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A study evaluating the effect of Educational Needs Assessment Tool (ENAT) focused patient education, on health outcomes in patients with Rheumatoid arthritis: Protocol of an ongoing study

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Open Journal of Nursing 2013年第2期3卷 287-292页

作者： Bernadette Hardware Claire Hale Dawn Johnson Jackie Hill Tracey Young Adewale Adebajo Academic and Clinical Unit for Musculoskeletal Nursing Institute of Rheumatic and Musculoskeletal Medicine University of Leeds Leeds UK Academic and Clinical Unit for Musculoskeletal Nursing School of Healthcare University of Leeds Leeds UK Medical Statistics School of Health and Related Research University of Sheffield Sheffield UK R&D Department Barnsley Hospital NHS Foundation Trust Barnsley UK

Aims and objectives: To evaluate the effectiveness of a patient education tool (the ENAT) on self efficacy, patient knowledge, health outcomes and its usability in practice. Background: The effectiveness and value of patient education in rheumatoid arthritis have been questioned. The ENAT was developed to help the nurses to provide more focused, individualized and relevant education. The psychometric properties of the ENAT have been assessed. Design: This study is a single blind randomized controlled trial using both quantitative and qualitative methodology. The primary outcome is patient self efficacy. Secondary outcomes are physical function, psychological status, pain levels, social interaction and patient knowledge of disease. Methods: 130 RA patients will be randomized into an experimental (EG) or control group (CG). The EG patients will complete the ENAT prior to seeing a Clinical Nurse Specialist (CNS) at weeks 0, 16 and 32. The CNS will use the ENAT as a template to meet patients perceived educational needs in addition to the usual care. The CG will receive their usual care from the CNS without the aid of the ENAT. To determine the ENAT’s usability, semi-structured quailtative interviews will take place with the practitioners and a sample of patients once they have completed the quantitative arm of the study. Results: The study commenced in April 2011 and the results are expected to be available after April 2013. Conclusions: It is hypothesized that nurses’ use of the ENAT will lead to increased patient self efficacy, and improved patient knowledge and health outcomes among the patients who used it. Furthermore, it is hypothesized that the ENAT will be easy for staff and patients to use. Relevance to clinical practice: The ENAT was developed to assess the perceived educational needs of patients with rheumatoid arthritis and thus help the nurses to provide more focused, individualised and relevant education.

关键词： Educational Needs Assessment Tool Protocol Rheumatoid arthritis Self Management Patient Education

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跨越人工智能在精神疾病临床应用中的鸿沟

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Science Bulletin 2023年第15期68卷 1606-1610页

作者：陆唐胜刘晓星孙杰鲍彦平 Björn W.Schuller 韩盈陆林 National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence research Peking UniversityBeijing 100191China Peking University Sixth Hospital Peking University Institute of Mental HealthNHC Key Laboratory of Mental Health(Peking University)National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital)Chinese Academy of Medical Sciences Research UnitPeking UniversityBeijing 100191China pain Medicine Center Peking University Third HospitalBeijing 100191China GLAM-Group on Language Audio&MusicImperial College LondonLondon SW72AZUK Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain research Peking UniversityBeijing 100871China

Mental disorder is one of the greatest health challenges of our time,attracting increasingly more public awareness and causing high disability and huge socioeconomic *** to the 2019 Global Burden of Disease led by the Institute for Health Metrics and Evaluation,12.5%of the global population has been suffering from a mental ***,mental illness contributes to 32.4%of years lived with disability and 13.0%of disability-adjusted life-years[1].

关键词：精神疾病人工智能 attracting

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A Randomized Longitudinal Double-Blind Clinical Trial on Long-Term Neuropathic Symptomatology Relief &pain Analgesia

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Health 2020年第7期12卷 738-749页

作者： Xanya Sofra Nuris Lampe Department of Signaling IELLIOS Research Center Ipswich UK Clinical Dermatology Horatio Oduber Hospital Lg Smith Blvd Orangestad Aruba

