastrophic climate change. However, large disagreement prevails on how to forge forest-based mitigation strategies, in particular in regions where forests are currently growing in area and carbon density. Two opposing viewpoints prevail in the current discourse: (1) A widespread viewpoint, specifically in countries in the Global North, favours enhanced wood use, including bioenergy, for substitution of emissions-intensive products and processes. (2) Others instead focus on the biophysical, resource-efficiency and time-response advantages of forest conservation and restoration for carbon sequestration and biodiversity conservation, whilst often not explicitly specifying how much wood extraction can still safeguard these ecological benefits. We here argue for a new perspective in sustainable forest research that aims at forging "no-regret" forest-based climate change mitigation strategies. Based on the consideration of forest growth dynamics and the opportunity carbon cost associated with wood use, we suggest that, instead of taking (hypothetical) wood-for-fossil substitution as starting point in assessments of carbon implications of wood products and services, analyses should take the potential and desired carbon sequestration of forests as starting point and quantify sustainable yield potentials compatible with those carbon sequestration potentials. Such an approach explicitly addresses the possible benefits provided by forests as carbon sinks, brings research on the permanence and vulnerability of C-stocks in forests, of substitution effects, as well as explorations of demand-side strategies to the forefront of research and, in particular, aligns better with the urgency to find viable climate solutions.

13.
Cancer Drug Resist ; 5(2): 511-533, 2022.
Article in English | MEDLINE | ID: mdl-35800363

ABSTRACT

Aim: This study aimed to translate a known drug-resistance mechanism of long-term CSF1R inhibition into multicellular biomarkers that can serve as potential therapeutic targets as well as predictive markers for the survival of glioma patients. Methods: Using existing data from a published mouse study of drug resistance in immunotherapy for glioma, we identified multicellular differentially expressed genes (DEGs) between drug-sensitive and drug-resistant mice and translated the DEGs in mouse genome to human homolog. We constructed correlation gene networks for drug resistance in mice and glioma patients and selected candidate genes via concordance analysis of human with mouse gene networks. Markers of drug resistance and an associated predictive signature for patient survival were developed using regularized Cox models with data of glioma patients from The Cancer Genome Atlas (TCGA) database. Predictive performance of the identified predictive signature was evaluated using an independent human dataset from the Chinese Glioma Genome Atlas (CGGA) database. Results: Fourteen genes (CCL22, ADCY2, PDK1, ZFP36, CP, CD2, PLAUR, ACAP1, COL5A1, FAM83D, PBK, FANCA, ANXA7, and TACC3) were identified as genetic biomarkers that were all associated with pathways in glioma progression and drug resistance. Five of the 14 genes (CCL22, ADCY2, PDK1, CD2, and COL5A1) were used to construct a signature that is predictive of patient survival in the proneural subtype GBM patients with an AUC under the time-dependent receiver operating characteristic (ROC) of 2-year survival equal to 0.89. This signature also shows promising predictive accuracy for the survival of LGG patients but not for non-proneural type GBMs. Conclusion: Our translational approach can utilize gene correlation networks from multiple types of cells in the tumor microenvironment of animals. The identified biomarkers of drug resistance have good power to predict patient survival in some major subtypes of gliomas (the proneural subtype of GBM and LGG). The expression levels of the biomarkers of drug resistance may be modified for the development of personalized immunotherapies to prolong survival for a large portion of glioma patients.

14.
Eur J Gen Pract ; 28(1): 136-141, 2022 Dec.
Article in English | MEDLINE | ID: mdl-35666561

ABSTRACT

The European General Practice Research Network (EGPRN) has recently published an updated research strategy with the overall aim being to promote relevant research of the highest quality within general practice/family medicine (GP/FM). The Research Strategy indicates a global direction and serves as a basis for more detailed plans in individual countries that will take into account the characteristics of a country, its specific needs and the level of current research capacity. This paper aims to provide a summary of the EGPRN Research Strategy.The Research Strategy suggests that it is necessary to consider what the knowledge deficits are and to set research priorities. Research capacity building (RCB) is required at all levels. Research in GP/FM will also have to reflect the changes in the profession. An innovative and sustainable-oriented approach to conducting research is needed. Use of existing toolkits and engagement with patient platforms and representative groups are necessary to ensure meaningful user involvement. Knowledge transfer and exchange (KTE) is an important component to ensure a process of exchange between researchers and knowledge users.Working to improve leadership, to support the creation of a research culture in GP/FM and to increase national and international networking are considered as fundamental to ensuring a portfolio of high-quality research and for improving the impact of GP/FM research. The recommendations in the Research Strategy are based on a review of the literature on general practice research from 2010 to 2019 and are set in the context of a theoretical framework.


Subject(s)
Family Practice , General Practice , Capacity Building , Europe , Humans , Research Design
15.
Elife ; 112022 06 22.
Article in English | MEDLINE | ID: mdl-35731202

ABSTRACT

Working in Africa provides neuroscientists with opportunities that are not available in other continents. Populations in this region exhibit the greatest genetic diversity; they live in ecosystems with diverse flora and fauna; and they face unique stresses to brain health, including child brain health and development, due to high levels of traumatic brain injury and diseases endemic to the region. However, the neuroscience community in Africa has yet to reach its full potential. In this article we report the outcomes from a series of meetings at which the African neuroscience community came together to identify barriers and opportunities, and to discuss ways forward. This exercise resulted in the identification of six domains of distinction in African neuroscience: the diverse DNA of African populations; diverse flora, fauna and ecosystems for comparative research; child brain health and development; the impact of climate change on mental and neurological health; access to clinical populations with important conditions less prevalent in the global North; and resourcefulness in the reuse and adaption of existing technologies and resources to answer new questions. The article also outlines plans to advance the field of neuroscience in Africa in order to unlock the potential of African neuroscientists to address regional and global mental health and neurological problems.


