BACKGROUND Global education in psychiatry is heavily influenced by knowledge from Western,high-income countries,which obscures local voices and expertise.AIM To adapt a human simulation model to psychiatric education ...BACKGROUND Global education in psychiatry is heavily influenced by knowledge from Western,high-income countries,which obscures local voices and expertise.AIM To adapt a human simulation model to psychiatric education in a context that is specific to local languages and cultures.METHODS We conducted an observational study consisting of six human simulation sessions with standardized patients from two host countries,speaking their native languages,and following an adaptation of the co-constructive patient simulation(CCPS)model.As local faculty became increasingly familiar with the CCPS approach,they took on the role of facilitators—in their country’s native language.RESULTS Fifty-three learners participated:19 child and adolescent psychiatry trainees and 3 faculty members in Türkiye(as a group that met online during 3 consecutive months);and 24 trainees and 7 faculty in Israel(divided into 3 groups,in parallel in-person sessions during a single training day).Each of the six cases reflected local realities and clinical challenges,and was associated with specific learning goals identified by each case-writing trainee.CONCLUSION Human simulation has not been fully incorporated into psychiatric education:The creation of immersive clinical experiences and the strengthening of reflective practice are two areas ripe for development.Our adaptations of CCPS can also strengthen local and regional networks and psychiatric communities of practice.Finally,the model can help question and press against hegemonies in psychiatric training that overshadow local expertise.展开更多
Objectives:Persistent olfactory dysfunction(OD)following loss of smell associated with SARS-CoV-2 infection is a major feature of long COVID.Perspectives on the prevalence of persistent OD predominantly rely on self-r...Objectives:Persistent olfactory dysfunction(OD)following loss of smell associated with SARS-CoV-2 infection is a major feature of long COVID.Perspectives on the prevalence of persistent OD predominantly rely on self-reported olfactory function.Few studies have tracked longitudinal rates of recovery using psychophysical assessment among patients presenting for evaluation of persistent OD beyond a window of acute recovery.Data anchored in standardized testing methods are needed to counsel patients who fail to acutely regain their sense of smell.This study aims to quantify the degree of persistent OD in post-COVID-19 patients who experience subjective and psychophysical OD.Methods:We grouped participants presenting for OD evaluation into cohorts based on both subjective and psychophysical olfactory status at a baseline assessment and assessed their olfactory abilities with a visual analogue scale and the Sniffin'Sticks extended test at baseline and 1-year time points.Participants had confirmed a history of COVID-19 by lab evaluation or clinical diagnosis if lab evaluation was not available.Results:Baseline olfactory evaluation was completed by 122 participants,53 of whom completed the 1-year follow-up assessment.Among participants presenting with perceived OD,74.5%had confirmed psychophysical OD at baseline,with 55.1%at 1-year follow-up.Participants had reliable trends in self-rated versus psychophysically tested olfactory function at both time points.The total threshold,discrimination,and identification(TDI)score improved by+3.25 points in the cohort with psychophysical OD(p=0.0005),with this improvement largely attributable to an increase in median threshold scores(+2.75 points;p=0.0004).Conclusions:OD persists in a significant number of patients who fail to acutely recovery their sense of smell after COVID-19,with many demonstrating lingering deficits at 1-year.Improvements in threshold,but not discrimination or identification,most significantly mediate improvement of total TDI score at follow-up.展开更多
Despite the availability of an effective measles virus(MeV)vaccine and efforts to increase vaccine coverage by the WHO,UNICEF,and their partners,MeV has not been eradicated,and the estimated global measles death rose ...Despite the availability of an effective measles virus(MeV)vaccine and efforts to increase vaccine coverage by the WHO,UNICEF,and their partners,MeV has not been eradicated,and the estimated global measles death rose from 89,780 in 2016 to 207,500 in 2019.1 Because there is an effective measles vaccine,antiviral development for measles has not been prioritized,but recent outbreaks have highlighted the need for drugs to prevent transmission in unvaccinated populations and to protect and treat immunocompromised individuals.We identified several neutralizing mouse monoclonal antibodies(mAbs)that target the MeV fusion(F)protein in its prefusion state2 and inhibit fusion and viral infection.We engineered a single-chain variable fragment(scFv)from the most potent anti-MeV F mAb.The scFv retains the ability to inhibit fusion and prevents infection in vitro,and intranasal administration of the scFv antibody construct prevents infection in vivo.展开更多