Diabetic neuropathic pain is one of the most difficult to treat with high levels of reoccurrence and a substantial increase with aging. It involves expensive hospitalizations, often resulting in an amputated lower limb. We explored a variety of methods treating neuropathic pain such as low-level laser, monochromatic near-infrared treatment, TENS, acupuncture and pulsed electromagnetic fields that demonstrated inconclusive, limited or temporary pain relief with minor or short-term improvements in mobility. research conducted by ultra-low energy technologies reports pain relief and reduction of inflammation as a result of anti-oxidant electron donation transforming free radicals into stable molecules. We report the results of a randomized double blind one-year-long longitudinal clinical study on 10 diabetic mellitus (DM) subjects with chronic neuropathy, treated with ultra-low energy nanotechnology who experienced substantial long-term neuropathic pain relief. Importantly, pain analgesia and improvement in neuropathic symptomatology were not age-contingent. This contradicts past research postulating that age-accumulated inflammation and endothelial dysfunction can further exacerbate diabetic neuropathy. Importantly, a method offering age-independent, cost-effective, long-term neuropathic pain relief and increased mobility has major implications in reducing hospitalization time and overall expenses by offering a solution that enhances quality of life.

关键词： Aging pain Relief Diabetes Mellitus Neuropathy TENS Ultra-Low Energy Technologies Nanotechnology Limp Amputation Neuropathic pain

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National prevalence and risk factors for tungiasis in Kenya

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Infectious Diseases of Poverty 2023年第5期12卷 97-97页

作者： Lynne Elson Christopher Kamau Sammy Koech Christopher Muthama George Gachomba Erastus Sinoti Elwyn Chondo Eliud Mburu Miriam Wakio Jimmy Lore Marta Maia Ifedayo Adetifa Benedict Orindi Phillip Bejon Ulrike Fillinger Kenya Medical research Institute-Wellcome Trust research Programme Kilifi Kenya Nuffield Department of Medicine University of Oxford Oxford UK Department of Health Muranga Kenya Department of Health Kericho Kenya Department of Health Makueni Kenya Department of Health Nakuru Kenya Department of Health Samburu Kenya Department of Health Kilifi Kenya Department of Health Kajiado Kenya Department of Health Taita Taveta Kenya Department of Health Turkana Kenya London School of Hygiene and Tropical Medicine London UK International centre for Insect Physiology and Ecology (Icipe) Nairobi Kenya

Background Tungiasis is a highly neglected tropical skin disease caused by the sand flea,Tunga penetrans,the female of which burrows into the skin,causing pain and *** disease occurs throughout South America and sub-Saharan Africa but there are few systematic data on national disease *** tungiasis research community is keen to develop survey methods to fill this *** we used a school-based,thorough examination method to determine the prevalence and risk factors for tungiasis in *** We conducted the first nationally representative survey of tungiasis,including nine counties covering the major ecological zones of Kenya.A stratified multistage random sampling was used to select 22 primary schools from each of the nine counties and to select up to 114 pupils aged 8 to 14 years in each *** were examined thoroughly for *** surveys were conducted,the first between May and July 2021 and the second between October 2021 and April 2023 when pupils were also interviewed for risk *** effect logistic regression models were used to test associations of independent variables with tungiasis using the school as a random *** The overall prevalence of tungiasis in the first survey was 1.35%[95%confidence interval(CI):1.15-1.59%],and 0.89%in the second *** prevalence ranged from 0.08%(95%CI:0.01-0.59%)in Taita Taveta county to 3.24%(95%CI:2.35-4.44%)in Kajiado *** infection was associated with county of residence,male sex[adjusted odds ratio(aOR)=2.01,95%CI:1.52-2.67],and lower age(aOR=0.81,95%CI:0.75-0.88).For the first time we demonstrate an association with attending public schools rather than private schools(aOR=5.62,95%CI:1.20-26.22)and lower socioeconomic status(aOR=0.10,95%CI:0.03-0.33).Using a rapid screening method of the top of feet only,would have missed 62.9%of all cases,78.9%of mild cases and 20.0%of severe *** Tungiasis is widely but heterogeneously distributed across K

关键词： Tungiasis Neglected tropical diseases Prevalence Disease burden Kenya

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PGE2 activates EP4 in subchondral bone osteoclasts to regulate osteoarthritis

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Bone research 2022年第2期10卷 378-393页