Subject(s)
Ecosystem , Neurosciences , Africa , Child , Climate Change , Global Health , Humans
16.
Front Cardiovasc Med ; 9: 849007, 2022.
Article in English | MEDLINE | ID: mdl-35402575

ABSTRACT

Introduction: Cardiovascular disease (CVD) contribute the largest mortality burden globally, with most of the deaths (80% of all deaths) occurring in low and middle-income countries (LMICs), including Tanzania. Despite the increasing burden, to date, CVD research output is still limited in Tanzania, as it is for many sub-Saharan Africa (SSA) countries. This trend hinders the establishment of locally informed CVD management and policy changes. Here, we aim to review the existing gaps while highlighting the available opportunities for a sustainable CVD research strategy in Tanzania. Methods: A rapid review of available literature on CVD research in SSA was conducted, with emphasis on the contribution of Tanzania in the world literature of CVD. Through available literature, we identify strategic CVD research priorities in Tanzania and highlight challenges and opportunities for sustainable CVD research output. Findings: Shortage of skilled researchers, inadequate research infrastructure, limited funding, and lack of organized research strategies at different levels (regional, country, and institutional) are among the existing key bottlenecks contributing to the low output of CVD research in Tanzania. There is generally strong global, regional and local political will to address the CVD epidemic. The establishment of the East African Centre of Excellence in Cardiovascular Sciences (EACoECVS) offers a unique opportunity for setting strategies and coordinating CVD research and training for Tanzania and the East African region. Conclusion: There is a light of hope for long-term sustainable CVD research output from Tanzania, taking advantage of the ongoing activities and plans for the evolving EACoECVS. The Tanzanian experience can be taken as a lesson for other SSA countries.

18.
BMC Palliat Care ; 21(1): 22, 2022 Feb 15.
Article in English | MEDLINE | ID: mdl-35168622

ABSTRACT

BACKGROUND: Emergency department (ED) visits among older adults are common near the end of life. Palliative care has been shown to reduce ED visits and to increase quality of life among patients, but recruitment into these programs is often challenging. This descriptive analysis explores the barriers to enrolling seriously ill patients scheduled for discharge from the ED into palliative care research. METHODS: This descriptive sub-study aims to assess the reasons why patients with advanced illness scheduled for discharge home from 11 EDs across the United States decline to participate in Emergency Medicine Palliative Care Access (EMPallA), a Phase IV randomized controlled trial (RCT) comparing two modes of palliative care delivery. Our aim was to understand why patients decline to enroll to improve future recruitment rates and expand care for patients discharged home from the ED. Research coordinators documented reasons that patients declined to enroll in the larger EMPallA trial; reasons for refusing participation were independently analyzed by two researchers to identify overarching themes. RESULTS: Enrollment rate across all sites was 45%; of the 504 eligible patients who declined participation, 47% (n = 237) declined for reasons related to illness severity. 28% of refusals (n = 143) were related to the mode of palliative care delivery, while 24% (n = 123) were due to misconceptions or stigma related to palliative care. Less commonly, patients refused due to general research barriers (16.5%), family/caregiver barriers (11.7%), and physician-related barriers (< 1%). CONCLUSIONS: Patients with advanced illnesses presenting to the ED often refuse to participate in palliative care research due to the severity of their illness, the mode of care delivery, and misconceptions about palliative care. In contrast with other studies, our study found minimal physician gatekeeping, which may be the result of both changing attitudes toward palliative care and the nature of the ED setting. Robust training programs are crucial to overcome these misconceptions and to educate patients and providers about the role of palliative care. Future palliative care programs and study designs should recognize the burden this vulnerable population endures and consider alternative modes of care delivery in an effort to increase participation and enrollment. CLINICAL TRIALS REGISTRATION: NCT03325985 , October 30, 2017.


Subject(s)
Emergency Medicine , Hospice and Palliative Care Nursing , Aged , Emergency Service, Hospital , Humans , Palliative Care , Quality of Life
19.
JDR Clin Trans Res ; 7(2): 215-217, 2022 04.
Article in English | MEDLINE | ID: mdl-33618559

ABSTRACT

In qualitative research, the researcher is the research instrument. Therefore, a qualitative researcher who is also a clinician must consider how their dual position informs participant consent, data collection, and analysis. This reflexivity is essential in research design to effectively respond to ethical questions around role, authenticity, trust, and transparency around disclosing their clinician status to participants.


Subject(s)
Dental Research , Research Personnel , Humans , Qualitative Research , Trust
20.
Microscopy (Oxf) ; 71(1): 1-12, 2022 Jan 29.
Article in English | MEDLINE | ID: mdl-34950955

ABSTRACT

This review aims to clarify a suitable method towards achieving next-generation sustainability. As represented by the term 'Anthropocene', the Earth, including humans, is entering a critical era; therefore, science has a great responsibility to solve it. Biomimetics, the emulation of the models, systems and elements of nature, especially biological science, is a powerful tool to approach sustainability problems. Microscopy has made great progress with the technology of observing biological and artificial materials and its techniques have been continuously improved, most recently through the NanoSuit® method. As one of the most important tools across many facets of research and development, microscopy has produced a large amount of accumulated digital data. However, it is difficult to extract useful data for making things as biomimetic ideas despite a large amount of biological data. Here, we would like to find a way to organically connect the indispensable microscopic data with the new biomimetics to solve complex human problems.


Subject(s)
Biomimetics , Biomimetics/methods , Humans , Microscopy, Electron, Scanning
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