Objective:Proficiency in endoscopic endonasal skull base surgery requires both substantial baseline training and progressive lifelong learning.Endoscopic simulation models continue to evolve in an effort to optimize t...Objective:Proficiency in endoscopic endonasal skull base surgery requires both substantial baseline training and progressive lifelong learning.Endoscopic simulation models continue to evolve in an effort to optimize trainee education and preoperative preparation and improve surgical outcomes.The current scoping review systematically reviews all available literature and synthesizes the current paradigms of simulation models for endoscopic skull base surgery training and skill enhancement.Methods:In accordance with Preferred Reporting Items for Systemic Review and Meta-Analyses guidelines,we systematically searched PubMed,Embase,CINAHL,and Cochrane databases.Studies were categorized according to the type of simulation models investigated.Results:We identified 238 unique references,with 55 studies ultimately meeting inclusion criteria.Of these,19 studies described cadaveric dissection models,17 discussed three-dimensional(3D)printed models,14 examined virtual surgical planning and augmented reality-based models,and five 5 articles described task trainers.Conclusions:There are a wide variety of simulation models for endoscopic skull base surgery,including high-fidelity cadaveric,virtual reality,and 3D-printed models.These models are an asset for trainee development and preoperative surgical preparation.展开更多
Coronavirus disease 2019(COVID-19)has been an ongoing public health crisis since the end of 2019;besides vaccine development,there have been major research efforts focused on developing antiviral therapeutics.Remdesiv...Coronavirus disease 2019(COVID-19)has been an ongoing public health crisis since the end of 2019;besides vaccine development,there have been major research efforts focused on developing antiviral therapeutics.Remdesivir was the first US Food and Drug Administration(FDA)-approved antiviral drug for COVID-19.Subsequently,the FDA granted emergency use authorization(EUA)for three monoclonal antibody treatments,including sotrovimab or a combination of casirivimab and imdevimab,or bamlanivimab and etesevimab,each of which targets the coronavirus spike protein to block viral entry.Most recently,Britain granted conditional authorization for the ribonucleoside analog molnupiravir,developed by Merck as a viral replication inhibitor.The protease inhibitor PF-07321332 developed by Pfizer and boosted by ritonavir showed promising results in a phase III clinical trial,reducing the risk of hospitalization or death by 89%compared with placebo.展开更多
文摘BACKGROUND Global education in psychiatry is heavily influenced by knowledge from Western,high-income countries,which obscures local voices and expertise.AIM To adapt a human simulation model to psychiatric education in a context that is specific to local languages and cultures.METHODS We conducted an observational study consisting of six human simulation sessions with standardized patients from two host countries,speaking their native languages,and following an adaptation of the co-constructive patient simulation(CCPS)model.As local faculty became increasingly familiar with the CCPS approach,they took on the role of facilitators—in their country’s native language.RESULTS Fifty-three learners participated:19 child and adolescent psychiatry trainees and 3 faculty members in Türkiye(as a group that met online during 3 consecutive months);and 24 trainees and 7 faculty in Israel(divided into 3 groups,in parallel in-person sessions during a single training day).Each of the six cases reflected local realities and clinical challenges,and was associated with specific learning goals identified by each case-writing trainee.CONCLUSION Human simulation has not been fully incorporated into psychiatric education:The creation of immersive clinical experiences and the strengthening of reflective practice are two areas ripe for development.Our adaptations of CCPS can also strengthen local and regional networks and psychiatric communities of practice.Finally,the model can help question and press against hegemonies in psychiatric training that overshadow local expertise.