作者： Wenhao Jiang Yunyun Jin Shiwei Zhang Yi Ding Konglin Huo Junjie Yang Lei Zhao Baoning Nian Tao PZhong Weiqiang Lu Hankun Zhang Xu Cao Karan Mehul Shah Ning Wang Mingyao Liu Jian Luo Yangzhi Rehabilitation Hospital(Sunshine Rehabilitation centre) Tongji University School of MedicineShanghaiPR China Shanghai Key Laboratory of Regulatory Biology Institute of Biomedical Sciences and School of Life SciencesEast China Normal UniversityShanghaiPR China Departments of Orthopaedic Surgery and Biomedical Engineering and Institute of Cell Engineering The Johns Hopkins University School of MedicineBaltimoreMDUSA Department of Oncology and Metabolism The University of SheffieldSheffieldUK

Prostaglandin E2(PGE2), a major cyclooxygenase-2(COX-2) product, is highly secreted by the osteoblast lineage in the subchondral bone tissue of osteoarthritis(OA) patients. However, NSAIDs, including COX-2 inhibitors, have severe side effects during OA treatment. Therefore, the identification of novel drug targets of PGE2 signaling in OA progression is urgently needed. Osteoclasts play a critical role in subchondral bone homeostasis and OA-related pain. However, the mechanisms by which PGE2 regulates osteoclast function and subsequently subchondral bone homeostasis are largely unknown. Here, we show that PGE2 acts via EP4 receptors on osteoclasts during the progression of OA and OA-related pain. Our data show that while PGE2 mediates migration and osteoclastogenesis via its EP2 and EP4 receptors, tissue-specific knockout of only the EP4 receptor in osteoclasts(EP4 Lys M) reduced disease progression and osteophyte formation in a murine model of OA. Furthermore, OA-related pain was alleviated in the EP4 Lys M mice, with reduced Netrin-1 secretion and CGRP-positive sensory innervation of the subchondral bone. The expression of plateletderived growth factor-BB(PDGF-BB) was also lower in the EP4 Lys Mmice, which resulted in reduced type H blood vessel formation in subchondral bone. Importantly, we identified a novel potent EP4 antagonist, HL-43, which showed in vitro and in vivo effects consistent with those observed in the EP4 Lys Mmice. Finally, we showed that the Gαs/PI3 K/AKT/MAPK signaling pathway is downstream of EP4 activation via PGE2 in osteoclasts. Together, our data demonstrate that PGE2/EP4 signaling in osteoclasts mediates angiogenesis and sensory neuron innervation in subchondral bone, promoting OA progression and pain, and that inhibition of EP4 with HL-43 has therapeutic potential in OA.

关键词： osteoclast homeostasis PGE2

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Acupuncture for pain:An Overview of Cochrane Reviews

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Chinese Journal of Integrative Medicine 2011年第2期17卷 187-189页

作者： Myeong Soo Lee Edzard Ernst Brain Disease research Center Korea Institute of Oriental MedicineDaejeonSouth Korea Complementary Medicine Peninsula Medical SchoolUniversity of ExeterExeterUK

Objective： Cochrane reviews have the reputation for being more transparent and rigorous than other reviews. The aim of this overview was to evaluate and summarize Cochrane reviews of acupuncture for the treatment of any type of pain. Methods： We searched the Cochrane Database and evaluated the Cochrane reviews that were concerned specifically with the effectiveness of acupuncture for pain. Data were extracted according to pre-defined inclusion criteria by two independent reviewers. Results： Eight Cochrane reviews were included. They were all of high methodological quality. They related to a wide range of pain syndromes. Four reviews concluded that acupuncture is effective for migraines, neck disorders, tensiontype headaches, and peripheral joint osteoarthritis; one review failed to demonstrate the effectiveness of acupuncture for rheumatoid arthritis; and three reviews were inconclusive for shoulder pain, lateral elbow pain, and low back pain. Conclusion： Several Cochrane reviews of acupuncture for a wide range of pain conditions have recently been published. All of these reviews were of high quality. Their results suggest that acupuncture is effective for some but not all types of pain.

