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BACKGROUND: To investigate the knowledge, attitude, and practice (KAP) of healthcare professionals regarding cognitive dysfunction and cognitive rehabilitation in Parkinson's disease (PD). METHODS: This multicenter, cross-sectional survey enrolled physicians and nurses in 10 hospitals between October 2022 and November 2022. A self-administered questionnaire was developed to collect the demographic information of the participants and their knowledge, attitude, and practice toward cognitive dysfunction in PD and cognitive rehabilitation. RESULTS: This study enrolled 224 physicians and 229 nurses. The knowledge, attitude, and practice scores were 12.57 ± 3.76 (total score: 22), 29.10 ± 3.71 (total score: 32), and 21.07 ± 8.03 (total score: 28) among physicians, and 9.97 ± 4.70 (total score: 22), 25.27 ± 8.96 (total score: 32), and 25.27 ± 8.96 (total score: 28) among nurses. Among physicians, the knowledge scores (OR = 4.23, 95%CI: 2.36-7.58, P < 0.001) and attitude scores (OR = 3.00, 95%CI: 1.67-5.37, P < 0.001) were independently associated with good practice. Among nurses, the knowledge scores (OR = 4.31, 95%CI: 2.31-8.05, P < 0.001), attitude scores (OR = 5.18, 95%CI: 2.82-9.53, P < 0.001), working department (Ref: rehabilitation; neurology: OR = 2.26, 95%CI: 1.01-5.08, P = 0.048; public health service/chronic disease follow-up center: OR = 2.98, 95%CI: 1.12-7.92, P = 0.028) were independently associated with good practice. CONCLUSIONS: Physicians and nurses have insufficient knowledge, favorable attitudes, and active practice regarding cognitive dysfunction and cognitive rehabilitation in PD. This study identified gaps in KAP and suggested education activities to improve the KAP toward cognitive dysfunction in PD.
Asunto(s)
Disfunción Cognitiva , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/complicaciones , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Entrenamiento Cognitivo , Disfunción Cognitiva/etiologíaRESUMEN
Paper-based cultural relics constitute a significant and invaluable part of human civilization and cultural heritage. However, they are highly vulnerable to environmental factors such as ultraviolet (UV) photodegradation and acidification degradation, posing substantial threats to their long-term preservation. Carbon quantum dots (CQDs), known for their outstanding optical properties, high water solubility, and good safety, offer a promising solution for slowing down UV damage and acidification of paper-based relics during storage and transportation. Herein, we propose a feasible strategy for the simple preparation of CQDs with high dispersion stability, excellent UV absorption, room-temperature phosphorescence, and photostability for the safety protection of paper. Accelerated aging experiments were conducted using UV and dry-heat aging methods on both CQD-protected paper and unprotected paper, respectively, to evaluate the effectiveness of CQD protection. The results demonstrate a slowdown in both the oxidation and acid degradation processes of the protected paper under both UV-aging and dry-heat aging conditions. Notably, CQDs with complex luminescence patterns of both fluorescence and room-temperature phosphorescence also endue them as enhanced optical anticounterfeiting materials for multifunctional paper protection. This research provides a new direction for the protection of paper-based relics with emerging carbon nanomaterials.
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Leveraging the power of artificial intelligence to facilitate an automatic analysis and monitoring of heart sounds has increasingly attracted tremendous efforts in the past decade. Nevertheless, lacking on standard open-access database made it difficult to maintain a sustainable and comparable research before the first release of the PhysioNet CinC Challenge Dataset. However, inconsistent standards on data collection, annotation, and partition are still restraining a fair and efficient comparison between different works. To this line, we introduced and benchmarked a first version of the Heart Sounds Shenzhen (HSS) corpus. Motivated and inspired by the previous works based on HSS, we redefined the tasks and make a comprehensive investigation on shallow and deep models in this study. First, we segmented the heart sound recording into shorter recordings (10 s), which makes it more similar to the human auscultation case. Second, we redefined the classification tasks. Besides using the 3 class categories (normal, moderate, and mild/severe) adopted in HSS, we added a binary classification task in this study, i.e., normal and abnormal. In this work, we provided detailed benchmarks based on both the classic machine learning and the state-of-the-art deep learning technologies, which are reproducible by using open-source toolkits. Last but not least, we analyzed the feature contributions of best performance achieved by the benchmark to make the results more convincing and interpretable.
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Background: Anaplastic Large Cell Lymphoma (ALCL) is one of the most common subtypes of T-cell lymphoma. Among these, refractory and relapsed (r/r) ALK positive ALCL lacks effective therapies. The chimeric antigen receptor-modified T (CAR-T) cell therapy holds great promise as a therapeutic strategy for this disease. However, it is not known yet whether anti-CD5 CAR-T cells are sufficient for the definitive treatment of relapsed ALK+ ALCL, nor the role of accurate laboratory-based diagnoses during CAR-T treatment. Case presentation: The adolescent patient received autologous T cells containing sequences encoding VH domains specific to CD5. Following the infusion, there was an increase in both the copy number and proportion of CAR-T cells in peripheral blood. IL-6 and ferritin levels in the patient exhibited significant fluctuations, with increases of 13 and 70 folds respectively, compared to baseline after the treatment. Additionally, adverse effects were observed, including grade 4 rash, grade 1 headache, nausea, and neck-pain. Surprisingly, a relapsed disease phenotype was identified based on the results of PET/CT and histopathological analysis of the inguinal lymph node biopsy. After conducting a thorough diagnostic assessment, which included flow cytometry, next-generation sequencing (NGS), examination of immune-related gene rearrangements, and analysis of the immune repertoire of T-cell receptors (TCR), we conclusively determined that the hyperplastic T cells identified in the lymph node were the result of an expansion of CAR-T cells. Ultimately, the patient has attained complete remission (CR) and has sustained a disease-free survival state for 815 days as of the cutoff date on August 30, 2023. Conclusion: Taken together, the results demonstrate that anti-CD5 CAR-T cells can induce a clinical response in r/r ALK+ ALCL patient. Furthermore, this case underscores the importance of utilizing advanced technologies with high sensitivity and accuracy for biological detection in clinical laboratory diagnosis and prognosis in CAR-T cell treatment. Trial registration number: NCT04767308.