基金National Institute on Deafness and Other Communication Disorders and the National Institutes of Health,Grant/Award Number:K23DC019678National Center for Advancing Translational Sciences,National Institutes of Health,Grant/Award Number:UL1TR001873。
文摘Objectives:Persistent olfactory dysfunction(OD)following loss of smell associated with SARS-CoV-2 infection is a major feature of long COVID.Perspectives on the prevalence of persistent OD predominantly rely on self-reported olfactory function.Few studies have tracked longitudinal rates of recovery using psychophysical assessment among patients presenting for evaluation of persistent OD beyond a window of acute recovery.Data anchored in standardized testing methods are needed to counsel patients who fail to acutely regain their sense of smell.This study aims to quantify the degree of persistent OD in post-COVID-19 patients who experience subjective and psychophysical OD.Methods:We grouped participants presenting for OD evaluation into cohorts based on both subjective and psychophysical olfactory status at a baseline assessment and assessed their olfactory abilities with a visual analogue scale and the Sniffin'Sticks extended test at baseline and 1-year time points.Participants had confirmed a history of COVID-19 by lab evaluation or clinical diagnosis if lab evaluation was not available.Results:Baseline olfactory evaluation was completed by 122 participants,53 of whom completed the 1-year follow-up assessment.Among participants presenting with perceived OD,74.5%had confirmed psychophysical OD at baseline,with 55.1%at 1-year follow-up.Participants had reliable trends in self-rated versus psychophysically tested olfactory function at both time points.The total threshold,discrimination,and identification(TDI)score improved by+3.25 points in the cohort with psychophysical OD(p=0.0005),with this improvement largely attributable to an increase in median threshold scores(+2.75 points;p=0.0004).Conclusions:OD persists in a significant number of patients who fail to acutely recovery their sense of smell after COVID-19,with many demonstrating lingering deficits at 1-year.Improvements in threshold,but not discrimination or identification,most significantly mediate improvement of total TDI score at follow-up.
基金supported by grants from the NIH:All21349,NS091263,and NS105699,Al 146980 to M.P.,from the French ANR NITRODEP(ANR-13-PDOC-OO10-01)to C.M.and from the Region Auvergne Rhone Alpes and LABEX ECOFECT(ANR-11-LABX-0048)of Lyon University within the program"Investissements d'Avenir"(ANR-11-IDEX-0007),operated by the French National Research Agency(ANR)to B.H.The Sharon Golub Fund at Columbia University Irving Medical Center(CUIMC).
文摘Despite the availability of an effective measles virus(MeV)vaccine and efforts to increase vaccine coverage by the WHO,UNICEF,and their partners,MeV has not been eradicated,and the estimated global measles death rose from 89,780 in 2016 to 207,500 in 2019.1 Because there is an effective measles vaccine,antiviral development for measles has not been prioritized,but recent outbreaks have highlighted the need for drugs to prevent transmission in unvaccinated populations and to protect and treat immunocompromised individuals.We identified several neutralizing mouse monoclonal antibodies(mAbs)that target the MeV fusion(F)protein in its prefusion state2 and inhibit fusion and viral infection.We engineered a single-chain variable fragment(scFv)from the most potent anti-MeV F mAb.The scFv retains the ability to inhibit fusion and prevents infection in vitro,and intranasal administration of the scFv antibody construct prevents infection in vivo.
文摘Objective:Proficiency in endoscopic endonasal skull base surgery requires both substantial baseline training and progressive lifelong learning.Endoscopic simulation models continue to evolve in an effort to optimize trainee education and preoperative preparation and improve surgical outcomes.The current scoping review systematically reviews all available literature and synthesizes the current paradigms of simulation models for endoscopic skull base surgery training and skill enhancement.Methods:In accordance with Preferred Reporting Items for Systemic Review and Meta-Analyses guidelines,we systematically searched PubMed,Embase,CINAHL,and Cochrane databases.Studies were categorized according to the type of simulation models investigated.Results:We identified 238 unique references,with 55 studies ultimately meeting inclusion criteria.Of these,19 studies described cadaveric dissection models,17 discussed three-dimensional(3D)printed models,14 examined virtual surgical planning and augmented reality-based models,and five 5 articles described task trainers.Conclusions:There are a wide variety of simulation models for endoscopic skull base surgery,including high-fidelity cadaveric,virtual reality,and 3D-printed models.These models are an asset for trainee development and preoperative surgical preparation.
文摘Coronavirus disease 2019(COVID-19)has been an ongoing public health crisis since the end of 2019;besides vaccine development,there have been major research efforts focused on developing antiviral therapeutics.Remdesivir was the first US Food and Drug Administration(FDA)-approved antiviral drug for COVID-19.Subsequently,the FDA granted emergency use authorization(EUA)for three monoclonal antibody treatments,including sotrovimab or a combination of casirivimab and imdevimab,or bamlanivimab and etesevimab,each of which targets the coronavirus spike protein to block viral entry.Most recently,Britain granted conditional authorization for the ribonucleoside analog molnupiravir,developed by Merck as a viral replication inhibitor.The protease inhibitor PF-07321332 developed by Pfizer and boosted by ritonavir showed promising results in a phase III clinical trial,reducing the risk of hospitalization or death by 89%compared with placebo.