关键词： acupuncture pain Cochrane review evidence

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Framework for Personalized Chronic pain Management:Harnessing AI and Personality Insights for Effective Care

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Journal of Artificial Intelligence and Technology 2024年第2期4卷 132-144页

作者： Akshi Kumar Rahul Seewal Dipika Jain Ravleen Kaur Department of Computing Goldsmiths University of LondonLondonUK Chelsea and Westminster Hospital and East Kent Hospital NHS Find Trust UK Mypain■ UK Department of Computer Science&Engineering Delhi Technological UniversityNew DelhiIndia Department of Computer Science&Engineering Netaji Subhas University of TechnologyNew DelhiIndia

This paper introduces a cutting-edge framework for personalized chronic pain management,leveraging the power of artificial intelligence(AI)and personality *** explores the intricate relationship between personality traits and pain perception,expression,and management,identifying key correlations that influence an individual’s experience of *** integrating personality psychology with AI-driven personality assessment,this framework offers a novel approach to tailoring chronic pain management strategies for each patient’s unique personality *** highlights the relevance of well-established personality theories such as the Big Five and the Myers-Briggs Type Indicator(MBTI)in shaping personalized pain management ***,the paper introduces multimodal AI-driven personality assessment,emphasizing the ethical considerations and data collection processes necessary for its *** illustrative case studies,the paper exemplifies how this framework can lead to more effective and patient-centered pain relief,ultimately enhancing overall *** conclusion,the paper positions the need of an“AI-Powered Holistic pain Management Initiative”which has the potential to transform chronic pain management by providing personalized,data-driven solutions and create a multifaceted research impact influencing clinical practice,patient outcomes,healthcare policy,and the broader scientific community’s understanding of personalized medicine and AI-driven interventions.

关键词： artificial intelligence health informatics pain personality traits

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Analgesic and Anti-Arthritic Effect of <i>Enicostemma littorale</i>Blume

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Advances in Bioscience and Biotechnology 2014年第13期5卷 1018-1024页

作者： Mohamed M. Shabi Subashini Uthrapathy Chellappan David Raj Gayathri Krishnamoorthy Dhevi Ravindhran Jipnomon Joseph Victor G. Rajamanickam Department of Pharmacy Asia Metropolitan University Cheras Malaysia centre for Advanced research in Indian System of Medicine (CARISM) SASTRA University Thanjavur India Department of Pharmacology Amrita School of Pharmacy Amrita Institute of Medical Science (AIMS) Amrita Vishwa Vidyapeetham University Kochi India centre for research Sairam Group of Institutions Chennai India

Enicostemma littorale (Blume), the folk medicine is used for rheumatic pain and it was selected for scientific validation. The 85% methanolic extract obtained from the whole plant of Enicostemma littorale has been assessed for analgesic and anti-inflammatory activity. The analgesic activity has been evaluated by hot plate and tail immersion method and the anti-inflammatory and antioxidant activities are evaluated by Complete Freund’s adjuvant induced arthritic model. The results of the evaluation of analgesic activity in hot plate and tail immersion method revealed that the extract exhibits significant activity at 150 mg/kg body weight and the effect is found to increase dose dependently. In Freund’s adjuvant induced arthritis, Enicostemma littorale is found to decrease the paw volume (15.81%). Significant protection is also observed by elevating antioxidant enzymes. In conclusion, the 85% methanolic extract of Enicostemma littorale possesses significant analgesic and anti-inflammatory activities in Freund’s adjuvant induced arthritic model in rats.

关键词： Complete Freund’s Adjuvant Hot Plate Oxidative Stress Tail Immersion

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Efficacy of vasopressin, steroid, and epinephrine protocol for in-hospital cardiac arrest resuscitation: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis

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Journal of Geriatric Cardiology 2022年第9期19卷 705-711页

作者： Danish Iltaf Satti Yan Hiu Athena Lee Keith Sai Kit Leung Jeremy Man Ho Hui Thompson Ka Ming Kot Arslan Babar Gauranga Mahalwar Abraham KC Wai Tong Liu Leonardo Roever Gary Tse Jeffrey Shi Kai Chan International Health Informatics Study(IHIS)Network Cardiovascular Analytics Group Hong KongChina-UK Collaboration Emergency Medicine Unit Li Ka Shing Fac-ulty of MedicineThe University of Hong KongHong KongChina Aston Medical School Faculty of Health&Life SciencesAston UniversityBirminghamUnited Kingdom Li Ka Shing Faculty of Medicine The University of Hong KongHong KongChina Department of Anaesthesia and pain Service Princess Margaret HospitalLai Chi KokKowloonHong KongChina Department of Medicine Cleveland Clinic FoundationClevelandUSA Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease Department of CardiologyTianjin Institute of Cardi-ologySecond Hospital of Tianjin Medical UniversityTianjinChina Department of Clinical research Federal Uni-versity of UberlândiaUberlândiaBrazil Kent and Medway Medical School CanterburyKentUnited Kingdom 不详

OBJECTIVES To assess the effect of vasopressin,steroid and epinephrine(VSE)combination therapy on return of spontan-eous circulation(ROSC)after in-hospital cardiac arrest(IHCA),and test the conclusiveness of evidence using trial sequential ana-lysis(TSA).METHODS The systematic search included PubMed,EMBASE,Scopus,and Cochrane Central Register of Controlled *** controlled trials(RCTs)that included adult patients with IHCA,with at least one group receiving combined VSE therapy were *** was extracted independently by two *** main outcome of interest was *** out-comes included survival to hospital discharge or survival to 30 and 90 days,with good neurological *** We included a total of three RCTs(n=869).Results showed that VSE combination therapy increased ROSC(risk ra-tio=1.41;95%CI:1.25-1.59)as compared to *** demonstrated that the existing evidence is *** was also validated by the alpha-spending adjusted relative risk(1.32[1.16,1.49],P<0.0001).Other outcomes could not be meta-analysed due to differences in timeframe in the included *** VSE combination therapy administered in cardiopulmonary resuscitation led to improved rates of ***-ture trials of VSE therapy should evaluate survival to hospital discharge,neurological function and long-term survival.

关键词： resuscitation analysis return

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A Case Report of Mesenteric Panniculitis and Primary Sjogren’s Syndrome

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Open Journal of Rheumatology and Autoimmune Diseases 2013年第4期3卷 227-230页

作者： R.L.Batten W.F.Ng Musculoskeletal research Group Institute of Cellular MedicineNewcastle UniversityNewcastle upon TyneTyne and WearNew-castleUK.

Mesenteric Panniculitis is a benign fibro-inflammatory process involving adipose tissue of the mesentery. It is characterised by fat necrosis, chronic inflammation and fibrosis, causing thickening and shortening of the mesentery. Patients may present with localised abdominal pain, abdominal mass, intestinal obstruction and ischaemic colitis. We report a case of mesenteric panniculitis causing abdominal pain in a patient with active Primary Sjogren’s Syndrome. The rarity of this case makes it of interest. We review the current literature on mesenteric panniculitis and its association with connective tissue disease and inflammatory conditions. A 64-year-old Caucasian male presented in 1994 with dry mouth. A diagnosis of Primary Sjogren’s Syndrome (PSS) was made on salivary gland biopsy. In 2010 he presented with an exacerbation of his eye symptoms, muscle pain and fatigue. He complained of abdominal pain and night sweating, but denied any weight loss or change in bowel habit. There was no significant past medical history other than PSS. On examination he had a small right submandibular node and mild synovitis at the right proximal interphalangeal joint and carpometacarpal joint. Examination of the abdomen showed marked umbilical tenderness but no organomegally. Blood tests at this time showed an active inflammation: CRP of 61 (NR 5 mg/L), ESR 39 (NR 20 mm/s), strongly positive ENA Ro and La. IgG was elevated at 18.6 (NR 5.8-15.4), Complement was low at 0.17 (NR 0.18-0.6). An abdominal ultrasound scan demonstrated a 6 × 3 ×3 cmarea of diffuse homogenous fat encasing some mesenteric vessels in the area of focal tenderness. CT abdomen and pelvis showed oedematous mesenteric fat and lymph nodes in the jejunal small bowel mesentery, consistent with mesenteric panniculitis. Laparoscopic biopsy was discussed with the surgical team, but was felt not indicated as risk outweighed potential benefit. The patient was treated with a 9-week reducing course of oral steroids. His abdo

关键词： Sjogren’s Syndrome Autoimmune Disease Mesenteric Panniculitis

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